Rahmani Keyvan, Karimi Saeed, Raeisi Ahmad Reza, Rezayatmand Reza
Department of Health Services Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Med J Islam Repub Iran. 2022 Apr 23;36:40. doi: 10.47176/mjiri.36.40. eCollection 2022.
Despite the fact that medical equipment is critical for providing good health services and also incurs significant expenditures for the health system, little is known about how to procure it effectively. To date, only a few comparative studies on the procurement framework for medical equipment between nations have been conducted. Thus, the purpose of this study was to examine this issue between the leading countries. To conduct this comparative study, Canada, the United Kingdom, Australia, Spain, Italy, Turkey, Thailand, and Iran were selected. Medical devices, medical equipment, procurement, purchasing, and acquisition were keywords considered to search PubMed, ProQuest, Web of Science, Scopus, Science Direct, and Google scholar databases. Also, the websites of the related organizations, such as the World Health Organization (WHO), the World Bank, and the Ministry of Health of respective countries were searched for the gray literature. Providing information about the procurement framework and availability of evidence in the English language was considered as the inclusion criteria and the lack of access to full texts, letters, and commentary article designs were the exclusion criteria. The results were summarized and reported using comparative tables. Most of the countries involved in this study are trying to align procurement activities with national health care priorities. In view of this, there is a trend toward centralized procurement, especially in Italy, Spain, England, Italy, Canada, and Iran. While a range of actors participate in the procurement process, a greater role for physicians and patients is necessary to be defined to meet patient needs. Moving from price-based approaches to value-based approaches is in the agenda to consider a broader range of criteria to achieve value for money and support patient access to innovations. Most of the countries have reorganized the mechanism of medical equipment procurement. The price of products is the important factor, and recently the value factor has become more important in procurement. Reinforcing the role of decision-making teams and hospital committees in the procurement of medical equipment is suggested. Further studies are needed on the application of value-based approaches to evaluate their effects in hospitals.
尽管医疗设备对于提供优质医疗服务至关重要,同时也给卫生系统带来了巨额支出,但对于如何有效采购医疗设备却知之甚少。迄今为止,仅开展了少数关于各国医疗设备采购框架的比较研究。因此,本研究的目的是考察主要国家之间的这一问题。为进行这项比较研究,选取了加拿大、英国、澳大利亚、西班牙、意大利、土耳其、泰国和伊朗。将医疗设备、医疗器械、采购、购买和购置作为关键词,用于检索PubMed、ProQuest、科学引文索引、Scopus、Science Direct和谷歌学术数据库。此外,还搜索了世界卫生组织(WHO)、世界银行以及各国卫生部等相关组织的网站,以查找灰色文献。将提供英文的采购框架信息和证据可用性作为纳入标准,将无法获取全文、信函和评论文章设计作为排除标准。结果通过比较表进行总结和报告。本研究涉及的大多数国家都在努力使采购活动与国家医疗保健优先事项保持一致。鉴于此,存在集中采购的趋势,尤其是在意大利、西班牙、英国、加拿大和伊朗。虽然一系列行为体参与采购过程,但有必要明确医生和患者发挥更大作用,以满足患者需求。从基于价格的方法转向基于价值的方法已提上议程,以便考虑更广泛的标准,实现性价比并支持患者获取创新成果。大多数国家已对医疗设备采购机制进行了重组。产品价格是重要因素,而近来价值因素在采购中变得更为重要。建议加强决策团队和医院委员会在医疗设备采购中的作用。需要进一步研究基于价值的方法在医院中的应用及其效果。