关键词: 日间手术, 眼科, 医疗费用

Abstract:  Objective  To explore the impact of ophthamic ambulatory surgery model on total medical expenses, medical insurance fund payment, and individual patient payment. Design Retrospective cohort study. Participants Data of 362,492 inpatients from a class-A tertiary hospital in Beijing, between 2022 and 2024. The participants were divided into two groups based on the exposure factor of whether they had undergone ambulatory surgery. Methods Descriptive statistics were used to compare differences in demographic characteristics and expense indicators between the two groups. A multiple linear regression model was applied to control for confounding factors and analyze the independent impact of ambulatory surgery on expenses. Main Outcome Measures Medical insurance fund payment, individual patient payment. Results  86.2% of ophthalmic inpatient surgeries adopting the ambulatory model, compared to only 10.6% of non-ophthalmic surgeries. The average age of patients in the ambulatory surgery group was significantly higher than that in the non-ambulatory surgery group (62.9 years vs. 52.9 years, P<0.001). Expense analysis showed that the median total expenses (5340 yuan), medical insurance fund payment (3101 yuan), and individual patient payment (2361 yuan) in the ambulatory surgery group were significantly lower than those in the non-ambulatory surgery group (14456 yuan, 8249 yuan, and 4624 yuan respectively, all P<0.001). Multiple linear regression analysis indicated that after controlling for factors such as year, age, gender, and type of medical insurance, choosing ambulatory surgery could reduce the medical insurance fund payment by an average of 6983 yuan (95% CI: 6870~7096) and the individual and the individual patient payment by an average of 4698 yuan (95% CI: 4620~4777). Conclusions  The ambulatory surgery model in ophthalmology can significantly reduce the total medical cost, effectively alleviate the pressure on the medical insurance fund and the economic burden of individual patients, and thus is an efficient medical service model worthy of promotion.

Key words: Ambulatory surgery, Ophthalmology, Medical expenses