The current instrumentation of the Foundation IRCCS Neurological Institute Carlo Besta for the Service of Neuroradiology Magnetic Resonance Imaging is made by two machines, an obsolete one with a 0.5 T magnetic field and a newer one with 1.5 T. The purpose of this study is to analyze the workload of the system and its performance and achieving an assessment about the changing the old machine with a new one with 1.5 T, similar to one already present, taking into account the additional guidelines of the Health Department. It has been determined to make a reference model of the already existing 1.5 T MRI, to determine its actual capacity than the 0.5 T machine, getting ideas for a HTA report from the protocol INAHTA. The analysis results have shown a difference of 20.13% in efficiency of the two machines, risult which includes a different organization of work applied to this two equipments. The changing of the machine with 0.5 T thus brings to a global efficiency gain of 4.2%. The analysis of cost-effectiveness has led to a marked difference in efficacy (23.4%) and in costs (30.3%), therefore in the ICER index, that it‟s equal to 1.29 (0.29 € / % of effectiveness). Have been identified later the drivers causing further loss of efficiency and effectiveness (amount to 18.48% of the whole time for a diagnostic exam), in conclusion proposing an improvement plan including interventions in the organization.
La strumentazione attuale della Fondazione IRCCS Istituto Neurologico Carlo Besta per il servizio di Risonanza Magnetica di NeuroRadiologia conta di due macchinari, uno obsoleto da 0.5 T e uno più recente da 1.5 T. Lo scopo di questo lavoro è di analizzare il carico di lavoro del sistema e le sue prestazioni e di realizzare un assessment della sostituzione del vecchio macchinario con uno nuovo da 1.5 T simile a quello già presente, tenendo in conto delle direttive aggiuntive della Direzione Sanitaria. Si è così stabilito di prendere a modello di riferimento la già esistente RM da 1.5 T, per verificare le sue effettive capacità rispetto alla 0.5 T, prendendo spunto per un report HTA dal protocollo INAHTA. I risultati delle analisi hanno messo in mostra una differenza d‟efficienza del 20,13% tra le due macchine, dato che tiene conto anche della diversa organizzazione del lavoro a cui vengono sottoposte le due strumentazioni. La sostituzione della macchina a 0.5 T porta dunque ad un incremento d‟efficienza globale del 4,2 %. L‟analisi del rapporto costo-efficacia ha condotto ad una sensibile differenza nell‟efficacia (23,4%) e nei costi (30,3%), di conseguenza nell‟ICER, che risulta 1.29 (0,29 €/% d‟efficacia). Sono stati individuati in seguito i driver che causano ulteriori perdite di efficienza ed efficacia (ammontano al 18,48% sul tempo totale d‟esame), proponendo in conclusione un piano di miglioramento comprendente d‟interventi sull‟organizzazione.
Analisi del servizio e rapporto HTA per l'UO di neuroradiologia
VIOLA, MAURO
2009/2010
Abstract
The current instrumentation of the Foundation IRCCS Neurological Institute Carlo Besta for the Service of Neuroradiology Magnetic Resonance Imaging is made by two machines, an obsolete one with a 0.5 T magnetic field and a newer one with 1.5 T. The purpose of this study is to analyze the workload of the system and its performance and achieving an assessment about the changing the old machine with a new one with 1.5 T, similar to one already present, taking into account the additional guidelines of the Health Department. It has been determined to make a reference model of the already existing 1.5 T MRI, to determine its actual capacity than the 0.5 T machine, getting ideas for a HTA report from the protocol INAHTA. The analysis results have shown a difference of 20.13% in efficiency of the two machines, risult which includes a different organization of work applied to this two equipments. The changing of the machine with 0.5 T thus brings to a global efficiency gain of 4.2%. The analysis of cost-effectiveness has led to a marked difference in efficacy (23.4%) and in costs (30.3%), therefore in the ICER index, that it‟s equal to 1.29 (0.29 € / % of effectiveness). Have been identified later the drivers causing further loss of efficiency and effectiveness (amount to 18.48% of the whole time for a diagnostic exam), in conclusion proposing an improvement plan including interventions in the organization.File | Dimensione | Formato | |
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https://hdl.handle.net/10589/5065