关键词: 集中采购, 白内障, 人工晶状体, 卫生经济学

Abstract:  Objective To analyze the cost-control effectiveness of cataract surgery under the national centralized procurement policy. Design Health economics evaluation. Participants Hospitalized patients undergoing phacoemulsification with intraocular lens (IOL) implantation at Beijing Tongren Hospital from January to December, 2024, including 18,743 cases (18,743 eyes) before policy implementation (pre-procurement group) and 19,346 cases (19,346 eyes) after implementation (post-procurement group). Methods Compare and analyze the brand specifications, dosage, and average hospitalization expenses of IOL used by patients before and after centralized procurement. Compare the average total hospitalization cost and material cost per case of DRGs paid patients admitted by the top 15 doctors in terms of surgical volume with the average medical insurance cost in Beijing in 2024. Main Outcome Measures Utilization rates of monofocal and multifocal IOLs; per-case total hospitalization costs and material costs. Results Post-policy implementation: Monofocal IOL usage decreased by 39.29%, while multifocal (including extended depth-of-focus) IOL utilization rose to 44.84%. Per-case total hospitalization costs decreased by RMB 647.83, with material costs dropping RMB 774.50 (22.29%), of which over 90% was attributable to reduced IOL expenses. Among the top 15 surgeons, 6 achieved per-case material costs below Beijing’s average (0.96%-19.99% reduction) , and 11 achieved per-case total hospitalization costs below the average (1.92%-20.99% reduction). Conclusion  After the introduction of the national centralized procurement policy of IOL, through the implementation of the DRGs payment reform policy linkage mechanism with Beijing medical insurance, it not only effectively realized the rationalization control of medical expenses, but also optimized the allocation of resources, so that medical services can better respond to the personalized medical needs of cataract patients on the basis of ensuring the basic needs.

Key words:  Volume-based procurement, Intraocular lenses, Health economics