Transcript of "Decision making in management for large medical equipment"
Decision making in management for large medical equipment Ilya Ivlev and Peter Kneppo firstname.lastname@example.org
Number of MRI units per million population Source: OECD Health Data
The difference in the availability of MRI 41Japan MexicoMRI units/mill: 43,1 MRI units/mill: 1,5 Source: OECD Health Data
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● 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”
Development of a system for rational choice of large medical equipment
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?
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
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
General competence index for a specific expertshjo; hjs - objective and subjective indiceskа – index of argumentationki – index of familiarity with the problem
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
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.
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 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.