7．Health Technology Assessment from the Viewpoint of Patients and Patient Groups / 薬剤疫学

Patients can receive advanced medical care at a relatively low burden with the support of the system of the public health insurance for the whole nation and high-cost medical expense benefit in Japan. Despite these systems, some patients feel that they have many economic burden of medical care and cancer patient groups have demanded the reduction of economic burden. On the other hand some claim that the application of insurance to new drugs should be revised as the prices of new drugs are highly rising. As for health technology assessment cost-effectiveness evaluation is now being introduced from the point of cutting costs and patients now do not participate in the process of appraisal.

High-cost consumables barcode management based on the No.1 military medical project / 中国医学装备

Objective: To solve the problem, that the high-cost consumables exists many management blind spots and shortcomings, under the traditional medical high-cost consumables purchase management mode. Methods:Combined with the characteristics of medical high-cost consumables, design a new high-cost consumables purchase management mode. Based on theArmy No.1high-cost consumables management system, using bar code technology, to realize the full closed tracking management of medical high-cost consumables. Results:Realized the unified control of the whole hospital medical high-cost consumables, timely and accurately mastered the material purchase, storage and usage, and to realize the object of the high-cost medical material management and safe usage. Conclusion:The scheme is feasible, and solve many problems, those are high-cost consumables management denominated in error, cost volatility and unseasonal financial processes and so on. It can become the effective means of hospital high-cost consumables management.

Clinical characteristics and medical cost of amputations in a single center in 2007-2011 / 中华创伤杂志

Objective To study demographic features,clinical characteristics and in-hospital cost of patients due to different causes in one center in 2007-2011 and discuss their correlation.Methods A retrospective analysis was conducted on all patients who were treated with amputation from 2007 to the first half of 2011 in the Second Affiliated Hospital of Zhejiang University to carefully record their data,such as demographic characteristics,entity,medical history,clinical information,amputation location,amputation level,hospital day and medical cost.Results A total of 805 patients at age of (42.1 ± 18.1)years underwent amputation from 2007 to the first half of2011.Among them,the male patients accounted for 72.3％.The patients engaged in farm,industry and transportation accounted for 69.7％.Traumatic amputation occupied 66.1％,followed by 15.3％ of tumor amputation and diabetic amputation proportioned 4.5％,occupying 13.2％ of non-traumatic amputation.Ratios of lower limb amputations and amputations above levels of joints of palmar digitals and toes were 64.9％ and 61.7％.Mean hospital day was 20 days (range,14-34 days) and mean medical cost was 15 000 RMB (range,8 881-31 975 RMB).Conclusions Amputation largely occurs in the male adults and mainly results from trauma.High amputation,long hospital stay and high medical cost are the main characteristics.

Process management for purchase & supply of high-cost medical consumables in hospitals / 医疗卫生装备

Process management is discussed on purchase and supply of high-cost medical consumables in hospitals.Reserve material-circulation is applied to purchase & supply management,i.e.consumables is clinically used before in-storeroom and out-storeroom examination on the basis of normative purchase.Problems brought by various standards and types of consumables are solved including difficulties in stocking goods,huge amount of money tied up,unreasonable consumption,etc.Process management facilitates clinical application,standardizes management and enhances benefits.

Cost analysis of total knee replacement surgery / 中华骨科杂志

Objective To analyze the composition of hospital cost for total knee replacement (TKR)in recent years in order to improve the effectiveness of TKR,reduce its complications and extend the TKR more widely in China.Methods The data was obtained for primary unilateral TKA performed in2001,1998,1995compared with that performed in1992in Peking University People's Hospital.There were no postoperative complications and other surgical treatments during the hospitalization period.Results From1992through2001,prosthetic and physical therapy cost were predominantly increased214.2%and318.0%respectively in1998;219.8%and291.4%respectively in2001.The least cost was hospital room and blood transfusion fee.Among all the hospital costs in these four individual years,the most expensive was at-tributed to prosthesis cost,reached as54.7%,56.1%,56.0%and63.3%of total costs respectively.The influ-enced factors of the increasing hospital costs for TKR were as following:1)The using of imported knee im-plants increased in achieving better post-operative function of knee;2)The expensive imported antibiotic was widely used because of high drug-resistance due to the abuse of antibiotics;3)The anti-coagulative drugs on account of reducing the incidence of post-operative DVT was widely accepted;4)The emphasis on physical therapy was more considered.The possible factors of the decreasing hospital costs for TKR were using less expensive home-made antibiotics in short time just to prevent infections,reducing the length of hospital stay by enough preparation before operation,improving surgical technique and adopting preoperative blood salvage and re-transfusion to reduce the blood transfusion cost.Conclusion Through the analysis of total hospi tal cost of TKR in recent ten years,the prosthesis cost accounted for the most proportion,and the in crease of the hospital cost was attributed to prosthesis,anti-coagulative drugs,antibiotics and physical ther-apy.At same time,the average postoperative ROM of knee increased from93.6?to112.3?,and the in ci-dence of compli cations decreased from10.3%to5.3%.The better result of TKR,satisfactory knee function and the life quality of patient were obtained.