出厂价3万多，医院收28万？西安交大一附院回应“心脏瓣膜谜团”

Core Viewpoint - The Xi'an Jiaotong University First Affiliated Hospital has acknowledged public concerns regarding the treatment of a patient, Li, who passed away after undergoing a complex heart surgery. The hospital has initiated a special task force to investigate the issues raised and has provided a detailed account of the medical procedures and costs involved [1][2]. Summary by Sections Basic Information - Patient Li, a 70-year-old male, was admitted for treatment of multiple severe health conditions, including heart valve disease and hypertension, and underwent a transcatheter aortic valve replacement (TAVR) on November 21, 2020. Following complications, he was transferred out of the hospital on December 8, 2020, and unfortunately passed away on January 4, 2021. The family has raised concerns and filed a lawsuit against the hospital, which is currently under review [2]. Investigation Findings - Medical Costs and Valve Details: The total medical expenses for the patient amounted to 613,200 yuan, with 293,200 yuan covered by insurance and 320,000 yuan paid out-of-pocket. The cost of the artificial heart valve was 280,000 yuan, representing 87.5% of the out-of-pocket expenses [2]. - Compliance in Procurement and Charges: The heart valve and related equipment were procured through a public bidding process, with the hospital adhering to the "zero markup" policy mandated by the state. The family was informed of the costs and risks prior to the procedure, and a consent form was signed [3]. - Surgical Materials and Charges: During the TAVR procedure, a second valve was implanted due to the first valve's misplacement, and the hospital charged for each valve without double billing [3]. Medical Supplies and Charges - The "6,000 yuan gauze" referred to in public discourse was actually absorbable hemostatic gauze, essential for controlling bleeding during surgery. The hospital used two packages of this gauze and one set of absorbable vascular sealing glue, with all charges compliant with pricing regulations [4]. Insurance Fund Usage - An audit by the Xi'an Medical Insurance Fund Management Center identified 26 instances of general violations related to insurance fund usage during the patient's hospitalization, totaling 75,060.4 yuan. The violations included improper billing practices and the use of medications that exceeded insurance coverage limits [5]. Rectification Measures - In response to the identified issues, the hospital has committed to rectifying management deficiencies and has implemented a smart monitoring system for insurance billing. The hospital expressed understanding of the family's grief and is cooperating with investigations to clarify facts and responsibilities [6]. Additional Context - The Xi'an Jiaotong University First Affiliated Hospital is a comprehensive hospital with a history dating back to 1937, currently equipped with 3,600 beds and over 7,000 staff members. The hospital is recognized for its advanced capabilities in cardiovascular disease treatment and has conducted numerous complex surgeries [11].