Purchasing high-cost medical devices and equipment in hospitals: a systematic review

Hinrichs, Saba; Ditewig, Bor; Boulding, Harriet; Chalkidou, Anastasia; Erskine, Jamie; Shokraneh, Farhad

doi:10.1136/bmjopen-2021-057516

Cited by 19 publications

(6 citation statements)

References 45 publications

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“…Since the BCEL has to work in a multidisciplinary team 20 and be able to dialogue with different stakeholders from various backgrounds, they require expertise to cover all the aspects of the project, from public health to project management, while also considering clinical aspects, hospital design, infrastructure, installation, MDs design and technology. 21 The assessment of the local capacities and conditions is a key element in the work of the BCEL to:…”

Section: Discussionmentioning

confidence: 99%

Sustainable procurement of medical devices in an international context - Part 3

Di Virgilio,

Becerra Posada,

Bouchard Saindon

2024

GlobalCE

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Background and Objectives This article is the third in a series of three manuscripts published in this journal. It aims to describe how sustainable procurement of medical devices (MDs) can be implemented in operational projects in the context of developing countries. It also further details how the biomedical/clinical engineer lead (BCEL) in charge of technical support during the MD procurement process can apply sustainability principles and concepts of value-based procurement. Material and Methods Based on the authors’ experience of more than 20 years in procurement projects and implementation of MDs, the role of the BCEL will be developed from a theoretical point of view with the description of the second and third pillars of a sustainable purchase following the needs assessment: the assessment of existing conditions along with local capacities and the evaluation of the use conditions during the lifetime of the medical equipment. The application of these principles in operational projects will be further discussed by analyzing literature and lessons learned from projects implemented in developing countries. Results/Proposal The BCEL has a key role in the sustainable procurement of MDs to design the technical specifications of the goods, related services, and post-sales conditions to maximize the benefit of the investment. As the specialist can analyze the local existing conditions and capacities while ensuring efficient use of the MDs during their lifespan, they can contribute to a sustainable implementation of MDs in developing countries. The BCEL shall also be able to analyze the local and international markets to find all possible technological solutions that meet the needs, local conditions, and capacities and ensure quality use during the lifespan of the purchased MD. The BCEL shall have competencies in identifying all the risks related to the use of the MD from the safety risks linked to its installation, use, and maintenance to the sustainability risks linked to obtaining the conditions that guarantee the use of the device and maintaining them as long as possible. Examples of these conditions include the presence of qualified and trained users, availability of maintenance and consumable budgets, availability and maintenance of infrastructure conditions (access, electrical power, water, drainage, medical gasses, etc.), and last but not least, presence of patients requiring a diagnosis or treatment using the purchased MD who were identified during the evaluation of the first pillar: a sound needs assessment. Conclusion As an evolution of the BCEL’s traditional biomedical and clinical engineering work, he/she shall assume the responsibility to guarantee the sustainability of the MD purchase. This quality assurance and control role is achieved by a sound theoretical background knowledge based on the three sustainable procurement pillars: the needs, existing and lifetime use conditions assessments, the analysis of the local and international markets, and a broad understanding of sustainability risks.

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Section: Discussionmentioning

confidence: 99%

Sustainable procurement of medical devices in an international context - Part 3

Di Virgilio,

Becerra Posada,

Bouchard Saindon

2024

GlobalCE

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“…This financial barrier can be incredibly challenging for smaller hospitals and healthcare facilities with limited budgets. To address this, healthcare institutions may explore options such as group purchasing agreements, financing arrangements, or partnerships with more extensive facilities to make robotic surgery more accessible [59].…”

Section: Cost and Accessibilitymentioning

confidence: 99%

Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers

Reddy,

Gharde,

Tayade

et al. 2023

Cureus

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Robotic surgery, a groundbreaking advancement in medical technology, has redefined the landscape of surgical procedures. This comprehensive overview explores the multifaceted world of robotic surgery, encompassing its definition, historical development, current applications, clinical outcomes, benefits, emerging frontiers, challenges, and future implications. We delve into the fundamentals of robotic surgical systems, examining their components and advantages. From general and gynecological surgery to urology, cardiac surgery, orthopedics, and beyond, we highlight the diverse specialties where robotic surgery is making a significant impact. The many benefits discussed include improved patient outcomes, reduced complications, faster recovery times, cost-effectiveness, and enhanced surgeon experiences. The outlook reveals a healthcare landscape where robotic surgery is increasingly vital, enabling personalized medicine, bridging healthcare disparities, and advancing surgical precision. However, challenges such as cost, surgeon training, technical issues, ethical considerations, and patient acceptance remain relevant. In conclusion, robotic surgery is poised to continue shaping the future of health care, offering transformative possibilities while emphasizing the importance of collaboration, innovation, and ethical governance.

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“…Medical device purchasing decisions are further complicated by the fact that they are often made by multi-disciplinary committees, where participants from different functions may have conflicting goals, partly due to professional backgrounds or formal and informal incentive structures (Atilla et al ., 2018; Hinrichs-Krapels et al ., 2022; Miller et al ., 2019). Those participating in medical purchasing committees function as, essentially, agents on behalf of the hospital organisation.…”

Section: Introductionmentioning

confidence: 99%

Realising the promise of value-based purchasing: experimental evidence of medical device selection

Matinheikki,

Kenny,

Kauppi

et al. 2024

IJOPM

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Purpose Despite the unparalleled importance of value within healthcare, value-based models remain underutilised in the procurement of medical devices. Research is needed to understand what factors incentivise standard, low-priced device purchasing as opposed to value-adding devices with potentially higher overall health outcomes. Framed in agency theory, we examine the conditions under which different actors involved in purchasing decisions select premium-priced, value-adding medical devices over low-priced, standard medical devices.Design/methodology/approach We conducted 2 × 2 × 2 between-subjects scenario-based vignette experiments on three UK-based online samples of managers (n = 599), medical professionals (n = 279) and purchasing managers (n = 449) with subjects randomly assigned to three treatments: (1) cost-saving incentives, (2) risk-sharing contracts and (3) stronger (versus weaker) clinical evidence.Findings Our analysis demonstrates the harmful effects of intra-organisational cost-saving incentives on value-based purchasing (VBP) adoption; the positive impact of inter-organisational risk-sharing contracts, especially when medical professionals are involved in decision-making; and the challenge of leveraging clinical evidence to support value claims.Research limitations/implications Our results demonstrate the need to align incentives in a context with multiple intra- and inter-organisational agency relationships at play, as well as the difficulty of reducing information asymmetry when information is not easily interpretable to all decision-makers. Overall, the intra-organisational agency factors strongly influenced the choices for the inter-organisational agency relationship.Originality/value We contribute to VBP in healthcare by examining the role of intra- and inter-organisational agency relationships and incentives concerning VBP (non-) adoption. We also examine how the impact of such mechanisms differs between medical and purchasing (management) professionals.

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Purchasing high-cost medical devices and equipment in hospitals: a systematic review

Cited by 19 publications

References 45 publications

Sustainable procurement of medical devices in an international context - Part 3

Sustainable procurement of medical devices in an international context - Part 3

Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers

Realising the promise of value-based purchasing: experimental evidence of medical device selection

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