1. Optimal replacement policy in the medical equipment management Czech Republic Czech Technical University in Prague Faculty of Biomedical Engineering Ilya V. Ivlev

2. 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. 3

4. physical life annual costs of the acquisition; annual maintenance costs investment in the hospital 4

5. Create a mathematical model that contains the main components: 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

6. Possible solution requires certain rules: First rule: medical device down time (t dow ) for repair and maintenance should not exceed half time of operation (t op ); Efficiency coefficient is: A. M. Aronov, Biomedical Engineering, 2007 6

7. 7 device down time (t dow ) time of operation (t op ) efficiency coefficient (C eff ) 12530,99 ……… 152390,87 ……… 302240,73 ……… 721820,21 Working days per year = 254 (working year)

8. Second rule: efficiency coefficient C eff during medical device normal service life varies: Fig. C eff variation during medical device service life. C eff Time of use, years I - varies of C eff during normal service life of medical device; II - varies of C eff after double normal service life (if the medical device is still used); III - C eff after making 300% of the resource. 8

9. Third rule: Practical value of C eff over than value determined by the first rule is criterion of final medical device impracticability - THE MEDICAL DEVICE SHOULD BE REPLACED. Time of use, years C eff 9

10. The expectancy economic life of medical equipment: Chen Kang, Chinese J. of Medical Instrumentation, 2009 P 0 - initial price of medical equipment; W - increase in operating costs each year. 10

11. CT scanner: General Electric (HiSpeed CT/e Plus): initial price (P 0 ) $ 190K ; increase in operating costs each year (W) $ 15K 11

12. 1. 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; 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

13. DĚKUJI ZA POZORNOST