Development of an admission criterion framework for high-cost medical consumables in governmental hospitals: a systematic review.

BACKGROUND: High-cost medical consumables (HMCs) have emerged as significant economic and technological challenges for numerous national healthcare systems. Governmental hospitals play an indispensable role in many national health systems, closely linked to the evaluation of admissions and the management of procurement for HMCs. Nevertheless, many governmental hospitals face avoidable management risks due to the lack of a decision-making tool. In response, we conducted a systematic review to establishing a framework for the admission criteria of HMCs. This framework aims to enhance their effective utilization and maximize economic, clinical, and social benefits. METHODS: In accordance with a systematic review protocol developed for our study, we conducted comprehensive searches in the PubMed, Web of Science, and Embase databases to identify all correlation studies conducted prior to December 31, 2021. Subsequently, two independent reviewers performed a two-round screening process, resulting in the inclusion of 23 articles in our study. Finally, a third reviewer meticulously examined the selected indicators and contributed to the development of the final criterion framework. RESULTS: The criterion framework was established with 7 first-level indicators and 23 s-level indicators. Among the first-level indicators, "Clinical Benefit" held the highest significance, with a combined weight of 1.606, followed by "Economic Value" and "Organizational Impact" at 1.497 and 1.159, respectively. At the second level, "Safety" and "Efficacy" carried equal weight in the decision-making tool, with combined weights of approximately 1.300 each and a standard combined weight of 0.130. CONCLUSION: This admission criteria framework serves as a vital decision-making tool for managing admissions and highlights several crucial evaluation indicators. Economic considerations emerge as the principal determinant in HMCs procurement decisions. Consequently, healthcare managers and decision-makers are recommended to give precedence to value-based healthcare and evidence-based procurement practices. In the long term, governmental hospitals must grapple with the challenge of judiciously allocating limited resources to maximize both social and economic benefits.

Challenges and countermeasures for China's centralised volume-based procurement policy in healthcare.

To reduce the cost of healthcare expenditures in China, the government has developed a centralised volume-based procurement (CVBP) policy for medicines and medical consumables. Based on tracking the development history of centralised procurement in China, this study explores China's CVBP model. By comparing the centralised procurement models and healthcare expenditure data among China, the United States (U.S), the United Kingdom (UK), and Singapore, we find that China still faces many challenges in implementing the CVBP policy. The main challenges are as follows. First, the policy cannot be guaranteed the effectiveness of implementation without a well-coordinated regulatory mechanism. Second, the CVBP rules and quality evaluation standards are imperfect. Third, the interests of healthcare companies cannot be guaranteed. Fourth, the policy affects the benefits of medical institutions, and the government has not built a compensation mechanism for medical institutions. Fifth, it poses a challenge to the operational capacity and innovation level of Chinese companies. Therefore, this paper posits a three-stage strategy and nine measures that could benefit China's progress in implementing the CVBP policy.

[Information Construction of Hospital Medical Consumables Management Based on SPD Mode].

To change the traditional hospital medical supplies rough management mode, the hospitals build an information material management platform which combines suppliers and hospitals, information systems and smart devices, clinical needs and professional operations innovatively. Finally, a lean management system called SPD is formed under the guidance of supply chain integration and supported by supply chain management theory and information technology. It has realized the whole process of consumables circulation information traceability, intelligent service in the hospital, and refined management of consumption settlement. The application of SPD in hospitals effectively improves the informatization level and overall operation efficiency of medical consumables management which is an important part of hospital information construction.

[Management Research of Secondary Warehouse of Medical Consumables in Operating Room by Using TRM Method under Support of Smart Healthcare].

