ObjectiveTo investigate the variations in patient hospitalization expenses before the enforcement of the centralized procurement policy, after the implementation of the drug centralized procurement policy, and after the introduction of the consumables centralized procurement policy. The efficacy of the centralized procurement policy will also be examined. MethodsThis retrospective study utilizes data obtained from the medical records homepage of the Health Information Statistics Center under the Health Commission of Gansu Province. It included 32 938 inpatients who underwent PCI surgery for coronary heart disease in Gansu province between January 1, 2018, and December 31, 2022. A double-breakpoint interrupted time series model was employed to analyze the fluctuation trends in hospitalization costs among patients across various stages of the centralized procurement policy's implementation. ResultsThroughout the three phases of implementing the centralized procurement policy, the average total hospitalization costs were RMB 46 149.49 yuan, RMB 46 629.12 yuan, and RMB 28 771.76 yuan, respectively. After the centralized procurement policy with a focus on drug volume was initiated, there was an immediate reduction in average total hospitalization costs, drug costs, consumable costs, and medical service fees by 4.64%, 5.62%, 18.12%, and 8.85%, respectively. However, there was a subsequent increase of 25.28% in average medical service fees. Following this phase, average out-of-pocket costs, treatment costs, and other expenses exhibited a consistent upward trajectory, increasing by an average of 2.23%, 1.51%, and 1.21% per month. Upon the introduction of the centralized procurement policy for consumables, there was an immediate surge of 23.75% in average medical service fees, while average total hospitalization costs, out-of-pocket costs, consumable costs, treatment costs, and rehabilitation costs experienced a gradual decline. ConclusionThe enforcement of centralized procurement policies for drugs and consumables has effectively managed to reduce hospitalization costs for patients undergoing PCI surgery due to coronary heart disease, thereby easing the financial burden on patients. However, changes in consumable costs and average medical service fees were relatively modest. Going forward, it is essential to refine the centralized procurement policy concerning consumables, improve the compensation mechanism for medical service pricing, and enhance the overall value proposition of medical services.
The outline of the "Healthy China 2030" states that medical institutions should serve as the primary purchasing agents for medicines and medical consumables, and joints purchasing should be encouraged. Since its establishment, the National Healthcare Security Administration has conducted five batches of national centralized procurement of high-value medical consumables, forming a nationwide collaborative framework involving national, provincial (including inter-provincial alliances), and local municipalities (including local municipal alliances). This study explains the current development status of the centralized procurement of medical consumables in representative countries, and explores the role of research evidence, such as health technology assessment (HTA), in the centralized procurement of medical consumables in China. Looking ahead, various forms of research evidence, such as HTA, will contribute to the dynamic adjustment of the catalogue for the collection and procurement of medical consumables, and the construction of a comprehensive evaluation index system for the clinical use of medical consumables, as well as the integration of evidence-based and artificial intelligence technology for the whole life-cycle management of medical consumables, will inject new impetus into the management of collection and procurement and innovation.