Board of Directors, Sint Maartenskliniek, Nijmegen, The Netherlands
Institute for Management Research, Radboud University, Nijmegen, The Netherlands.
BMJ Open. 2020 Feb 18;10(2):e035174. doi: 10.1136/bmjopen-2019-035174.
To assess whether there is a difference between the net prices of medical products used by Dutch hospitals and, if there is, how this difference can be explained.
Cross-sectional self-administered electronic survey.
We surveyed the prices paid for 17 commonly used medical products, such as pacemakers, gloves and stents in 38 Dutch hospitals (including general, specialised and academic hospitals) in 2017. Hospitals voluntarily and anonymously provided these data and received a personalised free benchmark tool in return. This tool provides information about the variance in prices of the medical products they buy.
38 out of 79 hospitals entered and completed the study.
Actual price paid excluding Value Added Tax (VAT) per item, the order size per year, total spending for an assortment group and total spending for all products purchased from a specific supplier were measured.
We found large price variations for the medical products surveyed (average coefficient of variation of 71%). In general, these differences were hard to explain (average R of 26%). Only purchasing volume (for 8 out of 17 products) was significantly associated with the net price paid by a hospital. Total spending for an assortment group (in euros with a specific supplier) and total spending (for all products in euros with a specific supplier) were not related to the net price paid.
We conclude that only purchasing volume is associated with lower prices paid. Total spending for an assortment group and total spending for all products purchased from a specific supplier are not. These results are in stark contrast to expectations based on economic theory. Other sources of differences in bargaining power might explain these findings. Further research might involve comparing prices across countries.
评估荷兰医院使用的医疗产品的净价是否存在差异，如果存在，差异的原因是什么。
横断面自我管理的电子调查。
2017 年，我们调查了 38 家荷兰医院（包括综合医院、专科医院和学术医院）使用的 17 种常用医疗产品（如起搏器、手套和支架）的支付价格。医院自愿匿名提供这些数据，并收到一个个性化的免费基准工具作为回报。该工具提供了有关他们购买的医疗产品价格差异的信息。
79 家医院中有 38 家参与并完成了研究。
测量了每个项目的不含增值税（VAT）的实际支付价格、每年的订单规模、一组产品的总支出和从特定供应商购买的所有产品的总支出。
我们发现调查的医疗产品价格差异很大（平均变异系数为 71%）。一般来说，这些差异很难解释（平均 R 为 26%）。只有采购量（17 种产品中的 8 种）与医院支付的净价显著相关。特定供应商的一组产品的总支出（以欧元计）和特定供应商的所有产品的总支出（以欧元计）与净价无关。
我们得出结论，只有采购量与较低的支付价格相关。特定供应商的一组产品的总支出和从特定供应商购买的所有产品的总支出与支付的净价无关。这些结果与基于经济理论的预期形成鲜明对比。其他讨价还价能力的差异来源可能解释了这些发现。进一步的研究可能涉及比较不同国家的价格。