OBJECTIVE: To explore the application effect of the team resource management (TRM) mode in the management of the secondary warehouse of medical consumables in the operating room based on the support of smart healthcar. METHODS: Using the TRM management method， a new mode of intelligent management of medical consumables in the operating room was implemented to form a complete closedloop management process of medical consumables through the unique identification (UDI) and radio frequency identification (RFID) scanning technology of smart medical. RESULTS: The average purchase amount of high-value consumables for each operation in the operating room of the hospital decreased by 6.2%, the proportion of low-value consumables used decreased by 32%, and the efficiency of supplier distribution increased by 11.7% in 2021. The cumulative reduction in medical costs is more than 40 million CNY. CONCLUSIONS: Based on the new management model of the secondary warehouse of medical consumables in the operating room by using the TRM method under the support of smart healthcare, the team cooperation has been strengthened, and the management level of medical consumables in the operating room has been effectively improved.

[Design and Implementation of Medical Consumables Management Information Systems Based on Cloud Server].

There are common problems in realistic medical consumables management such as inconsistent material names, irregular billing, extensive management of sub-warehouse. It is necessary to use information systems to achieve full-process, refined, traceable management of medical consumables. A cloud-based information management system of medical consumables is introduced, which connects consumables access, acceptance, consumption and settlement by matching UDI code, charge code and medical insurance code. The system connects to external systems such as charging system. The system realizes traceable management of full-process from manufacture, supplier to hospital material management department, and finally to consumption department. The management efficiency of medical consumables supply chain is improved.

[Exploration and Thinking on Fine Management of Cost Accounting of Medical Consumables].

With the gradual advancement of The Reform Plan to Control High-value Medical Consumables published by the State Council, the reform policies such as purchase with quantity, charging consumables" zero bonus" were born, the operating pressure of medical institutions on medical consumables increased sharply, and the fine cost accounting management demands were improving. Due to the manage features of medical consumables, this will lead to the inaccurate and cross-cycle of cost accounting. In order to achieve the refined cost accounting management, the related business system and process adjustment are studied.

[Inquiry of Application Value about Medical Consumables Unique Device Identifier (UDI) in Internet of Things].

OBJECTIVE: To discuss how to implement and promote the lean management of medical devices life cycle through establishing medical device UDI. METHODS: Discuss the application of UDI on medical consumables lean management by relying on the construction of medical device UDI system in our country, and summarize the pilot experience of implanted medical devices in Shanghai. RESULTS: Improve the application value of UDI in medical device Internet of Things through analyzing the present situation of implanted medical device and further strengthen the UDI application standardization. CONCLUSIONS: Form the interconnection and mutual recognition during medical device life cycle and reduce the input of product cost and resource consumption in our country through establishing a more standardized and effective UDI circulation system.

[Application Study of Medical Consumables Supply Chain Reengineering in Hospitals Based on SPD].

The supply chain management of medical consumables in hospitals is an important guarantee for the improvement of clinical diagnosis and treatment. It requires continuous re-engineering and optimization on procurement and supplier management, costs and efficiency of daily operation. Based on the practical case of Shanghai Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital, the study discusses the practical path and key points as well as improvement results in hospital medical consumables supply chain re-engineering via SPD model. Also, the research can provide references on medical consumables supply chain management to large and medium-size hospitals.

[Medical Consumable Management System Research under the New Situation].

With the continuous improvement of the difficulty of surgery, we need to investigate and analyze the current situation, to understand the structure and related attributes of medical consumables. Rely on the information construction of medical consumables; Improve the supervision method and further improve the refined management effect; Establish multi-modal procurement management; Improve management methods; Maximize the benefits of transformation structure and study the trace management of medical consumables in the key areas of the hospital's full life process at the same time. Provide data decision-making services for hospitals through the early warning management of medical consumables based on clinical quality management, and use tools such as HB-HTA to further construct a reasonable evaluation system for medical consumables.

[Research on the Construction of SPD Intelligent Logistics].

