健康发展与政策研究2025，Vol.28Issue(5)：532-539,8.DOI:10.12458/HDPR.202409018
冠状动脉支架集中带量采购对医疗费用、支架使用及健康结局的影响:基于中断时间序列分析
The impact of national volume-based procurement of coronary stents on medical costs,stent usage,and health outcomes:an interrupted time series analysis
摘要
Abstract
Objective To explore the impact of national volume-based procurement of coronary stents on medical costs,stent usage,and health outcomes.Methods This study utilized an interrupted time series analysis to assess the effect of national volume-based procurement(VBP)policy for coronary stents,implemented in January 2021 on seven key indicators.Data came from a tertiary hospital in Hangzhou from January 2020 to December 2022,focusing on inpatients in DRG groups FM11,FM13,and FM15,who underwent percutaneous coronary stent implantation.The indicators included total hospitalization cost,number of stents used,stent-related expenditure,length of stay,proportion of inpatients using bid-winning stents,clinical improvement rate,and 28-day reoperation rate.Results A total of 3,132 patient-visits were included.Immediately following the policy implementation in January 2021,patients'total hospitalization cost and stent-related expenditures decreased significantly by 27.92%and 91.65%,respectively(both P＜0.001).The proportion of inpatients using tender-winning stents increased sharply by 50.13%(P＜0.001),and the average number of stents implanted per case increased by 0.31(P＜0.001)at the time of policy implementation.No statistically significant immediate changes were observed in length of stay,disease improvement rate,or 28-day reoperation rate.The long-term trend showed a continuous decline in total hospitalization costs(P=0.001),while no significant long-term changes were identified for the other indicators.Conclusions The implementation of national volume-based procurement policy for coronary stents led to a reduction in stent-related expenditures,achieving a notable cost-saving effect.The clinical usage pattern of coronary stents was reshaped,and patients'health outcomes were not adversely affected.A short-term rise in the average number of stents implanted per case was observed,indicating potential adjustments in clinical practice.Continuous monitoring and systematic evaluation of the long-term effectiveness of bid-winning products are recommended.关键词
冠状动脉支架/集中带量采购/中断时间序列Key words
coronary stents/the national volume-based procurement/interrupted time series分类
预防医学引用本文复制引用
王煜昊,林敏,路娜娜,尚波波,徐伟..冠状动脉支架集中带量采购对医疗费用、支架使用及健康结局的影响:基于中断时间序列分析[J].健康发展与政策研究,2025,28(5):532-539,8.基金项目
2022年浙江省医学会临床医学科研专项资金项目(第二批)重大项目(2022ZYC-D06) （第二批）
