The Research On Allocation And Utilization Efficiency Of Large Medical Equipment In Secondary General Hospitals In One District Of Shanghai

Medical equipments, the main constitution of hospital assets, are important substance foundation for medical care, teaching and research in hospitals. The management of medical equipments becomes a significant part of modern hospital management. Therefore, it is important to continuously improve the allocation and utilization efficiency of medical equipments, to enhance hospital management, to reduce economical burden of diseases and to facilitate the harmonization of the society.Since the Ministry of Health of our country issued the management regulations of large medical equipments, the framework of the equipment management and the quota management system were established in the whole country to guide the device allocation planning. From the utilization point of view, low efficiency and induced demand are the most difficult problems to the health managers.The objective of this study is to analyze on the allocation and utilization efficiency of medical equipment in one district in Shanghai in order to provide the information for the decisions on improving the management of medical equipment, enhancing the effectiveness of governmental financial investment on hospital large medical equipment, and facilitating the allocation and utilization of large medical equipment to meet the need and demand of regional health development.By cross-sectional study, and analysis the allocation and utilization status of large medical equipment of secondary general hospitals in one district in Shanghai, this research focus on the efficiency, cost, safety and suitability of three large medical equipment (MRI, CT and DSA). The core methods of materials are as following:1st:Collect the Statistics Yearbook, reports and other relevant information at home and abroad for nearly a decade.2nd:Investigate the basic information and data of equipments in 5 general secondary hospitals.3rd:Evaluate cases through random sampling by 4 clinical experts. According to the survey, nearly 20% of procurement costs of large medical equipment (>=a million yuan) came from governmental financial input. In recent several years, the special inputs to medical equipment from the district government had been more than 15 millions, accounting for nearly 30% of the total equipment costs in secondary general hospitals. Because of the strong support, the allocation of medical equipments in secondary general hospitals in the district basically met the demand of the regional health development.The process of purchase, utilization and scrap of medical equipment was well managed, whereas the registration rate for utilization and maintain of large medical equipment did not reach 100%, preventive and rehabilitative repair was not enough,10 of the large medical equipment was working with defects and 5 was not used. The maintenance and repair of equipments should be focused on. In addition, Scientific management and use of medical equipment must be concerned to extend period of use.According to the research, CT, Color Doppler and DR had shorter return period and good economic efficiency. The large medical equipment that had longer return period was usually the equipment for auxiliary examination and treatment, such like monitor and surgical navigation systems. These equipments were not cost-effective, but played important roles in the whole medical process.The investigation shows, a part of patients had been checked and treated unnecessary with relevant equipments. In the case with clear indication, hospitals should control the waste of medical resources and reduce the economic burden of patients.The occupational safety of relevant employees should be improved. Currently, the training time and the rate of qualifying examination certificate were low, which would increase the risk of using equipments. In addition, it must be concerned, that a lot of people had Fatigue, chest tightness, palpitation, insomnia, dizziness and headache. The safety of the relevant employees should be ensured. 1. The allocation of large medical equipment met the requirements of the regional health development. Most demands of medical equipment in the next few years are from equipment update and adjustment of functional orientation.2. Scientific, rational, economic and effective ideas should be concerned in the process of using medical equipments. The registration of use and maintenance should be completed. The disable equipment should be maintained or replaced timely to avoid wasting and idling recourses.3. The costs of purchase and maintenance should be controlled, and the favorable maintenance strategy should be selected.4. The proper evaluation system should be established to promote the proper use of large medical equipment.5. The training and assessment of relevant employees should be strengthened, and necessary psychological counseling and intervention should be provided.