This paper introduced the workflow and use effect of SPD intelligent logistics supply chain management system in medical consumables management, analyzed the problems encountered in the process of hospital introduction of SPD management mode, and used PDCA principle to promote the hospital SPD before and after. using the PDCA principle to SPD before and after the introduction in such aspects as propaganda, information, system, safety management process continuously improve, in order to enhance the level of hospital consumables lean management and provide the reference for the introduction of the management system of hospital.

[Clinical Pathway and Alert Management of Intelligent Medical Consumables].

Relying on the information construction of medical consumables, based on the use of single-disease medical consumables, establish a clinical pathway and early warning management of intelligent medical consumables to ensure the rational use of medical consumables. In this way, the supervision method is improved and the refined management effect is further improved. Establishing a clinical pathway and early warning management of intelligent medical consumables can more effectively standardize the rational use of medical consumables, and provide data monitor and control for economic evaluation in the management of single-disease in the future.

[Preliminary Study on Classifcation and Purchase of Medical Consumables in China].

In the process of deepening the reform of the medical and health system, purchasing process as an important link to control health care costs, has an important influence on the formation of drugs and medical consumables value chain. Compared with drugs, medical consumables have the characteristics of complex and diverse models, varieties, manufacturers, etc. So the purchasing system of medical consumables is urgently needed to establish and standardize the procurement. This paper, regarding the classification of procurement as the research object, analyzes the necessity of material classification, and referring to the typical medical consumables purchase mode, probes the existing problem and puts forward some suggestions and solutions to improve the classification system of medical consumables.

Robotic surgery reduces the consumption of medical consumables: cost analysis of robotic pancreatic surgery from a tertiary hospital in China.

Robotic surgery has been increasingly adopted in various surgical fields, but the cost-effectiveness of this technology remains controversial due to its high cost and limited improvements in clinical outcomes. This study aims to explore the health economic implications of robotic pancreatic surgery, to investigate its impact on hospitalization costs and consumption of various medical resources. Data of patients who underwent pancreatic surgery at our institution were collected and divided into robotic and traditional groups. Statistical analyses of hospitalization costs, length of stay, costs across different service categories, and subgroup cost analyses based on age, BMI class, and procedure received were performed using t tests and linear regression. Although the total hospitalization cost for the robotic group was significantly higher than that for the traditional group, there was a notable reduction in the cost of medical consumables. The reduction was more prominent among elderly patients, obese patients, and those undergoing pancreaticoduodenectomy, which could be attributed to the technological advantages of the robotic surgery platform that largely facilitate blood control, tissue protection, and suturing. The study concluded that despite higher overall costs, robotic pancreatic surgery offers significant savings in medical consumables, particularly benefiting certain patient subgroups. The findings provide valuable insights into the economic viability of robotic surgery, supporting its adoption from a health economics perspective.

Cost analysis of severe burn victims in Southwest China: A 7-year retrospective study.

Background: Severe burn injury can be a life-threatening experience and can also lead to financial issues for suffers. The purpose of the current study was to analyze the direct hospitalization costs of severe burn inpatients in Southwest China. Methods: Data related to all inpatients admitted with severe burns [total body surface area (TBSA) ≥30%] pooled from 2015 to 2021 were reviewed retrospectively at the Institute of Burn Research of Army Medical University. Demographic parameters, medical economics, and clinical data were obtained from medical records. Results: A total of 668 cases were identified. The average age was 37.49 ± 21.00 years, and 72.3% were men. The average TBSA was 51.35 ± 19.49%. The median length of stay of inpatients in the burn intensive care unit was 14 [interquartile range (IQR): 5.0-34.8] days, and the median length of stay (LOS) was 41 (IQR: 22.0-73.8) days. The mortality rate was 1.6%. The median total cost was 212,755.45 CNY (IQR: 83,908.80-551,621.57 CNY) per patient varying from 3,521.30 to 4,822,357.19 CNY. The direct cost of scald burns was dramatically lower compared with that of other types of burns, with 11,213.43 to 2,819,019.14 CNY. Medical consumables presented the largest portion of total costs, with a median cost of 65,942.64 CNY (IQR: 18,771.86-171,197.97 CNY). The crucial risk factors for medical cost in our study were TBSA, surgical frequency, LOS, depth of burn, and outcome. Conclusion: We conclude that an effective burn prevention program, shorter hospital stays, and facilitating the healing of wounds should be focused on with tailored precautionary protocols to reduce the medical costs of inpatients with severe burns.

