摘要
目的探索医疗新技术运用对手术科室的医疗质量、医疗安全、效率以及住院费用的影响。方法以达芬奇手术机器人作为新技术使用项目,将2023年某三甲医院开展该技术的患者纳入研究作为新技术组,使用传统腔镜的患者作为对照组建立数据库。并以手术方式为自变量(传统腔镜手术作为对照),患者个体特征作为控制变量,运用Stata 16.0对患者的术中出血、住院天数、手术时间、住院费用、出院转归以及0~7 d再入院率进行回归分析,探索新技术运用对手术科室医疗服务的影响。结果经过数据清洗后,新技术组为276例,对照组为759例。相较于传统腔镜技术,新技术组的异地医保付费患者比例更高(P<0.05)。运用新技术提升了患者治愈率,降低了患者的术中出血量、术后住院天数,但术前住院天数和手术时间均有延长,差异均有统计学意义(P<0.05),总住院天数差异不显著(P>0.05)。同时住院次均费用、药费、耗材费、检查费、服务费及手术费均显著增加(P<0.05),抗菌药物费用略有下降,但差异无统计学意义(P>0.05)。结论新技术的运用提升了患者医疗质量和医疗安全,体现了新技术的精准定位和学科影响力,减少了手术风险,极大提高了手术的治愈率。但运行效率有待提升,并且疾病经济负担上升对医疗机构的运营成本提出了巨大挑战,医院需建立完善的评估体系以及医保政策支持激励医疗机构有序开展新技术。
Objective To explore the influence of the application of new medical technology on the medical quality,medical safety,efficiency and hospitalization cost of surgical departments.Methods Taking Da Vinci surgical robot as a new technology application project,patients who carried out this technology in a gradeⅢ-A hospital in 2023 were included in the study as the new technology group,and patients who used traditional endoscopy as the control group to establish a database.With surgical method as the independent variable(traditional endoscopic surgery as the control)and individual characteristics of patients as the control variable,Stata 16.0 was used to conduct regression analysis on patients’intraoperative bleeding,hospitalization days,operation time,hospitalization cost,discharge outcome and 0-7 day readmission rate,so as to explore the impact of the application of new technologies on medical services in surgical departments.Results After data cleaning,there were 276 cases in the new technology group and 759 cases in the control group.Compared with the traditional endoscopy technology,the proportion of patients with remote medical insurance payment in the new technology group was higher(P<0.05).The application of the new technology improved the cure rate of patients,reduced the amount of intraoperative bleeding and postoperative hospitalization days of patients,but the preoperative hospitalization days and operation time were extended,with all the differences were statistically significant(P<0.05),while the total hospitalization days were not significantly different(P>0.05).At the same time,the average hospitalization cost,drug cost,consumables cost,inspection cost,service cost and operation cost were significantly increased(P<0.05),and the cost of antibiotics was slightly decreased,but the difference was not statistically significant(P>0.05).Conclusion The application of the new technology has improved the medical quality and medical safety of patients,reflected the precise positioning and disciplinary influence of the new technology,reduced the risk of surgery,and greatly improved the cure rate of surgery.However,the operation efficiency needs to be improved,and the rising economic burden of diseases poses a great challenge to the operating costs of medical institutions.Hospitals need to establish a sound evaluation system and medical insurance policies to support and encourage medical institutions to carry out new technologies in an orderly manner.
作者
俞骏仁
郑蕴欣
罗莉
余锦娟
徐桔密
俞传芳
YU Junren;ZHENG Yunxin;LUO Li;YU Jinjuan;XU Jumi;YU Chuanfang(Department of Medical Operations,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Department of Medical Equipment,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Office of Party Committee,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Office of Performance Management,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Office of Medical Insurance Administration,Shanghai Sixth People’s Hospital,Shanghai 200233,China;Center for Hospital Operation,China Hospital Development Institute,Shanghai Jiao Tong University,Shanghai 200233,China)
出处
《中国医疗设备》
2025年第2期82-88,共7页
China Medical Devices
基金
国家重点研发计划(2022YFC2407005)
上海申康医院发展中心医疗质量安全与医疗服务模式创新项目(SHDC12023609)
上海市第六人民医院院级科研项目(lygl2023019)
上海市卫健委政策研究课题(2024HP67)。
关键词
医疗新技术
医疗服务
住院费用
手术科室
医疗质量
医疗安全
达芬奇手术机器人
new medical technology
medical service
hospitalization cost
surgical department
quality of medical care
medical safety
Da Vinci surgical robot
