脑深部电刺激疗法的医保支付比例调整对患者医疗费用影响研究
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中图分类号：R197.323 文献标识码：A
Research onthe ImpactofAdjustments inMedical Insurance Payment Proportions forDepBrain StimulationTherapyonPatientsMed ical Expenses/XING Qian，HU Hongfei，HE Da，et al.//Chinese Health Quality Management，2025，32（10）：70一73，79
Abstract ObjectiveTaking deep brain stimulation therapy as an example，this study analyzes the impact of adjustments in medical insurance payment proportions on patients'medical expenses，providing a scientific basis for the governance of high一value consumables and the optimization of medical insurance payment policies.MethodsUsing patients who underwent deep brain electrode implantation and setted medical insurance claims in Shanghai from 2017 to 2023 as samples，a regresion discontinuity design model was employed to empirically analyze differences in patients medical expense burdens before and after two adjustments in Shanghai's medical insurance payment proportions. ResultsFolowing both adjustments in payment proportions，patientsout一of-pocket expenses decreased to varying degrees，while medical insurance fund expenditures increased.After the second adjustment，total hospitalcost with reimbursement proportions rose （ P<0.05 ），and the results remained robust under different bandwidth tests.Conclusion Adjustments in medical insurance payment proportions have a cost一reducing and burden一aleviating efect on patients，although factors such as industrialupgrades and iterations contributeto increases intotal expenses.Itis necessary tofurther enhance surgical managementcapabilities，continuously explore intelligent monitoring measures for medical insurance funds，optimize disease grouping and payment standards，and ensure the sustainability of the funds.
Key words Medical Insurance Payment;Deep Brain Stimulation; High-Value Therapy; Hospitalization Expenses； Regression Discontinuity Design
First-author'saddress Shanghai Health Development and Research Centre/Shanghai Medical Science and Technology Information Institute，Shanghai，2olloo，China
近年来，上海市针对国内外领先、临床应用价值显著且安全性与质量控制水平较高的高值医疗技术，出台了一系列支持政策，包括完善价格形成机制、优化临床应用路径以及调整医保支付标准等[1]。（剩余5797字）
