مقاله انگلیسی رایگان در مورد مدیریت تکنولوژی مراقبت های بهداشتی بی اثر – الزویر 2017

Healthcare technologies offer many benefits and have greatly enhanced the ability of health professionals to prevent, diagnose and treat diseases (1). The quality of healthcare delivery can be assessed along the STEEEP criteria of being Safe, Timely, Effective, Efficient, Equitable, and Patient-centered (2). However, many developing countries in general, and Benin in particular, face problems in satisfying these due to the limited availability, or lack of, healthcare technologies. Healthcare technology is defined as the application of organized knowledge and skills in the form of devices, medicine, vaccines, procedures and systems developed to solve health problems and improve the quality of lives (1, 3-8). When used in this paper, the term is used as the different types of devices or equipment used in health facilities, encompassing medical equipment for clinical use, hospital furniture, vehicles, service supplies, plant, communication equipment, firefighting equipment, fixtures in the building, office equipment, office furniture, training equipment, walking aids and workshop equipment (3). Healthcare Technology Management (HTM) in developing countries has a great number of contextual challenges. Since about 95% of the healthcare technology used in these countries is imported (9), mismatches commonly occur as the technology development process happening in developed countries hasn’t accounted for the specific demands of the environment of placement. These mismatches in the transfer process, from high-income countries to non-producing countries, affect both the cost and the use of the technology (10-15). Healthcare provision in Benin is delivered through both the public and private health sectors. The public healthcare delivery system has been reorganized on the basis of decentralization policies and comprises three hospital levels (the primary or zone hospital, the secondary or departmental hospital and the tertiary or university hospital), and many health centers. The zone hospital remains the first referral hospital and most heavily used facility, compared to health centers and polyclinics (16). Many technical reports have described weaknesses in Benin’s public HTM system which contribute to low quality, cost-ineffective and inefficient community healthcare (17-24). Many facilities, particularly primary and secondary hospitals, still lack the basic technologies they need to provide standard care, as equipment is unavailable, inoperative, misused or inappropriate. The situation is most severe in health facilities located in remote areas with implications for the treatment and prevention of diseases. Although huge financial resources have been injected into the acquisition of devices, not enough attention has been paid to their strategic management. While some equipment has been donated, a significant portion has been purchased with loans provided by bilateral and multilateral agencies which will have to be paid back.