日间手术模式对医疗费用控制的作用机制研究

目的:研究日间手术模式在控制医疗费用方面的机制特点。方法:将2018年度出院的854例单病种患者,分为日间组(818例)和非日间组(36例),比较两组在肿块大小、年龄、住址、住院日、住院费用结构、实际费用消耗等方面的差异。结果:在年龄、住院日、住院费用方面,日间组明显低于非日间组。加上门诊相关费用后,日间组和非日间组在实际费用消耗方面差异不显著。结论:日间手术开展依赖于微创技术的发展。日间手术模式能够降低与住院日密切相关的床位费、护理费、药费等费用,但由于高值耗材的使用,同时也抬升了卫生材料费用。日间手术能够有效降低患者隐形社会成本支出。推行日间手术需要兼顾医师的工作积极性。推广日间手术与医保费用管控并不矛盾。

Study on the Functionary Mechanism of Ambulatory Surgery Mode on Medical Expense Control

Objective:To explore the mechanism characteristics of ambulatory surgery mode in controlling medical expenses.Methods:854 patients discharged from Union Hospital in 2018 were divided into day group(818 cases)and non-day group(36 cases).The differences of mass size,age,address,length of stay,hospitalization cost structure and actual cost consumption between these two groups are compared.Results:In terms of age,length of stay and hospitalization expenses,the day group is significantly lower than the non-day group.Including outpatient related expenses,there is no significant difference in actual cost consumption between day group and non-day group.Conclusion:The day surgery depends on the development of minimally invasive technology.Ambulatory surgery mode can reduce the costs of bed,nursing and medicine.Because of the use of high-value consumables,it also increases the cost of health materials.Ambulatory surgery can effectively reduce the invisible social cost.The enthusiasm of the surgeons has to be taken into account while promoting ambulatory surgery.There is no contradiction between the promotion of ambulatory surgery and the cost control of medical insurance.