Regional Optimal Allocation Of Large Medical Equipment

Large medical equipment is a significant part of health resources, which is thematerial foundation and important auxiliary means at all levels of clinical institutions tocarry out medical work. It improves the level of medical treatment. With the developmentof our country Socioeconomic and medical science, a large number of large medicalequipment is introduced. However, the method of configuration planning which developedby health administrative agencies is lagging behind, and Decision-making with obviousblindness. The repeated purchase and low utilization rate of equipments result in a seriouswaste of medical resources in the region. Analysis large medical equipment configurationin the microscopic and the macroscopic, optimal allocate large medical equipment is animportant task in modern hospital management.This paper takes large medical equipment configuration planning of the countries andareas as reference, and the large medical equipment configuration process as the main line.The large medical equipment configuration process is divided into four parts. They arecurrent situation evaluation, demand forecasting, single medical configuration and areaequipment configuration. The theory and method of configuration of large medicalequipment are analyzed. Combined with the example of B-large medical equipmentconfiguration planning, the results of theoretical research are verified with the actualsituation. Theory and method supports optimal configuration of large medical equipmentare provided. The main research work and conclusion are as follows:(1)Control mechanism of large medical equipment is analyzed. From the relatedmanagement policies of the countries and regions of large medical equipment, SelectB-large medical equipment from A and B large medical equipment as the research object.In accordance with the state of B-large medical equipment planning permission, selectmunicipalities as the study area. According to the guiding ideology of the regionalconfiguration program of large medical equipment, identify the configuration principlesuch as coordination with region economy, function orientation, and so on. The basicconditions that clinical institution must have to configure large medical equipment areclear. Explicit object and research directions of study for future research.(2)From angle of equipment configuration fairness, economy and efficiency, thecomprehensive evaluation of the equipment status is carried out. In accordance with thetheory of fairness and equity in health concept, Lorenz curve, Gini coefficient and Theil-Lindex are used to of analysis the large medical equipment fair situation from the view offairness; In accordance with the principle of objective rationality, economic and practical, according to the equipment depreciation, cost, income and other indicators, Methods ofstatic investment payback period, the profit rate of investment, net present value, internalrate of return are chose to analysis the current economic situation of large medicalequipment from the angle of economics; From the efficiency angle, the use efficiencysituation of the large medical equipment are analyzed, based on statistical data such asYear inspection trips, daily inspection trips, per capita of machine time, the annual boottime, the average starting time. In accordance index selection criteria of objectivity,independence, comparability, the evaluation index system of configuration of largemedical equipment is established, which first layer index including equity, economic,efficiency and supporting of hospital facilities and staff. The advantages and disadvantagesof the commonly used evaluation methods are overviewed. The number of evaluationindexes is much, and most of which are quantitative indicators. Principal componentanalysis is used to evaluate status. Problems are found out through the comprehensiveevaluation, which provide reference for the next step of configuration.(3)The inspection requirements of large medical equipment in the region are predicted.The impact factor of large medical equipment inspection is summarized from two aspectswhich include the regional socio-economic and hospitals. The procedures, principles andcommon methods for demand prediction are introduced. Auto-regression analysis methodis chosen to predict each factor,The inspection amount of large medical equipment is predicted by multiple linearregression method which bases on the historical data and predict results. And exponentialsmoothing method is used to predict the amount of equipment checks. Regard the averageof predict results by two ways as final equipment inspection requirements in order toincrease the credibility of the prediction. A rough the number of the base configuration oflarge medical equipment is estimated which reference to reasonable check passengers of Blarge medical equipment one year in related studies.(4) Optimal configuration of large medical equipment is researched frommicrocosmic aspect. The patients' inspection process in line and queuing systemcharacteristics are analyzed. The rule of inspection queue is determined. The article takesMRI examination of a hospital as an example. The average inspection time is calculatedaccording to the check time of different position. The queue is divided into single queueand a two queue. The M/M/1model and M/M/Cmodel are used to calculate queuesystem indexes of different queue. The result shows that indexes of two queues aresuperior to single queue. Simulation tool of SIMIO is used to simulate queue system. The credibility of the results is validated. The effect of different arrival rates to queuing systemis discussed. The effect of queuing system to establish check and treat center of MRI in thearea is discussed briefly. The result demonstrates that the formation of check and treatcenter can improve efficiency of the equipment. Waiting time of patient examination isshorten.(5)The model of optimal configuration of regional large medical equipment isestablished from the macro aspect. The maximum coverage optimization configurationmodel of regional large medical equipment is established. The goals of the model areimproving configuration fairness and maximizing covering population. The constraints ofthe model include the cost of configuration, and so on. The multi-objective optimizationproblem is transform into single objective optimization problem by subjective weightingmethod. The parameters of the model are discussed. They are the shortest path, theprobability of patients selecting the equipment, equipment prices, check of demand andequipment's maximum coverage distance. Timing optimization model of area large scalemedical equipment is established. The goals of the model are improving the fairness andefficiency of equipment, and reducing distribution cost. The constraints of the modelinclude Gini coefficient, the efficiency of the equipment and the construction of timing.Genetic algorithm is adopted to solve the problem.The main innovations of this paper are as follows:(1) Status evaluation index system of configuration of large medical equipmentestablished which integrates four aspects. They are equipment configuration fairness,economic, the use efficiency and related conditions. Method is provided for tracking thesituation of large scale medical equipment planning. It provides convenience to find out theproblems existing in the original planning.(2)The equipment configuration in individual medical institutions is analyzed frommicrocosmic aspect, which using a M/M/1model and M/M/Cmodel in queuingtheory. The conclusion is drawn that the establishment of the regional check and treatcenter will reduce the waiting time of patient examination. It also proves that theestablishment of area check and treat central is necessity.(3)The model of optimal configuration of regional large medical equipment isestablished from the macro aspect in order to improving configuration fairness andmaximizing covering population. Timing optimization model of area large scale medicalequipment is established in order to improving the fairness and efficiency of equipment,and reducing distribution cost. It offers the method for large medical equipment planning.