基于队列模型生存率数据的跨年度生存患者干预方案医保基金支出的计算方法
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篇名: 基于队列模型生存率数据的跨年度生存患者干预方案医保基金支出的计算方法
TITLE: Calculation Method of Medical Insurance Fund Expenditure of Intervention Scheme for Cross-year Survival Patients Based on Survival Data of Cohort Model
摘要: 目的:构建一种能够较为准确地反映跨年度生存患者干预方案医保基金支出的计算方法,为医保预算影响分析(BIA)研究提供参考。方法:基于队列模型的生存率数据,以各年份中每个周期确诊的患者作为一个队列,计算各队列患者在研究年份内各状态下的人均生存周期数,即平均生存时间;在此基础上,再根据各队列的人数和各状态下的周期人均费用计算研究年份内所有队列的患者产生的总费用。以某癌症的干预方案作为示例,按所构建的计算方法进行演算,并将计算结果与目前几种常见算法结果进行比较;同时,对所构建的算法在特殊情形下的拓展情况提出应用建议。结果与结论:所构建的算法相比目前几种常见算法,其计算过程更符合真实世界中药物干预方案相关医保基金支出的过程,且其能够灵活适应多种特殊情形下的计算需求。该算法可较为准确地计算特定年份下某一干预方案的医保基金支出,在一定程度上解决了原有算法未充分考虑跨年度生存患者或计算过程简易、粗略而导致医保基金支出预测不准确的问题,可为我国医保BIA相关研究提供更准确的方法选择。
ABSTRACT: OBJECTIVE:To construct a calculation method which can accurately reflect the medical insurance fund expenditure of intervention scheme for cross-year survival patients ,and to provide reference for the research of medical insurance budget impact analysis(BIA). METHODS :Based on survival data of cohort model ,taking the patients diagnosed in each cycle in each year as a cohort,the number of per capita survival cycle of cohort patients in each state in the study year was calculated ,i.e. the average survival time ;on this basis ,the total cost of patients in all cohorts in the study year was calculated according to the number of people in each cohort and the per capita cost each cycle in each state. Taking the intervention scheme of a cancer as an example , the calculation was carried out by the established algorithm ,and the calculation results were compared with the results of several common algorithms ;at the same time ,the application suggestions were put forward for the expansion of the constructed algorithm in special cases. RESULTS & CONCLUSIONS :Compared with the several common algorithms ,the calculation process of the constructed algorithm is more in line with the process of medical insurance fund expenditure related to drug intervention scheme in the real world ,and it can flexibly adapt to the calculation needs in a variety of special situations. This algorithm can more accurately calculate the medical insurance fund expenditure of a intervention scheme in a specific year ,and to a certain extent solve the problem of inaccurate prediction of medical insurance fund expenditure due to insufficient consideration of cross-year survival patients or simple and rough calculation process. It can provide a more accurate method choice for the research of medical insurance BIA in China.
期刊: 2021年第32卷第17期
作者: 黄元楷,陈磊,李莹,席晓宇
AUTHORS: HUANG Yuankai ,CHEN Lei,LI Ying,XI Xiaoyu
关键字: 预算影响分析;跨年度生存;医保基金支出;计算方法;生存率
KEYWORDS: Budget impact analysis ;Cross-year survival ;Medical insurance fund expenditure ;Calculation method ;Survival
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