Methodology for the replacement of high-tech medical equipment, applying economic evaluation and business process analysis

Abstract

Introduction: decision-making about when MEs replacement should take place is a traditional hospital
challenge due to its high cost for health institutions and the risk it could represent in any existing medical
care practice or procedure. The Health Technology Assessment (HTA) for MEs allows prioritizing
its replacement in a hospital. Most MEs replacement evaluations focus solely on cost analyses;
however, these evaluations do not consider the full role that MEs play in the healthcare processes
In this sense, the investment cost of the equipment and other critical factors to evaluate the process,
costs and productivity must be considered either. Objective: this paper proposes a methodology to
support the decision to replace or not MEs, based on economic evaluation and business process
analysis. Material and methods: cost-effectiveness, intermediate effectiveness, and process workflow
analysis are applied. The best MEs alternative is identified through a decision-tree and time indexes,
productivity and performance indicators. This methodology was tested by evaluating, as a case
study, whether it is necessary to replace the sterilizers/washing machine that are in the last stage
of their lifecycle, operating in our Central Sterilization Units. Results: the methodology presented
in this paper has a high potential to detect delays, measure efficiency, productivity and costs of the
processes, and even, based on the workflow analysis, to be able to improve the processes where
MEs are operating. Conclusion: furthermore, HTA-based MEs replacement methodology allows to
generate cost-effective information for decision-making at the management level.