摘要
目的分析颈动脉内膜剥脱术(carotid endarterectomy,CEA)的价格上调对中国医保基金总支出的预算影响。方法以2021年为基线年,研究年限为2022—2026年,建立预算影响分析模型,对颈动脉内膜剥脱术价格上调30%后的医保基金支出变动进行预算影响分析。收集全国和4个样本省市的医保患者人数、治疗成本、市场份额变动等数据,数据收集时间为2022年5—7月。结果颈动脉内膜剥脱术手术价格提升后,5年内将令全国范围内的医保基金总支出减少14317.62万元;样本省市的医保基金总支出也会出现不同程度的下降。术式价格提升幅度越高,医保基金总支出的下降幅度越大。术式市场份额对医保基金总支出的影响最大。结论颈动脉内膜剥脱术的价格提升可能导致其市场份额上升,并降低5年内医保基金支出。
Objective To analyze the budget impact of a price increase for carotid endarterectomy(CEA)on the total expenditure of health insurance expenditure in China.Methods We set 2021 as the base year,and 2022-2026 as the study years.A budget impact analysis model was developed to calculate the expenditure of health insurance funds over the next 5 years following a 30%price increase for carotid endarterectomy.Data on the target population,treatment costs,and market share changes both nationwide and in four sample cities were used.The data was collected in May to Jul 2022.Results The price increase for carotid endarterectomy will reduce total health insurance fund expenditures nationwide by 143.1762 million yuan over five years.Total health insurance fund expenditures in the sample cities will also decrease to varying degrees.The higher the price increase for the surgical procedure,the greater the decrease in total expenditure of the health insurance fund.The market share of the surgical procedure has the greatest impact on the total expenditure of the health insurance fund.Conclusion Increasing the price of carotid endarterectomy may lead to increase in its market share and decline in the health insurance fund expenditures in future five years.
作者
方晢伊
刘瑾瑜
黄葭燕
FANG Zhe-yi;LIU Jin-yu;HUANG Jia-yan(Department of Hospital Management,School of Public Health,Fudan University,Shanghai 200032,China;NHC Key Laboratory of Health Technology Assessment(Fudan University),Shanghai 200032,China;Hospital Director’s Office,Shanghai Pulmonary Hospital,Shanghai 200433,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2024年第2期230-237,共8页
Fudan University Journal of Medical Sciences
