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Decision making in management for large medical equipment
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Transcript of Decision making in management for large medical equipment
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Number of MRI units per million population
Source: OECD Health Data
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The difference in the availabilityof MRI
JapanMRI units/mill: 43,1
41
MexicoMRI units/mill: 1,5
Source: OECD Health Data
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Financial losses in health care
Source: WHO “World health statistics 2010”
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WHO: causes of inefficiency and recommendations
CAUSES 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”
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Development of a system for rational choice of large medical equipment
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Difficulties in decision making
Suppler policies
difference in purchase price
heterogeneous information
about the units
Objectives of the application
specialization of health
facility
Specifi-cations
more than 900
specifications
difficult for understandin
g
Source: XJ., Zhou, How can I Purchase My Dream MRI Scanner?
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Questionnaire for evaluation of expert's competence
Golupkov, Е., 1998
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Reference table of indices of argumentation (ka)
Fedoraev, S.V., 2010
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General competence index for a specific experts
hjo; hj
s - objective and subjective indiceskа – index of argumentationki – index of familiarity with the problem
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Private weights of experts
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The overall competence of the experts
0 1 2 3 4 5 6 7 8 90.40
0.45
0.50
0.55
0.60
0.65
0.708.00
7.006.00
5.00
4.00 3.00 2.00
1.00
Serial number of expert
Mai
n w
eigh
ting
coe
f-fic
ient
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AHPMAUT;
ELECTRE
ease
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AHPMAUT;
ELECTRE
ease adding new alternatives
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AHPMAUT;
ELECTRE
adding new alternatives
no hard and preferences
ease
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AHPMAUT;
ELECTRE
adding new alternatives
no hard and preferences
ease
level of preference
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AHPMAUT;
ELECTRE
adding new alternatives
no hard and preferences
measurement of quality
ease
level of preference
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AHPMAUT;
ELECTRE
adding new alternatives
no hard and preferences
measurement of quality
ease
level of preference
evaluation of inconsistency
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AHPMAUT;
ELECTRE
ease
level of preference
evaluation of inconsistency
qualitative characteristics
adding new alternatives
no solid opinion
measurement of quality
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Proposed decision hierarchy for MRI
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Pairwise comparisons
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Results of paired comparisons
serial number of the specifications
seria
l num
ber o
f the
spe
cific
ation
s
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Mutual dependence of the characteristics
serial number of the specifications
seria
l num
ber o
f the
spe
cific
ation
s
Independent characteristicsDependent characteristics
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Mutual dependence(network structure)
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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.
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Examination design and the prediction of the characteristics weights
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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.