ObjectivesTo explore classification management method of evidence-based evidence for medical consumables based on cost multiplication and to conduct empirical test.MethodsFour quadrants was used to explore the classification management of consumables evidence.Results95.22% of the “recommended” items in the consumables department were “recommended” by the group. 100% of group “recommended” items passed the committee resolution. Advice of consumables department and group was highly relevant with decision of commission.ConclusionsOne-dimensional recommendations allow the decision-making of group and committee to be more convenient. Cost calculation is based on all consumables required for medical treatment, which is similar to reality. The classification threshold requires further optimization, and the classification basis requires continual adjustment under different conditions of hospital. The evidence-based evidence evaluation method for medical consumables based on incremental cost ratio is a simple and rapid hospital health technology assessment method suitable for China’s national conditions.
ObjectiveTo compare the cost changes of total knee arthroplasty (TKA) before and after the cancellation of medical consumables addition, so as to provide reference for the national medical reform policy.MethodsThe patients treated with TKA between September 2018 and February 2019 were admitted as objects of study, and 372 of them met the selection criteria and were finally included in the study. According to the time node of cancelling the medical consumables addition (December 24, 2018), all patients were allocated to pre-cancelling and post-cancelling groups (n=186). The clinical data of patients (gender, age, length of stay, disease classification), and various treatment costs (the costs of diagnosis and treatment, examination, laboratory, material, anesthesia, bed, nursing, operation, drug, and others) were collected. And the changes of various costs and proportions before and after cancelling the medical consumables addition were compared.ResultsThere was no significant difference in gender, age, and disease classification between the two groups (P>0.05); the length of stay after cancelling the medical consumables addition was significantly longer than that before cancelling (t=2.114, P=0.035). There was no significant difference in the total cost of TKA before and after cancelling the medical consumables addition (t=0.214, P=0.831). Compared with that before cancelling the medical consumables addition, the cost of material was significantly reduced, and the costs of diagnosis and treatment, anesthesia, nursing, and operation were significantly increased (P<0.05); the costs of examination, laboratory , bed, drug, and others were basically stable, and the differences were not significant (P>0.05).ConclusionThe total cost of TKA is stable, the proportion of material cost is significantly reduced, the proportion of diagnosis and treatment cost reflecting the technical content of medical staff is significantly increased, which is in line with the expectation of the national policy of cancelling the medical consumables addition.
Objective To systematically review the impact of the centralized volume-based procurement (CVBP) of medical consumables on patients' hospitalization expenses in China. Methods The PubMed, Web of Science Core Collection, Scopus, CNKI, CBM, and WanFang Data were electronically searched to collect studies on the impact of CVBP medical consumables on patients' hospitalization expenses from Jan 1, 2000 to May 13, 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. Results The meta-analysis showed that the implementation of the CVBP policy for medical consumables significantly reduced the average patient hospitalization expense (SMD=?4.754, 95%CI ?7.434 to ?2.075, P<0.001). Subgroup analysis indicated that the average patient hospitalization expense decreased after CVBP of coronary stents (SMD=?0.721, 95%CI ?1.040 to ?0.402, P<0.001) and intraocular lenses (SMD=?0.660, 95%CI ?0.984 to ?0.337, P<0.001), with the largest reduction observed after the procurement of artificial joints (SMD=?10.344, 95%CI ?15.147 to ?5.540, P<0.001). Conclusion Evidence from evaluations of the CVBP from the patient's perspective in China is mainly concentrated in developed provinces and cities. Moderate-quality evidence suggests that the largest reduction in average patients' hospitalization expenses occurred after the CVBP of artificial joints, followed by coronary stents and intraocular lenses. It is recommended to further expand the scope of CVBP in the future in China.
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.
As a methodological tool, evidence-based management can assess the technological advantages and economical value of medical consumables scientifically, and select the most cost-effective products into the hospital access directory with guarantees of the development of clinical disciplines. Now this method has been widely used for consumable access management in our hospital. Policies and processes have been established to normalize the assess, allocation, and usage, and the management mode is transformed from experience-based management into evidence-based management. With clinical nominalism being changed, the method of evidence-based management can be used for every link of comsumble management, to reduce the costs and ensure the safety and quality of medical consumables at the same time, so as to promote the rational cost of medical consumables.
ObjectiveTo construct a comprehensive value evaluation index system for the hospital admission of predicate consumables, providing a reference for the admission evaluation of predicate consumables in hospitals. MethodsAn initial pool of comprehensive value evaluation indexes for the hospital admission of predicate consumables was established through literature research and expert consultation. The evaluation indexes were screened and optimized via two rounds of Delphi expert consultation, and the final admission evaluation index system was determined through an expert consensus meeting, and the analytic hierarchy process was adopted to determine the weights of the indexes. ResultsThe final comprehensive value evaluation index system comprised six first-level indexes: clinical effectiveness (0.372 3), reliability (0.273 3), economic efficiency (0.113 8), hospital management (0.093 1), values and preferences (0.087 2), and enterprise services (0.060 3), along with 14 second-level indexes. Among these, "failure rate" (0.273 3), "safety" (0.215 5), and "effectiveness" (0.156 8) carried relatively higher weights. The effective response rates for the two rounds of expert consultation were 80% and 100%, with expert authority coefficients of 0.86 and 0.92, and Kendall's coefficients of concordance of 0.208 and 0.205, respectively. ConclusionThe hospital admission evaluation system constructed in this study integrates multi-dimensional indexes, which can provide a scientific reference for the admission of predicate consumables in hospitals.
ObjectiveTo establish a hospital admission evaluation process for predicate consumables. MethodsAn initial evaluation process for predicate consumables was constructed through a combination of literature review and expert consultation. Subsequently, two rounds of Delphi expert consultation were conducted with 20 specialists to revise and refine the specific steps of the admission evaluation process. Finally, the definitive version of the process was confirmed via an expert consensus conference. ResultsThe finalized hospital admission evaluation process for predicate consumables consisted of 14 specific steps under three core phases: equivalence evaluation, evidence collection, and comprehensive evaluation of consumables. The two rounds of Delphi expert consultation yielded effective response rates of 80% and 100%, and expert authority coefficients (Cr) of 0.86 and 0.92, respectively. In the final consensus voting, the approval rate for all steps reached 100% except for two steps, which achieved an approval rate of 95%. ConclusionThe admission evaluation process established in this study is detailed, scientifically rigorous, and practically applicable, which can provide a decision-making framework for the standardized admission of predicate consumables.