The Influence Of Medical High-value Consumables Control On Medical Expenses And Physicians' Attitude

Objective:To analyze the change rules of medical cost structure,medical staff attitude and medical quality before and after the control of high-value consumables,discusses the corresponding influencing factors,and then puts forward the policy design of standardizing medical behavior to control the unreasonable increase of medical cost.Methods: Through document research,questionnaire survey and case analysis,the influencing factors of medical cost structure and medical behavior are analyzed and discussed,and the rules and methods are summarized to provide ideas and references for medical reform policies.Results: On patients in hospital cost analysis found by zero rate reform after the total cost per capita,per capita cost of high-value consumables,drug cost per capita,per capita medical service class fee,inspection fee per capita,per capita non-surgical treatment and operative treatment of per capita were altered obviously,and the difference was statistically significant(p<0.05),with high value material fee(group pedicle screws)in hospitalized patients with medical treatment in the total cost for 3 years accounted for 60.10%,60.20% and 60.77% respectively,high-value consumables costs 3 years per capita 36900 yuan,41400 yuan and 34500 yuan respectively.The average daily hospitalization after the implementation of high-value consumables control was higher than that before the control,especially when the zero-difference rate of consumables was implemented for one year,the difference was statistically significant(p=0.002).There were statistically significant differences in the cognition of orthopaedic surgeons with different years of medical service to limit the use of high-value consumables(p<0.05).Conclusion: The cost of high-value consumables has become the first major factor affecting medical expenses.However,after restricting the use of high-value consumables,the cure rate of the patients decreased and the average hospitalization day increased,which led to the corresponding increase in the cost of bed,nursing care,pharmaceutical products and treatment,while the total cost did not decrease significantly.It is indicated that the use of high-value consumables cannot be simply restricted,and the cost-effective consumables should be selected based on the patient's condition,economic status and other comprehensive considerations on the premise of ensuring medical quality.Factors affecting high-value consumables expenses relating to government,social,institutional and individual level,more advice should balance the interests of all aspects,improve the macroscopic policy,strengthen moral education,the doctors and patients,promote efficiency of management of medical institutions and the establishment of supervision mechanism,improving the social from all walks of life to high-value consumables cost control consciousness,promote the medical income structure rationalization,reduce medical expense rise too fast.