某醫院購置貴重儀器之系統性評估制度及應用案例

Establishment and Application of Systematic Evaluation Model on Hospital Valuable Medical Devices Purchase

在健保總額政策壓力與同業激烈競爭下，各醫院不但要提升服務品質，爭取更多的自費項目，更需要壓低成本以達到收支平衡的財務狀況。現在醫療科技發展快速，醫療儀器日新月異，相當多醫院不斷購置新穎的貴重儀器，以滿足病患及市場的需求，不過購置貴重儀器的支出也同時造成醫療成本高漲。因此，醫院應制定一套貴重儀器評估辦法，包括儀器引進前的預算評估、廠商報價和效益評估試算的採購評估，以及最易被醫院管理人員忽略的定期成效評估追蹤，以瞭解貴重儀器是否確實達到預期效益，並針對評估結果提出改善措施。本文以個案方式，呈現個案醫院購置昂貴儀器時的系統性評估制度，並輔以兩件個案醫院應用實例說明，藉以提供其他醫療院所作為評估貴重儀器參考。

The complexity of health care industry under National Health Insurance and also the peer competition makes the purchase and usability of valuable medical devices an important issue in hospital management for both the purposes of quality improvement and cost control. The explosive development of technology has dramatically improved health care techniques. Many health care administrators purchase expensive medical devices to satisfy patients and meet the market’s needs, but at the same time it results in the increasing the medical cost. Therefore, a Systematic Evaluation Model for the purchase of valuable medical devices in hospitals was established in this study according to thoroughness, fairness, cost effectiveness and clarity. This Systematic Evaluation Model is proposed to find out whether the valuable medical devices have achieved the expected cost effectiveness, and further improvement is necessary according to the assessment. It has offered a process to conduct budget evaluation before purchasing, costs comparison, and periodically economic benefit analysis which are often neglected by hospital administrators. This study has also demonstrated the application of Systematic Evaluation Model in two hospitals by case reports in order to provide the consultation for other hospitals in purchasing the valuable devices. It is recommended that a systematic evaluation should be performed on hospital procurement when administrators purchase valuable medical devices.