| 摘要: |
| 目的：了解公立医院不同价格区段高值医用耗材的使用和医保支付情况，为医院高值耗材的使用管理和支付政策改革提供依据。方法：从南京医保信息系统中调取2019年-2020年南京某公立医院高值医用耗材的使用和医保支付数据，采用四格表法检验分析不同分组的数据差异。结果：医院使用进口高值耗材费用占比从低价段到高价段分别为69.84%，56.68%，64.90%，96.60%；进口耗材医保支付比例为54.24%，国产耗材为59.45%，各区段支付比例随单价升高而逐步下降；使用耗材品种中，心血管与骨科类占比较高。结论：该医院使用进口耗材比重较高，医保支付比例国产与进口产品相差不大，使用耗材种类有明显的优势学科集中倾向。 |
| 关键词: 高值医用耗材 医保支付 公立医院 |
| DOI： |
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| 基金项目: |
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| Analysis on the Use and Medical Insurance Payment of High Value Medical Consumables in a Certain Nanjing Public Hospital |
| ZHAO Rong,XIA Haiming |
| (Purchasing and Logistics Center，Nanjing First Hospital;Office of Nanjing Medical Security Bureau) |
| Abstract: |
| Objective：To understand the use and medical insurance payment of high-value medical consumables，and to provide decision-making basis for the use management and payment policy reform of high-value medical consumables. Methods：The data of high-value medical consumables and medical insurance payment were collected in a certain Nanjing publichospitalfrom Nanjing Medical Insurance Information System from 2019 to 2020，and the data of different groups were analyzed by four-grid table method. Results：The proportion of imported high-value consumables in the hospital from low to high price group was 69.84%，56.68%，64.90%，96.60%，repectively.The proportion of medical insurance payment for high-value medical consumables is 54.24% in the imported consumables and 59.45% in the domestic products，with the increase of unit price，the proportion of payment in each group gradually decreased，as for consumable variety，the cardiovascular and the orthopedics class accounted for a higher proportion. Conclusion：The proportion of imported consumables used is higher in the hospital，and the proportion of medical insurance payment of domestic consumables is similar to that of imported products. The kinds of consumables have obvious tendency of discipline concentration. |
| Key words: High Value Medical Consumables Medical Insurance Payment Public Hospitals |
