To study the single-disease settlement cost and its influencing factors for age-related cataract surgery patients under the centralized volume-based procurement policy of intraocular lens, and to provide theoretical suggestions and data support for optimizing the cost structure, controlling the growth of medical costs, and improving the quota payment policy of intraocular lens materials.
The medical records and single-disease payment information of 215 age-related cataract patients admitted to the Department of Ophthalmology of a provincial tertiary public general hospital in Guangzhou from June 1, 2021 to April 30, 2022 were collected. Descriptive analysis, new grey correlation analysis and multiple linear regression model were used to analyze the composition and influencing factors of single-disease settlement expenses and the burden of intraocular lens materials.
The treatment cost, intraocular lens cost and diagnosis cost were the main types of hospitalization expenses for age-related cataract surgery patients (accounting for 52.12%, 19.79% and 13.56% respectively, accounting for 85.47% in total). At the same time, it was also the main type of expense affecting the average hospitalization expense per time (the correlation coefficients were 1.000, 0.751, 0.717). Multiple linear regression analysis showed that the length of hospital stay, anesthesia type (local anesthesia as the reference, general anesthesia β=3 513.340) and intraocular lens type (soft spherical three-piece monofocal non-astigmatism type as the reference, soft aspheric one-piece monofocal astigmatism type β=2 590.090; soft aspheric one-piece continuous visual field non-astigmatism type β=10 496.020, soft aspheric one-piece trifocal non-astigmatism type β=21 889.810) were the influencing factors of hospitalization expenses (P<0.001). Under the medical insurance limit payment of intraocular lens material fee, the proportion of the highest burden of patients is low when the selected intraocular lens unit price is less than the maximum limit standard (1 800 yuan), and the proportion of the highest burden of patients increases with the increase of the price of intraocular lens when the selected intraocular lens unit price is more than the maximum limit standard (1 800 yuan).
The structure of hospitalization expenses for age-related cataract surgery becomes more reasonable under the centralized volume-based procurement policy of intraocular lens, and the labor value of medical staff is realized. However, more attention should be paid to the changes of intraocular lens costs and diagnostic fees in the future. Shortening the length of hospital stay, reasonable selection of anesthesia methods, reasonable selection of different types of intraocular lens and reducing the price of intraocular lens can effectively reduce the hospitalization cost of age-related cataract surgery patients. Appropriately raising the fee limit of intraocular lens materials according to the affordability of local medical insurance fund is helpful to reduce the cost burden of surgical patients.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |