Coordination of the acquisition and use of expensive medical equipment is still weak

Helerin Kõrvemaa | 11/2/2011 | 9:06 AM

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TALLINN 2 November 2011 - The National Audit Office is of the opinion that no significant changes have occurred in the area of acquisition and use of expensive medical equipment even though they are essential to guarantee the sustainability of the hospital network.

The National Audit Office conducted a follow-up audit of the acquisition and use of medical equipment in order to ascertain whether or not the situation had improved after the audit conducted in the same area in 2008. As a result of the audit, the National Audit Office found that the Ministry of Social Affairs has not taken any significant steps to coordinate the area, which means that the services provided to patients in hospitals of the same type are not of the same quality, CT scanners in general hospitals are still not working at optimal capacity and not all hospitals are able to invest enough money in equipment.

The National Audit Office assessed within the course of the audit whether the chances of patients to receive the necessary tests have improved. The National Audit Office analysed the number of patients with suspected stroke who were given CT scans and found that the number of scanned patients has increased considerably in recent years, but more than 12% of all patients are still not given these scans at the right time. Almost 43% of patients with light head trauma have not been given the necessary scan. The risk of not receiving the scan is considerably higher for patients who are initially taken to their local county hospital that does not have a CT scanner (Põlva, Jõgeva, Rapla and Hiiu Counties) and the patient is not immediately sent to a hospital that does have the scanner.

Just like three years ago, the National Audit Office again assessed the workload of the CT scans acquired by Estonian hospitals. The workload of CT scanners had increased by a quarter on the average and in large hospitals, it was more than twice as big as the optimal workload. In county hospitals, however, the average workload is still just 65% of the optimal despite a significant increase.

In the audit completed three years ago, the National Audit Office found that the average age of the X-ray equipment used is ten years. The average age of X-ray equipment has decreased by now. However, whilst the average age of X-ray equipment used to be the same in both big and small hospitals, the X-ray equipment used in country hospitals now tends to be older than the Estonian average. Only a couple of county hospitals have acquired new X-ray equipment in recent years. The National Audit Office sees it as a problem, because purchasing new X-ray equipment was postponed in 2006 and 2007 when hospitals mainly focussed on the acquisition of CT scanners. It is now clear hospitals have still not been able to buy new X-ray equipment. The age of X-ray equipment does not pose a threat to the health of people, but new equipment is often better in diagnosing diseases.

The National Audit Office is of the opinion that all of the problems highlighted in the audit are more or less associated with the general problems of the hospital network, which the National Audit Office already pointed out in the audit ‘Sustainability of the Hospital Network’, which was completed in 2010. Hospitals are unable to guarantee optimal workloads for CT scans, because there are too few patients in the regions that the hospitals serve, or the hospitals do not have enough staff to keep the scanner working 24 hours a day. County hospitals are planning to invest considerable amounts of money into the development of nursing care in the coming years, which gives the National Audit Office reason to believe that it is unlikely that hospitals will be able to buy new expensive medical equipment in the future.

Background
As a result of the audit ‘Acquisition and Use of Medical Equipment in Health Care Institutions’ completed in 2008, the National Audit Office found that some hospitals did not use expensive medical equipment efficiently and their X-ray equipment did not meet current requirements. Even if the patient lives in a region that had the equipment required for the tests the patients needed, not all such patients were actually given these tests. At the same time, almost one-sixth of patients suffering from back pain were given MRI scans in situations where it was not justified. Other problems were also found in the area: there were no criteria for hospitals to proceed from in the acquisition of equipment; they also did not have the necessary staff and the state had no overview of the number, location and functionality of equipment. The National Audit Office found that the state’s activities in managing the area of medical equipment were modest.

The National Audit Office considered it necessary to conduct a follow-up audit in order to assess the measures taken for the improvement of the situation in the last three years. In the follow-up audit, the National Audit Office focussed on the radiological medical equipment it had discussed in its audit of 2008. The following equipment was assessed: MRI scanner, CT scanner and X-ray equipment.
 

Helerin Kõrvemaa
Assistant to Communication Manager
National Audit Office
+372 640 0704
+372 5344 3704
helerin.korvemaa@riigikontroll.ee

  • Posted: 11/2/2011 9:06 AM
  • Last Update: 11/10/2015 5:46 PM
  • Last Review: 11/10/2015 5:46 PM

CT scanners in general hospitals are still not working at optimal capacity.

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