摘要
目的对CT室大品规对比剂开展经济性评价,探索大包装剂量的临床应用。方法基于课题组现场调研及医院管理信息系统所构建的数据库中的1169例患者的对比剂使用情况及医保报销情况,运用一般统计学方法并结合决策树模型分析不同品规对比剂对医院扫描人次的影响,并使用最小成本法进行经济学评价。同时,通过定性访谈探究大品规对比剂在技术层面的优势及安全性。结果按样本医院的均值即年增强扫描49807人次计算,与100 ml(400 mg/ml)的品规相比,500 ml(400 mg/ml)品规对比剂平均每位患者检查时间节省29.60 s,年增加扫描患者人次为3890人次,可额外给医院年增收约300.68万元,平均每年为每家医院节省医保费用1205.58~1279.25万元(降幅为52.19%~55.38%),平均能减少医疗废弃物3832 kg,节省废弃物处理费用1.35万元。定性访谈结果显示,大品规对比剂在一定程度上可节省医院资源,并且在当前的技术水平下能够保证安全性。结论随着疾病诊断相关分组付费模式的不断推进,大品规对比剂具有较低的成本,并能够减少资源的浪费、节省护理人员的操作时间,可在一定程度上降低医院的经济负担,提升医保费用支付及医院运行的效率。
Objective To evaluate the economy of imaging bulk package contrast agents in CT rooms and explore the clinical application of bulk doses.Methods Based on contrast agent usage and medical insurance reimbursement of 1169 patients in the database built by the research team and the hospital management information system,general statistical methods and decision tree model were used to analyze the impact of different specifications of contrast agents on the number of hospital scans.Economic evaluation was conducted by the minimum cost method.Additionally,qualitative interviews were conducted to explore the technical advantages and safety of imaging bulk package contrast agents.Results According to the average annual scans of 49807 patients in the sample hospital,compared with the 100ml(400mg/ml)specification,the 500ml(400mg/ml)specification contrast agent saved an average of 29.60 s of examination time per person.This resulted in an annual increase of 3890 scan patients,generating an additional revenue of approximately 3.01 million RMB for the hospital.The 500ml(400mg/ml)specification contrast agent,on average,saved medical insurance expenses for each hospital by 12.06—12.79 million RMB annually(a reduction of 52.19%—55.38%).The 500ml(400mg/ml)specification contrast agent also reduced medical waste by an average of 3832 kg per year,saving waste disposal costs by 13500 RMB.Qualitative interview results indicated that imaging bulk package contrast agents could save hospital resources to a certain extent and ensure safety at the current technological level.Conclusion With the continuous promotion of disease diagnosis-related groups payment models,imaging bulk package contrast agents have lower costs and can reduce resource waste,save nursing staff operation time.This can effectively reduce the economic burden on hospitals,improve the efficiency of medical insurance payment and hospital operation.
作者
彭宇欣
朱致旭
肖敦明
魏艳
PENG Yuxin;ZHU Zhixu;XIAO Dunming;WEI Yan(School of Public Health,Fudan University,Shanghai 200032,China;Key Laboratory of Health Technology Assessment,National Health Commission(Fudan University),Shanghai 200032,China)
出处
《世界临床药物》
CAS
2024年第5期497-505,共9页
World Clinical Drug
关键词
大品规对比剂
对比增强CT扫描
最小成本法
真实世界数据
multidose packaging contrast agent
contrast-enhanced CT
cost minimization analysis
real-world data
