The WHO Regional The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters each with its own programme geared to the particular health conditions of the countries it serves. Member States Albania Andorra Rationalizing distribution and utilization of high value Armenia Austria Azerbaijan capital medical equipment in Greece Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czechia Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Assesment report Turkey Turkmenistan Ukraine United Kingdom UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Uzbekistan Tel.: +45 45 33 70 00 Fax: +45 45 33 70 01 E-mail: [email protected] With funding by the European Union Rationalizing distribution and utilization of high value capital medical equipment in Greece Assesment report This document was produced with the financial assistance of the European Union. The views expressed herein can in no way be taken to reflect the official opinion of the European Union. ABSTRACT This report presents the results of an assessment of the distribution and utilization of high value capital medical equipment in Greece, including detailed analysis of the regional distribution, use and costs for specific categories of equipment. Having highlighted the major distortions identified, the authors propose specific policy recommendations for efforts to be focused on improving investment planning for high value capital medical equipment and developing health technology assessment (HTA) capacities related to medical devices. Additional recommendations stress the importance of promoting evidence-based decisions for procurement; putting in place a well-structured medical equipment inventory; improving maintenance through the development of biomedical/clinical engineering departments in Greek hospitals and their adequate staffing; and adopting clinical guidelines. The assessment is part of a series of activities outlined in the context of the collaboration between WHO Regional Office for Europe and the Ministry of Health to strengthen the health system in Greece, financially supported by the Structural Reform Support Service of the European Commission. KEYWORDS DELIVERY OF HEALTH CARE EQUIPMENT AND SUPPLIES – ECONOMICS EQUIPMENT AND SUPPLIES – UTILIZATION EQUIPMENT AND SUPPLIES – SUPPLY AND DISTRIBUTION HOSPITALS GREECE Address requests about publications of the WHO Regional © World Health Organization 2018 Office for Europe to: All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its Publications publications, in part or in full. 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Contents Abbreviations .......................................................................................................................................... vii Acknowledgements ................................................................................................................................ viii Introduction ............................................................................................................................................ 1 Findings ................................................................................................................................................... 5 Introduction ....................................................................................................................................................................... 5 Overview of installed HVCE .................................................................................................................................................................. 5 Overview of use and cost data ........................................................................................................................................................... 8 Comparison with other EU countries................................................................................................................................................ 8 Mammography ................................................................................................................................................................. 9 Regional distribution ............................................................................................................................................................................... 9 Use and cost ............................................................................................................................................................................................... 11 Data analysis and discussion ............................................................................................................................................................. 13 CT ........................................................................................................................................................................................... 15 Regional distribution ............................................................................................................................................................................... 15 Use and cost ............................................................................................................................................................................................... 17 MRI ......................................................................................................................................................................................... 19 Regional distribution ............................................................................................................................................................................... 19 Use and cost ............................................................................................................................................................................................... 21 CT and MRI data analysis and discussion ..................................................................................................................................... 25 γ-camera/SPECT ............................................................................................................................................................. 26 Regional distribution ............................................................................................................................................................................... 26 Use and cost ............................................................................................................................................................................................... 29 PET/CT ................................................................................................................................................................................. 30 Regional distribution ............................................................................................................................................................................... 30 Use and cost ............................................................................................................................................................................................... 31 Nuclear medicine data analysis and discussion.......................................................................................................................... 33 RT...........................................................................................................................................................................................