| BackgroundA very important aspect of improving the medical quality of public hospitals is to have a higher level of medical equipment and a more perfect medical equipment management system.Medical equipment has the characteristics of high technical level and various project functions,so their investment can provide sufficient material guarantee for high-quality medical service and technology.At the same time,from the perspective of the hospital,due to the rapid development of diagnosis and treatment technology and the continuous shortening of the update cycle of medical equipment,the purchase of new medical equipment by the clinical departments of the hospital helps to carry out new projects and new technologies,meet the development needs of the hospital,enhance the competitiveness of the hospital,and improve the reputation and social influence of the hospital.The purchase of medical equipment is one of the important contents of hospital management.How to make good use of the annual financial allocation and the limited self raised funds of the hospital to purchase medical equipment scientifically and reasonably is an urgent problem to be solved.Proper purchase of equipment can not only avoid the waste of purchase funds and realize the optimal allocation of purchase funds,but also improve the treatment level of the hospital and attract more patients to seek medical treatment,which is conducive to the healthy development of the hospital.Therefore,the hospital needs a scientific equipment purchase demonstration scheme and index system.ObjectiveOn the basis of summarizing and analyzing the existing problems of the equipment purchase demonstration in S Hospital of Traditional Chinese Medicine(TCM),this study intends to establish a new set of demonstration scheme and index system of clinical medical equipment purchase based on evidence-based decision tree and expert consultation,and empirically analyze its effectiveness,so as to provide reference for improving the decision-making management of clinical equipment purchase in S Hospital of TCM.MethodsBased on the qualitative interviews with 5 persons in charge of clinical departments and 5 persons in charge of administrative departments in S Hospital of TCM,this paper aims to understand their views and suggestions on the demonstration of the purchase of clinical medical equipment in S Hospital of TCM,and summarize the positive aspects and shortcomings of the current scheme.According to the characteristics of the purchased equipment,the evidence-based decision trees of new equipment,additional equipment and replacement of old equipment are established respectively,and the demonstration index system of equipment purchase is determined by two rounds of Delphi expert consultation on 30 selected experts.In order to verify the effectiveness of the scheme,through validation analysis,the paper compares the actual benefit of the equipment after one year of normal use with the benefit evaluation before purchase,and measures whether the evaluation result of the new scheme is closer to the actual benefit;through specific cases,it shows the steps of the new scheme in the demonstration of equipment purchase.ResultsThrough qualitative interviews,it is found that the advantages of the current purchase scheme of equipment demonstration in S Hospital of TCM are:to understand the use of equipment in peer hospitals and carry out multi-dimensional demonstration.The shortcomings are:there is no classification of newly purchased equipment;the impact of equipment purchase on department construction is ignored;single department audit is prone to bias and subjectivity;the opinions of department head are not considered;the demonstration index does not consider the scientific research benefits of equipment.A total of 30 experts participated in Delphi expert consultation.The enthusiasm of experts in the first round of consultation was 93.75%,and that in the second round was 100%.The judgment degree(CA),familiarity degree(CS)and authority coefficient(CR)of the first and second rounds of expert consultation were 0.93 and 0.94,0.83 and 0.88 respectively.The W value of two rounds of expert consultation was between 0.085 and 0.132,and the corresponding p value was less than 0.05,with statistical difference.The final establishment of equipment purchase demonstration index system:the index dimension in the new scheme covers the basic conditions,scientific evidence,basic information,expected benefit and original benefit of equipment use.There are 5 first level indicators and 19 second level indicators for new equipment,6 first level indicators and 16 second level indicators for new equipment,and 2 first level indicators and 3 second level indicators for old equipment.The validation analysis is to select 8 types of equipment into the new equipment purchase demonstration index system for evaluation,and compare with the actual benefits of the equipment used for one year;it is found that except for one type of equipment,the prediction results of the other 7 types of equipment are completely consistent with the actual results.After the demonstration of the new purchase scheme,it is suggested to purchase the three-dimensional dynamic interference electrotherapy instrument in the specific case analysis.Conclusions and suggestionsConclusion:(1)there are some problems in the original demonstration scheme for the purchase of clinical medical equipment in S Hospital of TCM,such as not classifying the equipment,ignoring the scientific research benefits of the equipment,and demonstrating by a single department;(2)the new scheme is presented in the form of evidence-based decision tree,and the indicators have more dimensions for the evaluation of the equipment;(3)the evaluation results of the original scheme in S Hospital of TCM are compared with the results after one year of normal use of the equipment in 2019 Compared with the actual results,it is found that the prediction of the number of users and benefits of some equipment is inconsistent with the actual situation;(4)the empirical analysis shows that the equipment purchase demonstration scheme constructed in this study is effective..Based on the above research conclusions,the following suggestions are proposed:(1)to accurately evaluate the use of medical equipment based on the number of people;(2)to accurately evaluate the use of medical equipment.(4)Pay attention to the evaluation of scientific research benefit of equipment. |
