Research On The Development Of High-value Medical Consumables Access Scale For Hospitals Under Health Technology Assessment

Objective: To develop a tool scale for access to high-value medical consumables in public hospitals in accordance with the principles of science,integrity,feasibility,combination of quantitative and qualitative,and independence.This provides a scientific evaluation method for the admission of high-value medical consumables in hospitals,thereby improving the rationality of admission of high-value consumables.Methods: Based on the literature research method and personal in-depth interview method,the project pool of high-value medical consumables entry scale was initially prepared.Then through the Delphi method,a scientific and reasonable indicator system and weights are determined.Then the expert meeting method was used to determine the scoring rules and the level of evidence quality standards to form the hospital’s high-value consumables sanitary technology assessment access rating scale.At the same time,two representative types of high-value medical consumables(from 6 different manufacturers)were selected for retrospective demonstration.Results: 1.Project index pool initiated: based on personal in-depth interview method,the cognition and demand of clinical medical workers for high-value medical consumables and the admission standards of hospital administration for high-value medical consumables were acquired.After comparing the similarities and differences between clinical medical workers and hospital administration on the aspects and indexes of access for high-value medical consumables,and combining with literature research method,an initial access index pool was constructed,including 4 primary indexes,11 secondary indexes and 39 tertiary indexes.2.Indexes established: three rounds of expert consultation were conducted through the Delphi method to score the importance of indexes from the index pool,thereby determining the specific indexes of the access scale for high-value medical consumables.It includes 4 primary indicators,10 secondary indicators and 27 tertiary indicators.3.Weighting coefficients confirmed: the weighting coefficients of the primary indexes(including quality,demand,economy,supply)are 0.404,0.167,0.266 and 0.163 respectively.The weighting coefficients of secondary indexes(including safety,efficacy,advancement,patient demand,doctor demand,cost,hospital benefit,supply strength,service level,market reputation)are 0.2562,0.2064,0.0705,0.0796,0.0793,0.1103,0.0603,0.0524,0.0501 and 0.0335 respectively.The weighting coefficients of tertiary indexes(including product reliability,contraindications,recall system,consumables warning/recall times,proof of evidence-based medicine,market coverage,insurance products,patent certification,awards,material comfort,expectancy of consumables,potential complications,service life,operation handiness,failure rate,price,whether to need to form a complete set of materials or equipment,reimbursement,estimated annual number of people served,enterprise popularity,the enterprise quality system certification,annual sales records,industry rankings,timely delivery and after-sales service,customer satisfaction,integrity records,social support public welfare activities)are 0.1251,0.0702,0.0275,0.0334,0.0993,0.0873,0.0198,0.0503,0.0202,0.0157,0.0379,0.0260,0.0503,0.029,0.0692,0.0412,0.0404,0.0199,0.0151,0.0103,0.0139,0.0131,0.003,0.0201,0.0140,0.008 and 0.0115 respectively.4.Index points assigned: assign points to all levels of indexes regarding to their own weighting coefficients.Among the primary indexes,53 points are assigned to the quality index,16 points to the demand index,17 points to the economic index and 14 points to the supply index.5.Scoring rules determined: discuss with relevant experts to work out the scoring rules related.6.Admission passing line established: through a retrospective study,it is proposed to consider admission of high-value medical consumables with a score higher than 60 on the scale.Conclusion: 1.The index system of this scale is scientific and comprehensive,with high reliability of weighting coefficients and detailed scoring rules.2.The total Cronbach’s alpha of all the indexes of the scale and the Cronbach coefficient of the primary indexes are all above 0.8,and have good surface validity and content validity.3.through a retrospective empirical study,this scale is consistent with the results of experts using high-value medical consumables,and can be used as a scoring tool for admission of high-value medical consumables in hospitals.4.Through retrospective study,it is found that to improve the score of products,enterprises need to improve the score of related indexes of product quality and make efforts to include products in the medical insurance catalog.