Study on the Effects of Centralized Volume-based Procurement Policy on Direct Medical Expenses Related to Cardiovascular Disease One Year after First Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome
Lu Dongzhe
Chen Wen
Shao Zhenyi
Xue Di
Abstract：Objective:To analyze the effects of centralized volume-based procurement policy for coronary stents on direct medical expenses related to cardiovascular disease within one year after first Percutaneous Coronary Intervention(PCI)among patients with Acute Coronary Syndrome(ACS),based on real-world data of Shanghai medical institutions.Methods:ACS patients who underwent their first PCI in Shanghai between March 2019 and April 2022 were selected,and their data of cardiovascular-related medical care and direct medical expenses in outpatient visits and readmissions within one year after first PCI were collected.The policy effects on direct medical expenses related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI were analyzed,using Wilcoxon rank sum tests and a multilevel generalized linear mixed model.Results:After the implementation of coronary stent policy,the average total direct medical expense(including outpatient visits and readmissions)related to cardiovascular disease within 1 month,3 months,6 months and 1 year after first PCI in ACS patients significantly decreased in Shanghai;and the multivariate generalized linear mixed model also indicated that the policy implementation reduced the direct medical expenses related to cardiovascular disease for these patients within one year after first PCI.Conclusions:The implementation of coronary stent policy in Shanghai reduced direct medical expenses related to cardiovascular disease within one year after first PCI in ACS patients,alleviating patients' financial burden.It is recommended that medical expenses after first PCI among patients with ACS should be further reduced and that long-term follow-up assessment on social impacts of coronary stent policies should be conducted.
Keywords：centralized volume-based procurementacute coronary syndromepercutaneous coronary interventionmedical expense
Publication Date：2025-08-05
Online Publishing Date：2025-08-27(First online date of this platform, not the publication date of the document)
Pages：6( 36-41 )