Competitive Revenue Strategies in the Medical Consumables Industry: Evidence from Human Resources, Research and Development Expenses and Industry Life Cycle.

This study attempted to explore the competitive advantage strategies of the medical consumables industry (MCI) from the perspectives of human resources, research and development (R&D) and the industry life cycle. As one of the essential branches of modern medical device industry, the MCI has developed rapidly in recent years as global demand for medical consumables has shown continual growth, but it also faces market uncertainty. This study took Taiwan's small/medium medical consumables enterprises (SMMCEs) as a sample, and used the translog revenue function to study the competitive advantage of the MCI through human resource and R&D investment strategies and the stage characteristics of the industry life cycle curve. The results showed that the various human resources and R&D expenses of the small/medium medical consumables industry (SMMCI) can interact with each other to influence total revenue and that the SMMCI needs more varied types of human resources to enhance its competitive advantage. The total revenue of the SMMCI decreased as education inputs rose, but it increased along with increases in the number of employee and R&D inputs. Observed from the life cycle curve of the SMMCI, total revenue increased rapidly during the startup and growth stages, increased slowly during the maturity stage, and decreased during the decline stage. Finally, we put forward competitive advantage strategies and management suggestions for medical consumables enterprises (MCEs). We are the first to document the life cycle curve and competitive advantage strategies of the MCI, thereby contributing to the related literature.

[Impact of cancelling medical consumables addition policy on cost of total knee arthroplasty].

OBJECTIVE: To compare the cost changes of total knee arthroplasty (TKA) before and after the cancellation of medical consumables addition, so as to provide reference for the national medical reform policy. METHODS: The patients treated with TKA between September 2018 and February 2019 were admitted as objects of study, and 372 of them met the selection criteria and were finally included in the study. According to the time node of cancelling the medical consumables addition (December 24, 2018), all patients were allocated to pre-cancelling and post-cancelling groups ( n=186). The clinical data of patients (gender, age, length of stay, disease classification), and various treatment costs (the costs of diagnosis and treatment, examination, laboratory, material, anesthesia, bed, nursing, operation, drug, and others) were collected. And the changes of various costs and proportions before and after cancelling the medical consumables addition were compared. RESULTS: There was no significant difference in gender, age, and disease classification between the two groups ( P>0.05); the length of stay after cancelling the medical consumables addition was significantly longer than that before cancelling ( t=2.114, P=0.035). There was no significant difference in the total cost of TKA before and after cancelling the medical consumables addition ( t=0.214, P=0.831). Compared with that before cancelling the medical consumables addition, the cost of material was significantly reduced, and the costs of diagnosis and treatment, anesthesia, nursing, and operation were significantly increased ( P<0.05); the costs of examination, laboratory , bed, drug, and others were basically stable, and the differences were not significant ( P>0.05). CONCLUSION: The total cost of TKA is stable, the proportion of material cost is significantly reduced, the proportion of diagnosis and treatment cost reflecting the technical content of medical staff is significantly increased, which is in line with the expectation of the national policy of cancelling the medical consumables addition.

Application and Evaluation of SPD Based Logistics Management Model for Medical Consumables in Clinical Nursing Departments.

