An Empirical Study on Medical Insurance Payment Advantages of Radiofrequency Ablation Combined with Percutaneous Left Atrial Appendage Occlusion from the Perspective of DIP

China Health Insurance ›› 2024, Vol. 0 ›› Issue (3) : 83-88.

China Health Insurance ›› 2024, Vol. 0 ›› Issue (3) : 83-88. DOI: 10.19546/j.issn.1674-3830.2024.3.013
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An Empirical Study on Medical Insurance Payment Advantages of Radiofrequency Ablation Combined with Percutaneous Left Atrial Appendage Occlusion from the Perspective of DIP

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Abstract

Objective: The one-stop treatment of radiofrequency ablation combined with percutaneous left atrial appendage occlusion has been widely recognized in clinical practice. This study focuses on the medical insurance payment advantages of this treatment under the DIP policy. Methods: Functional statistical method was used to analyze the changes of disease enrollment and payment related to percutaneous left atrial appendage closure and radiofrequency ablation, and relevant data of distributed surgery and one-stop surgery were analyzed, including hospitalization cost per case, balance cost per case, and payment proportion of medical insurance fund. The main factors influencing the change of the cost structure of one-stop operation in different periods were analyzed by using the method of structural change degree analysis. Results: The combination of radiofrequency ablation combined with percutaneous left atrial appendage occlusion in 2022 DIP disease list improved the medical insurance payment score and made the medical insurance payment more accurate. The average cost of one-stop surgery patients was further reduced, and the hospitalization burden of the insured was reduced. The estimated average medical insurance balance of hospitals implementing one-stop surgery began to change from negative to positive, which will encourage tertiary medical institutions to treat patients with difficult and complex diseases. Conclusion: Periodic adjustment of DIP disease list is necessary, which is helpful to promote the graded diagnosis and treatment. The one-stop surgical combination is beneficial to the insured, effectively reducing their burden. Hospitals should pay more attention to the consumption ratio and increase the proportion of medical service fees.

Key words

DIP / radiofrequency ablation / left atrial appendage / occlusion / payment advantage

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An Empirical Study on Medical Insurance Payment Advantages of Radiofrequency Ablation Combined with Percutaneous Left Atrial Appendage Occlusion from the Perspective of DIP[J]. China Health Insurance. 2024, 0(3): 83-88 https://doi.org/10.19546/j.issn.1674-3830.2024.3.013

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