[1]罗慧佳,蓝天骄,潘 杰.低价值医疗服务风险评估研究 ——以子宫切除术为例[J].卫生经济研究,2024,41(01):59-64,69.
　LUO Huijia,LAN Tianjiao,PAN Jie.Study on the Risk Assessment of Low-value Care ——An Empirical Analysis of Hysterectomy[J].Journal Press of Health Economics Research,2024,41(01):59-64,69.
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低价值医疗服务风险评估研究
——以子宫切除术为例
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年01期
页码:
59-64,69
栏目:
改革探索
出版日期:
2024-01-03

文章信息/Info

Title:
Study on the Risk Assessment of Low-value Care
——An Empirical Analysis of Hysterectomy
作者:
罗慧佳1; 2; 3; 蓝天骄1; 2; 3; 潘 杰1; 2; 4
1.四川大学华西公共卫生学院/华西第四医院，四川 成都 610041
2.四川大学华西-协和陈志潜卫生健康研究院，四川 成都 610041
3.四川大学健康城市发展研究中心/西部农村卫生发展研究中心，四川 成都 610041
4.四川大学中国南亚研究中心，四川 成都 610065
Author(s):
LUO Huijia;  LAN Tianjiao;  PAN Jie
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan 610041, China
关键词:
低价值医疗服务; 风险评估; 子宫切除术; 成本-效果分析
Keywords:
low-value care;  risk assessment;  hysterectomy;  cost-effective analysis
分类号:
R19
文献标志码:
A
摘要:
目的：评估低价值医疗服务的风险。方法：基于文献回顾和四川省2016—2020年病案首页数据，构建低价值子宫切除术的风险评估指标，从全社会、患者、卫生体系和支付方四个角度构建决策树模型并进行成本-效果分析。结果：低价值子宫切除术提供比例为17.8%，其健康临床风险、健康人文风险和健康经济风险均高于替代服务，从全社会和患者角度看，低价值子宫切除术属于高成本、低效果服务；从卫生体系和支付方角度看，低价值子宫切除术属于低成本、低效果服务；成本-效果分析显示，以有效率和并发症发生情况为产出，低价值子宫切除术的经济性较差。结论：低价值子宫切除术具有较高风险，风险程度因成本测算角度不同而存在差异，需要进一步扩充低价值医疗服务的证据，从而制定更加科学全面的临床指南和政策。
Abstract:
Objective To assess the risk of low-value care in China. Methods Through literature review and hospital discharge records related to hysterectomy from 2016 to 2020 in Sichuan Province, key indicators of risk assessment for low-value care were constructed. Decision tree models were developed for cost-effectiveness analysis from four perspectives: the whole society, patients, healthcare system, and payers. Results The proportion of low-value hysterectomy episodes was 17.8%. Clinical risks, humanistic risks, and economic risks of low-value hysterectomy were all higher than those of alternative services. Low-value hysterectomy was considered a high-cost, low-efficiency service from the perspectives of the whole society and patients, while it was considered a low-cost, low-efficiency service from the perspectives of the healthcare system and payers. Besides, the cost-effectiveness analysis indicated that the economy of low-value hysterectomy was poor based on efficiency and complication occurrence as outputs. Conclusion Low-value hysterectomy poses higher risk and its direction and magnitude may vary under different cost assessment perspectives. It is necessary to further strengthen and expand the evidence base for low-value care to develop more scientific and comprehensive clinical guidelines and policies.

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[2]胡庆慧,谢 虹.公立医院践行内部控制研究[J].卫生经济研究,2018,(11):62.
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更新日期/Last Update: 2024-01-03