核医学学科新增医疗服务项目定价方法研究

目的：基于以价值为基础的定价方法，计算核医学学科新增医疗服务项目镭²²³ Ra]骨转移瘤治疗的医疗服务价格。为相关新增医疗服务项目的申报和定价打下循证基础，为合理补偿医务人员劳动价值、提升患者服务项目可及性提供依据。方法：采集2021年3—12月使用“镭核素²²³ Ra]骨转移瘤治疗资源投入及费用数据采集表”相关数据，开展专家访谈进行系数赋值和基线对照项目确定，得到镭²²³ Ra]骨转移瘤治疗服务各个环节的成本和新增服务的价值。结果：镭²²³ Ra]骨转移瘤治疗服务按服务特点分为注射前评估、治疗计划、给药、给药后监测、废弃物处理与监测等环节，各环节3地平均人力耗时分别为104分钟、39分钟、25分钟、72分钟和56分钟，中位物耗成本为48.20元，3地总成本(平均人力成本+中位物耗成本)为763.68元。结合系数赋值结果和基线对比项目，得到新增项目的价值为810.19元。结论：运用基于技术难度和风险程度的价值定价理论，计算镭²²³ Ra]骨转移瘤治疗新增医疗服务项目的服务价值，建议以价值作为服务定价依据。该定价公式和研究方法不仅可用于其他核医学学科新增服务项目的定价，还适用于现行医疗服务项目的价格动态调整，为未来学科价格工作提供方法学参考。

Research on the Pricing Method of Nuclear Medicine Department New Medical Service Items Based on Technical Difficulties and Risk Factors

Objective: To calculate the medical service price of radium ²²³ Ra] bone metastases, based on the clinical data collected in Beijing, Chongqing and Guangzhou, with standardized value pricing method. It would lay a foundation for future new medical service registration, pricing and reimbursement. The research also provided a basis for compensating contribution of medical professionals and improving the accessibility of patient service items. Methods: From March to December 2021, the research collected resource consumption raw data with specifically designed "Radium Nuclide ²²³ Ra] Bone Metastasis treatment Resource Input and Expense Data Collection Form". The research also conducted expert interviews to assign risk and difficulty coefficients and determine baseline comparison project. Results: The treatment service for radium ²²³ Ra] bone metastases was divided into five stages: pre-injection assessment, treatment plan, administration, post-administration monitoring, waste disposal and monitoring. The overall time spending for each stage is 104 min,39 min,25 min,72 min and 56 min. The standardization consumable value is 48.20 yuan, and the standardized value of the newly added items is 810.19 yuan. Conclusion: This study innovatively applied the value pricing theory based on risk and difficulty coefficients, and developed a pricing tool for the new medical service radium ²²³ Ra]bone metastases treatment. standardized value. The pricing formula and research method can not only be used for the pricing new treatment service in nuclear medicine department, but also for dynamic price adjustment of current medical service items, filling the theoretical gap of the lack of relevant pricing research in nuclear medicine department.