目的通过研究腹腔镜下子宫肌瘤剔除术患者住院费用结构与手术耗材的变化,找出导致费用过快上涨的主要原因,为控制医疗费用过快增长提供依据。方法选取2012年-2015年上半年在某院行腹腔镜下子宫肌瘤剔除术的1019例患者的住院费用、手术耗材的资料,分析不同年份、不同医疗组间费用结构变化,手术耗材的变化。结果 2015年人均费用较2012年增长31%,耗材费用206%,其中手术耗材增长297%;不同医疗组间人均费用最高与最低相差9%,药费相差31%,耗材相差206%,其中手术耗材相差297%;不同年份、不同医疗组间药品,耗材使用等方面均有显著性差异,耗材增长是外科患者费用增长的主要因素。结论通过采取细化各种临床路径,限定耗材种类,规范医师耗材使用等多种措施可以降低患者耗材费用,减轻患者负担。 Objective To find out the main reasons leading to the excessive increase of costs by studying the changes of hospital fee structure and surgical consumables in patients undergoing laparoscopic myomectomy and provide the basis for controlling the excessive growth of medical expenses. Methods A total of 1019 patients undergoing laparoscopic myomectomy in a hospital from 2012 to 2015 were enrolled in this study. The data of hospitalization costs and surgical supplies were analyzed. The changes of expense structure and surgical consumables in different years and between different medical groups were analyzed. . Results The per capita cost in 2015 was 31% higher than that in 2012, with the cost of supplies being 206% and the cost of operating supplies increasing by 297%. The highest and lowest per capita expenses among different medical groups were 9%, 31% and 31% respectively, with a difference of 206% 297% difference between consumables; in different years, different medical groups between the use of drugs, consumables and other aspects were significantly different, consumables growth is the main factor in the growth of surgical patients costs. Conclusions Various measures such as refining various clinical pathways, limiting the types of consumables, and regulating the use of medical consumables can reduce the cost of consumables for patients and reduce the burden on patients.