Objective: The paper attempts to investigate the impact of endoscopic stapler centralized procurement on hospitalization costs for patients undergoing lung malignant tumor surgery, evaluate the implementation effect of centralized procurement policy, and propose policy recommendations. Methods: According to the comprehensive supervision platform of medical institutions in Ningbo City, medical record homepage data of patients undergoing lung malignant tumor surgery in municipal general hospitals in Ningbo City from June 2022 to May 2024 were selected. Patients' hospitalization cost information was extracted, and the changes in average hospitalization cost, and cost structure of patients after staple centralized procurement was analyzed with degree of structure (DSV), and interrupted time series. Results: A total of 18065 patients' medical records were included, and the average hospitalization cost for patients undergoing lung malignant tumor surgery decreased from 36228.12 yuan before centralized procurement to 31126.41 yuan after centralized procurement (P<0.05). Consumables cost was highest in the cost structure (44.16%), followed by surgical treatment cost (20.23%). After endoscopic stapler centralized procurement, the proportion of consumables cost decreased by 6.52%, the proportion of drug cost decreased by 0.65%, while the proportion of surgical treatment cost, comprehensive medical service cost, and examination and testing cost increased. Among them, the contribution rate of DSV in consumables cost is the highest (45.47%), followed by surgical treatment cost (22.70%) and comprehensive medical service cost (17.45%). Through interrupted time series analysis, it was found that the average hospitalization cost for patients undergoing lung malignant tumor surgery after centralized procurement showed a significant downward trend (P<0.05). Conclusions: After stapler centralized procurement, the average hospitalization cost for patients undergoing lung malignant tumor surgery has significantly decreased, and the cost structure has been optimized to some extent. However, the increase in the proportion of medical service cost mainly depends on the decrease in consumables cost. It is suggested that the medical insurance department should take advantage of the opportunity brought by centralized procurement to promote the reform of medical service price adjustment, better reflect the technical service value of medical personnel, and further scientifically improve the rules of centralized procurement to reduce the impact of huge price difference of consumable on disease cost fluctuation.
Key words
endoscopic stapler /
centralized procurement /
lung malignant tumor surgery /
hospitalization cost
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