Czech Republic Czech Technical University in Prague Faculty of Biomedical Engineering Ilya V. Ivlev Decisive factor: the state of equipment used in hospitals Problematic issues: the standard service life of the majority of medical equipment has already expired Caution: use of this equipment can become hazardous to both - patients and medical personnel 2 3 annual maintenance costs investment in the hospital ↑ ↓ physical life ↓ ↑ annual costs of the acquisition; 4 Create a mathematical model contains the main components: that 1. the cost of procurement of medical equipment and annual costs of repair; 2. the annual operating costs (mainly including the costs of consumables and power consumption, etc.) 5 Possible solution requires certain rules: First rule: medical device down time (tdow) for repair and maintenance should not exceed half time of operation (top); Efficiency coefficient is: 6 A. M. Aronov, Biomedical Engineering, 2007 Working days per year = 254 (working year) device down time (tdow) time of operation (top) efficiency coefficient (Ceff) 1 … 15 … 30 … 72 253 … 239 … 224 … 182 0,99 … 0,87 … 0,73 … 0,21 7 Second rule: efficiency coefficient Ceff during medical device normal service life varies: Fig. Ceff variation during medical device service life. Ceff Time of use, years I - varies of Ceff during normal service life of medical device; II - varies of Ceff after double normal service life (if the medical device is still used); III - Ceff after making 300% of the resource. 8 Third rule: Practical value of Ceff over than value determined by the first rule is criterion of final medical device impracticability THE MEDICAL DEVICE SHOULD BE REPLACED. Ceff Time of use, years 9 The expectancy economic life of medical equipment: P0 - initial price of medical equipment; W - increase in operating costs each year. 10 Chen Kang, Chinese J. of Medical Instrumentation, 2009 CT scanner: General Electric (HiSpeed CT/e Plus): • initial price (P0) ≈ $190K; • increase in operating costs each year (W) ≈ $15K 11 there are different approaches to determining the optimal duration of life (physical, economic) of medical equipment; 2. application of mathematical models helps more carefully and dispassionately manage of equipment; 1. 3. no models that take into account most of the influencing factors and the specifics of medical equipment; 4. do not resolved the question of what is amortization. 12 DĚKUJI ZA POZORNOST