人工晶状体集中带量采购效果分析

doi:10.20223/j.cnki.1000-8535.2025.02.010

摘要/Abstract

摘要： 目的评价人工晶状体（IOL）集中带量采购政策对于白内障摘除术中人工晶状体选择的影响。方法回顾性分析2020年6月—2022年5月在广州市第一人民医院眼科完成白内障超声乳化摘除联合IOL植入术的患者,根据医院开始集采的时间（2021年5月）将患者分为集采前组与集采后组。比较两组患者的一般资料、IOL类别、IOL价格、手术费用、国产IOL占比等。结果集采前组（2020年6月—2021年5月）与集采后组（2021年6月—2022年5月）的白内障手术量分别为1 188例及1 099例（双眼手术者仅纳入一眼）,两组患者的年龄及性别比例比较差异均无统计学意义（P>0.05）。集采前IOL价格为3 770（3 162~7 950）元,高于集采后的1 613（1 079~4 994）元（P<0.001）。两组患者中非球面单焦点IOL所占比例均为最高,集采后多焦点及散光IOL的数量较集采前增加（集采前vs.集采后：多焦IOL：1.9% vs 15.0%;散光IOL：0.2% vs 1.3%,均P<0.05）,球面IOL的数量减少（集采前后：7.7% vs 0.6%,P<0.05）。集采后国产IOL的使用率由0.5%增加至3.5%（P<0.001）。并且集采后选择多焦点IOL的患者年龄更大[集采前（62.3±12.4）岁,集采后（66.1±10.5）岁,P=0.02]。结论 IOL集中带量采购政策减轻了白内障患者的经济负担,增加了高端IOL的使用量,同时减少了国家医疗保险的支出,并且促进国产医用耗材的使用。

关键词: 集中带量采购, 人工晶状体, 白内障, 医疗保险, 医用耗材

Abstract: Objective To evaluate the influence of intraocular lens（IOLs）purchasing policy in a centralized volume-based manner on patients' selection of cataract extraction surgery. Methods The patients who completed cataract phacoemulsification combined with IOLs implantation in the ophthalmology department of Guangzhou First People's Hospital from June 2020 to May 2022 were retrospectively analyzed．According to the time of centralized IOLs procurement policy implemented in our hospital（May 2021）,the patients were divided into before centralized purchase group（from June 2020 to May 2021）and centralized purchase group（from June 2021 to May 2022）．The demographics of study population,IOLs category,IOLs cost,operation cost and the proportion of Chinese-made IOLs were compared between the two groups. Results The total numbers of operations in the before centralized purchase group and centralized purchase group were 1 188 and 1 099 eyes（only one eye was included in the binocular surgery）,respectively．There was no significant difference in the age and sex between the two groups（P>0.05）．The median cost of IOLs in the before centralized purchase group was 3 770（3 162,7 950）,which was higher than that of centralized purchase group [1 613（1 079,4 994）,P<0.001]．The proportion of aspherical IOLs was the highest in both groups．The number of multifocal and astigmatic IOLs in the centralized purchase group increased significantly compared with those of before centralized purchase group（multifocal IOLs：1.9% and 15.0%;astigmatic IOLs：0.2% and 1.3%,all P<0.05）．The number of spherical IOLs decreased significantly（7.7% and 0.6%,P<0.05）．The utilization rate of domestic IOLs increased from 0.5% to 3.5%（P<0.001）．The patients who chose multifocal IOLs in centralized purchase group were older than patients in before centralized purchase group [（62.3±12.4）vs（66.1±10.5）,P=0.02]. Conclusions The centralized volume-based procurement policy of IOLs reduces the economic burden of patients and increase the use of high-end IOLs．At the same time,it reduces the expenditure of national medical insurance and promotes the use of domestic medical consumables．

Key words: centralized volume-based procurement, intraocular lens, cataracts, medical insurance, medical consumables

许焱鑫, 石峰, 冷云霞, 骆丽丝, 高宗银. 人工晶状体集中带量采购效果分析[J]. 广州医药, 2025, 56(2): 203-210.

XU Yanxin, SHI Feng, LENG Yunxia, LUO Lisi, GAO Zongyin. Effect of centralized volume-based procurement policy of intraocular lens[J]. Guangzhou Medical Journal, 2025, 56(2): 203-210.

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