Analysis of health facilities expenditures by facility parameters

Progress in technology has become possible in every country as well as in the health sector, allowing progress and increasing the quality of health services. These important developments in the health sector have enabled us to achieve international standards first and then to reach an advanced level in the fields of diagnosis, treatment and care throughout our country. These advances in the health sector have led to the intensification of competition in the health sector and the cost-oriented management approach. Rapidly developing medical devices require expertise in this area. The control and responsibility of medical and technical equipment belongs to the clinical engineers working in the healthcare facility. Medical devices are indispensable elements of the health facility operation. Clinical Engineering Services is a unit required for accurate and efficient use / management of medical devices. One of the main objectives of this unit is to ensure that medical equipment and equipment within the healthcare facility are cost-effective and make the maximum contribution to the quality of healthcare service. In this study, cost analysis of spare parts, maintenance-repair service expenses for medical devices in ten different hospitals and four different Oral and Dental Health Centers in Hatay province were carried out. In the examination using cost analysis method, medical device expenditures of health facilities were checked in detail. Analyzes made have evaluated the relationships between the data obtained and the parameters of the health facility subject to the study. The main purpose of this thesis is to establish a medical device expenditure management decision support system for expenditures for medical devices used in health facilities. It is also necessary to determine the relationship between health facility parameters and medical device expenditures. There are ten different hospitals affiliated to the Ministry of Health in Hatay and four different Oral and Dental Health Centers. The Ministry of Health uniform accounting management system, material resources management system and basic health statistics module were used as data collection tool. The Ministry of Health accounting system has about 2500 accounting codes. Expenditures for medical device maintenance have been identified through 12 codes which may be / are related to medical devices. The medical devices in the inventory have been identified from the material resources management system. In the basic health statistics module, information about health facilities was determined. As a result of the study, it was determined that the ratio of total medical device expenditure to medical device cost of the health facilities surveyed was 4.51% for 2015 and 4.01% for 2016. The ratio of the total budget of the health facilities examined to medical device expenditures is determined as 0.89% for the year 2015 and 0.82% for the year 2016. The total number of medical devices in health facilities is determined as 10133 for 2015 and 11344 for 2016. The total price of these devices is 72.710.256,71 TL for the year 2015 and 91.626.169,68 TL for the year 2016. The average age of the medical devices health facilities surveyed was 5.6 for the year 2015 and 5.0 for the year 2016. The highest volume of biomedical species in the review is the radiographic imaging group in 2015 and 2016. The most commonly spent biomedical species is the endoscopy system for the years 2015 and 2016. The biomedical species with the highest spending rate by total biomedical species is the purification / distillation / softening for the year 2015, the tooth scaler device for the year 2016. In the health facilities examined, the largest health facility in terms of the cost of the medical device was determined as Antakya State Hospital for 2015 and Hatay State Hospital for 2016. Antakya State Hospital's total medical device cost for 2015 is 20.626.977,95 TL. The total medical device cost of Hatay State Hospital for the year 2016 is 39.265.302,15 TL. Antakya State Hospital for the year 2015 and Hatay State Hospital for the year 2016 are the health facilities that make the most expenditure on medical devices. When expenditures and cost of the medical device is proportioned, the hospital which has the highest rate is Altınözü State Hospital with 5.66% for 2015 and Dörtyol State Hospital with 5.93% for 2016. The expenditures made are the highest rate when compared to the medical device, and the center of dental health is the Dortyol Oral and Dental Health Center for the years 2015 and 2016. The expenditure rate of the plant is 18.64% in 2015 and 24.25% in 2016. The hospital with the highest average medical device age is Hatay Maternity and Child Diseases Hospital in 2015 and Hassa State Hospital in 2016. The median age of medical device Hatay Maternity and Child Diseases Hospital for the year 2015 is 8.8 years. The median age of medical device Hassa State Hospital for the year 2016 is 6.7 years. In this thesis, the number of beds, the year of service and the role of services are examined in health facilities. The service role is defined as the level of development of the health care facility. The highest level of development was named as A1 and the lowest as E2. Among the facilities under investigation are the Kırıkhan State Hospital, which was opened in 1957 as the oldest health facility in year 2015. Dörtyol State Hospital, which was opened in 1983, is the oldest health facility for the year 2016. The hospital with the highest number of beds is the Iskenderun State Hospital with 600 beds in the A2 service role for the year 2015. For 2016, Hatay State Hospital with 627 beds in A2 service role. The hospital with the highest expenditure on medical devices per bed is Kırıkhan State Hospital with a cost of 3.937,38 TL for the year 2015. Dortyol State Hospital with 2.706.84 TL for the year 2016. Oral and dental health center with the highest expenditure on medical equipment per tooth unit is Hatay Dental Health Center with a cost of 4.383,67 TL for the year 2015. For the year 2016, Dörtyol Oral and Dental Health Center is 6.064,76 TL. In the analyzes made, it was seen that the expenditures increased with the increase of the number of beds of the health facility. When examined in terms of hospital service role, it was observed that group B and C hospital generally had higher bedhead costs than group D and A. It is also observed that bedside costs generally fall in 2015 as the healthcare facility's turnaround year approaches day-to-day. The relationship between the average age of the medical devices in the health facility and the cost per bed of the health facility was also evaluated. However, since the number of samples was small, no evaluation was made. As a result of the data obtained without working, it is seen that medical devices are taken seriously in Hatay and therefore the maintenance and repairs done to the medical devices in the inventory are increased. Controlling these expenditures will allow for better assessment of limited budgetary resources. In order to control spending, it is necessary to know which biomedical species is being spended and where. If biomedical species with high expenditure can be detected, maintenance contracts to be made in the coming years, education if they are caused by usage mistakes, and high costs by changing suppliers and similar applications can be prevented if problems arise from medical device suppliers. If these studies are developed and if the sample size is increased, health facilities in Turkey have the opportunity to compare costs with other healthcare facilities with a bedside role will consist in their service. Health facilities will be able to determine if the expenditure incurred for medical devices is high. Likewise, health facility investors or managers will be able to determine whether the health care facility is causing the year of service and therefore the physical condition of the health care facility to be affected by the use of medical device technology, and then decide which health care facility needs to be renewed. Health facility investors or managers will be able to follow indicators that the expenditure of medical devices per bed will increase or decrease at the change of service role of the health care facility. It will be able to determine at which interval of the average medical device age of the health care facility there are more maintenance, repair and spare parts expenses. In summary, this study will guide health facilities to assess medical device expenditures, compare medical device expenditures with other facilities, determine if their costs are effective, and decide on new investments.