BACKGROUND: Supply, processing, and distribution (SPD) model is sparingly used in hospitals in China. We evaluated its effects on the management efficiency, quality control, and operating costs of medical consumables (MCs) in the clinical nursing surroundings in a single Chinese hospital-Anhui Provincial Hospital from 2014 to 2015. METHODS: Amount-based packages (ABP) and procedure-based packages (PBP) models were created. They were introduced the use of quick response (QR) code scanning for using in clinical nursing departments (CNDs). Questionnaires were prepared by referring to previous literature and using Delphi method repeatedly, further discussed and formalized. Partial results of the formal questionnaire were analyzed using SPSS. RESULTS: Frequency of MCs claims reduced without any requirements of MCs in 70% of CNDs. Average time spent on the inventory per week decreased and the time required to procure MCs reduced. Moreover, the average satisfaction score with MCs management increased, reaching 100%. Average space occupied by MCs decreased significantly, reducing by 1.2444m3. Overall, 100% of the respondents concluded that the management of MCs improved effectively and the inventory turnover rate had accelerated. The cost of MCs decreased by 15% with more than 10% increase in in-hospital amount, and the average daily cost of MCs also showed decrease. CONCLUSION: SPD can improve the efficiency of MCs management in CNDs, reducing medical risks and disputes, saving hospital operating costs, and decreasing capital occupation.

A Deep Learning Approach for Managing Medical Consumable Materials in Intensive Care Units via Convolutional Neural Networks: Technical Proof-of-Concept Study.

BACKGROUND: High numbers of consumable medical materials (eg, sterile needles and swabs) are used during the daily routine of intensive care units (ICUs) worldwide. Although medical consumables largely contribute to total ICU hospital expenditure, many hospitals do not track the individual use of materials. Current tracking solutions meeting the specific requirements of the medical environment, like barcodes or radio frequency identification, require specialized material preparation and high infrastructure investment. This impedes the accurate prediction of consumption, leads to high storage maintenance costs caused by large inventories, and hinders scientific work due to inaccurate documentation. Thus, new cost-effective and contactless methods for object detection are urgently needed. OBJECTIVE: The goal of this work was to develop and evaluate a contactless visual recognition system for tracking medical consumable materials in ICUs using a deep learning approach on a distributed client-server architecture. METHODS: We developed Consumabot, a novel client-server optical recognition system for medical consumables, based on the convolutional neural network model MobileNet implemented in Tensorflow. The software was designed to run on single-board computer platforms as a detection unit. The system was trained to recognize 20 different materials in the ICU, while 100 sample images of each consumable material were provided. We assessed the top-1 recognition rates in the context of different real-world ICU settings: materials presented to the system without visual obstruction, 50% covered materials, and scenarios of multiple items. We further performed an analysis of variance with repeated measures to quantify the effect of adverse real-world circumstances. RESULTS: Consumabot reached a >99% reliability of recognition after about 60 steps of training and 150 steps of validation. A desirable low cross entropy of <0.03 was reached for the training set after about 100 iteration steps and after 170 steps for the validation set. The system showed a high top-1 mean recognition accuracy in a real-world scenario of 0.85 (SD 0.11) for objects presented to the system without visual obstruction. Recognition accuracy was lower, but still acceptable, in scenarios where the objects were 50% covered (P<.001; mean recognition accuracy 0.71; SD 0.13) or multiple objects of the target group were present (P=.01; mean recognition accuracy 0.78; SD 0.11), compared to a nonobstructed view. The approach met the criteria of absence of explicit labeling (eg, barcodes, radio frequency labeling) while maintaining a high standard for quality and hygiene with minimal consumption of resources (eg, cost, time, training, and computational power). CONCLUSIONS: Using a convolutional neural network architecture, Consumabot consistently achieved good results in the classification of consumables and thus is a feasible way to recognize and register medical consumables directly to a hospital's electronic health record. The system shows limitations when the materials are partially covered, therefore identifying characteristics of the consumables are not presented to the system. Further development of the assessment in different medical circumstances is needed.

SPD-based Logistics Management Model of Medical Consumables in Hospitals.

BACKGROUND: With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. METHODS: We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. RESULTS: We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. CONCLUSION: The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China.