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Decision making in management  for large medical equipment     Ilya Ivlev and Peter Kneppo          ilya.ivlev@fbmi.cvut.cz
Number of MRI units per million population                                Source: OECD Health Data
The difference in the availability            of MRI                       41Japan                       MexicoMRI units/m...
Financial losses in health care                   Source: WHO “World health statistics 2010”
WHO: causes of inefficiency and      recommendationsCAUSES OF INEFFICIENCY● EXCESSIVE PURCHASING and use of EQUIPMENT● Fin...
Development of a system for rational choice of large medical equipment
Difficulties in decision making  Suppler                 Objectives of                             Specifi-  policies     ...
Questionnaire for evaluation of experts                                 competence                       Objective evaluat...
Reference table of indices of               argumentation (ka)                                          Level of sources i...
General competence index for a             specific expertshjo; hjs - objective and subjective indiceskа – index of argume...
Private weights of experts
The overall competence of the experts                 0.75       0.67                 0.70                                ...
MAUT;AHP      ELECTRE
MAUT;AHP        ELECTRE       adding newease       alternatives
MAUT;AHP      ELECTRE
MAUT;   AHP              ELECTRE  level of   no hard andpreference   preferences             adding new  ease             ...
MAUT;AHP      ELECTRE
MAUT;    AHP                   ELECTREevaluation of   measurement ofinconsistency       quality    level of     no hard an...
MAUT;AHP      ELECTRE
Aim                     Level 1        Lvl. 2                          Level 3                  Level 4                   ...
Pairwise comparisons
Results of paired comparisons                                      serial number of the specificationsserial number of the...
Mutual dependence of the                                                 characteristics                                  ...
Mutual dependence(network structure)
Ranked by priority list of MRI                  • SIEMENS MAGNETOM                     Aera;                  • SIEMENS MA...
Examination design and the prediction   of the characteristics weights
Summary• Method for experts competence identification.• Defined the raked list of the experts.• AHP method with network el...
Thank youilya.ivlev@fbmi.cvut.cz
Decision making in management for large medical equipment
Decision making in management for large medical equipment
Decision making in management for large medical equipment
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Decision making in management for large medical equipment

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Decision making in management for large medical equipment.

Ilya Ivlev and Peter Kneppo

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Transcript of "Decision making in management for large medical equipment"

  1. 1. Decision making in management for large medical equipment Ilya Ivlev and Peter Kneppo ilya.ivlev@fbmi.cvut.cz
  2. 2. Number of MRI units per million population Source: OECD Health Data
  3. 3. The difference in the availability of MRI 41Japan MexicoMRI units/mill: 43,1 MRI units/mill: 1,5 Source: OECD Health Data
  4. 4. Financial losses in health care Source: WHO “World health statistics 2010”
  5. 5. WHO: causes of inefficiency and recommendationsCAUSES OF INEFFICIENCY● EXCESSIVE PURCHASING and use of EQUIPMENT● Financial drain etc. SOLUTION ● DEVELOPMENT OF SYSTEMS SELECTION AND PROCUREMENT ● Control government expenditure on health care ● Implementing new regulations etc.Source: WHO “The world health report: health systems financing: the path to universal coverage 2010”
  6. 6. Development of a system for rational choice of large medical equipment
  7. 7. Difficulties in decision making Suppler Objectives of Specifi- policies the application cations more than difference in 900purchase price specifications specialization of health facility difficult forheterogeneous information understandinabout the units g Source: XJ., Zhou, How can I Purchase My Dream MRI Scanner?
  8. 8. Questionnaire for evaluation of experts competence Objective evaluation - ho Subjective evaluation - hs Work experience participation in in the problem Job position the problem Total work experience Education Level of Grades Grades Grades Grades Grades (years) areaHead of Expert specializes in the given 1 Ph.D. 0.6 >10 1 >10 1 1organization issue Expert participates in practical Higher work on solving the issue butDeputy head 0.8 education 0.4 10-5 0.8 10-5 0.8 the issue does not belong to 0.8 (master) experts indicated specialization HigherHead of The issue belongs to experts 0.6 education 0.2 <5 0.6 <5 0.6 0.6department specialization (bachelor)Deputy head The issue does not belong toof 0.4 0.3 experts specializationdepartment Golupkov, Е., 1998
  9. 9. Reference table of indices of argumentation (ka) Level of sources influence on the expertsSources of arguments opinion high medium low zeroConducted theoretical analysis 0.3 0.2 0.1 0Work experience 0.5 0.4 0.2 0Summarizing papers by local authors 0.05 0.05 0.05 0Summarizing papers by foreign authors 0.05 0.05 0.05 0First-hand experience with state of the 0.05 0.05 0.05 0problem abroadExperts intuition 0.05 0.05 0.05 0 Fedoraev, S.V., 2010
  10. 10. General competence index for a specific expertshjo; hjs - objective and subjective indiceskа – index of argumentationki – index of familiarity with the problem
  11. 11. Private weights of experts
  12. 12. The overall competence of the experts 0.75 0.67 0.70 0.60Main weighting 0.65 0.57 coefficient 0.60 0.54 0.55 0.49 0.49 0.49 0.50 0.45 0.45 0.40 0 2 4 6 8 Serial number of expert
  13. 13. MAUT;AHP ELECTRE
  14. 14. MAUT;AHP ELECTRE adding newease alternatives
  15. 15. MAUT;AHP ELECTRE
  16. 16. MAUT; AHP ELECTRE level of no hard andpreference preferences adding new ease alternatives
  17. 17. MAUT;AHP ELECTRE
  18. 18. MAUT; AHP ELECTREevaluation of measurement ofinconsistency quality level of no hard and preference preferences adding new ease alternatives
  19. 19. MAUT;AHP ELECTRE
  20. 20. Aim Level 1 Lvl. 2 Level 3 Level 4 Magnetic field Strength Мain magnet Technical features Uniformity Stability Magnetic field Gradient coil systems gradient Slew rate Parallel imaging techniques Number of independent channels (RF coils)choose a new MRI The adequacy of Shimming the selection Size of aperture Ease of use Patient comfort and safety Size of tables Active shielding Safety Noise level Dimensions Compatibility Training Customer support Operator and reference manuals Service contract Remote diagnostics Scientific and Technical level The efficiency of Proposed decision hierarchy use Cost of use for MRI
  21. 21. Pairwise comparisons
  22. 22. Results of paired comparisons serial number of the specificationsserial number of the specifications
  23. 23. Mutual dependence of the characteristics serial number of the specificationsserial number of the specifications Independent characteristics Dependent characteristics
  24. 24. Mutual dependence(network structure)
  25. 25. Ranked by priority list of MRI • SIEMENS MAGNETOM Aera; • SIEMENS MAGNETOM Avanto; • GE HEALTHCARE Optima MR450w; • PHILIPS INTERA; • TOSHIBA1.5 T Vantage Atlas; • PHILIPS Achieva; • PHILIPS Ingenia; • SIEMENS MAGNETOM Espree… etc.
  26. 26. Examination design and the prediction of the characteristics weights
  27. 27. Summary• Method for experts competence identification.• Defined the raked list of the experts.• AHP method with network elements can be applied;• The way how to predict changes of weights.• Web-system for identification of experts preferences.• Defined a list of 16 key parameters.• Algorithm for selection of preferences of experts, processing and evaluation of results.
  28. 28. Thank youilya.ivlev@fbmi.cvut.cz
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