HAN Xuemei 1 , KANG Pan 1 , CUI Xiuyun 2 , TAO Shengxin 4 , SI Miaomiao 1 , YI Jikun 1 , MA Yichen 1 , MA Ziyuan 1 , LI Jingyi 1 , WANG Xingxing 3 , MIAO Rui 4 , ZHANG Jiawen 1
  • 1. School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
  • 2. Changqing oilfield social insurance center, Xi’an 710048, P. R. China;
  • 3. The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
  • 4. Health Statistics and Information Centre, Gansu Provincial Health Commission, Lanzhou 730000, P. R. China;
ZHANG Jiawen, Email: 1132554837@qq.com
Interrupted time series; Centralized procurement policy; Hospitalization costs; Coronary heart disease; PCI surgery
10.7507/1672-2531.202405086
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Objective This study aims to investigate the variations in patient hospitalization expenses before the enforcement of the centralized procurement policy, after the implementation of the drug centralized procurement policy, and subsequent to the introduction of the consumables centralized procurement policy. The efficacy of the centralized procurement policy will also be examined. Methods This retrospective study utilizes data obtained from the medical records homepage of the Health Information Statistics Center under the Health Commission of Gansu Province. It included 32 938 inpatients who underwent PCI surgery for coronary heart disease in Gansu Province between January 1, 2018, and December 31, 2022. A double-breakpoint interrupted time series model was employed to analyze the fluctuation trends in hospitalization costs among patients across various stages of the centralized procurement policy's implementation. Results Throughout the three phases of implementing the centralized procurement policy, the average total hospitalization costs were RMB 46 149.49 yuan, RMB 46 629.12 yuan, and RMB 28 771.76 yuan, respectively. Upon initiating the centralized procurement policy with a focus on drug volume, there was an immediate reduction in average total hospitalization costs, drug costs, consumable costs, and medical service fees by 4.64%, 5.62%, 18.12%, and 8.85%, respectively. However, there was a subsequent increase of 25.28% in average medical service fees. Following this phase, average out-of-pocket costs, treatment costs, and other expenses exhibited a consistent upward trajectory, increasing by an average of 2.23%, 0.15%, and 1.21% per month. Upon the introduction of the centralized procurement policy for consumables, there was an immediate surge of 23.75% in average medical service fees, while average total hospitalization costs, out-of-pocket costs, consumable costs, treatment costs, and rehabilitation costs experienced a gradual decline. Conclusion The enforcement of centralized procurement policies for drugs and consumables has effectively managed to reduce hospitalization costs for patients undergoing PCI surgery due to coronary heart disease, thereby easing the financial burden on patients. However, changes in consumable costs and average medical service fees were relatively modest. Going forward, it is essential to refine the centralized procurement policy concerning consumables, improve the compensation mechanism for medical service pricing, and enhance the overall value proposition of medical services.

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