Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants
Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants
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DOI：
10.1002/hpm.2657
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发表时间：
2019-01-01
影响因子：
2.7
通讯作者：
Jaafaripooyan, Ebrahim
中科院分区：
文献类型：
--
作者：
Abedini, Zahra;Sari, Ali Akbari;Jaafaripooyan, Ebrahim
背景：低收入和中等收入国家在为先进医学成像技术（AMITs）提供财政、人力和资本资源方面存在很多问题。适当分配这些昂贵的设备可能会增加获得这些服务的机会，并提高保健的质量和效率。本研究旨在确定影响伊朗AMITs扩散的因素，包括CT和MRI。方法：本研究为2017年开展的定性研究。我们与卫生部、医科大学、医院、健康保险公司和供应商公司有意挑选的一些决策者和管理人员进行了面对面和半结构化访谈。数据分析采用专题分析法。结果：确定了三类影响因素，包括情境因素、利益相关者相关因素和情境因素。就利益相关者而言，卫生部和医生在AMITs的传播过程中发挥了最重要的作用。医疗保险组织和供应商公司在设备分配方面发挥了次要作用。人们认为，当局向卫生部施加政治压力，要求其颁发购买医疗器械的许可证，这是推广医疗器械的最重要因素和最大挑战。结论：研究结果旨在帮助卫生系统主管部门有效管理AMITs的扩散，并公平分配昂贵资源。扩散管理与利用管理相结合，可以大大提高效率和控制成本。医疗技术扩散管理实际上需要供需双方的政策工具。
Background: Low-income and middle-income countries have a lot of problems in providing the financial, human, and capital resources for advanced medical imaging technologies (AMITs). Proper distribution of such expensive equipment might increase access to these services and enhance the quality and efficiency of health care. The present study aimed to identify the factors affecting the diffusion of AMITs including CT and MRI in Iran.Methods: This is a qualitative research conducted in 2017. A number of purposively chosen policy makers and managers from Ministry of Health, medical universities, hospitals, health insurance, and vendor companies were approached for face-to-face and semistructured interviews. Data analysis was done using thematic analysis method.Results: Three categories of influential factors were identified, including contextual, stakeholder related, and situational factors. With regards to the stakeholders, the ministry and physicians played the most important role in the diffusion process of the AMITs. Health insurance organizations and vendor companies played a minor role in distribution of the equipment. Application of political pressure by the authorities on the Ministry of Health to issue licenses for the acquisition of AMITs was taken as the most important factor and the greatest challenge in the diffusion of devices.Conclusion: The results sought to assist health system authorities to manage diffusion of AMITs effectively and assign an equitable access to the expensive resources. The diffusion management together with utilization management could largely improve efficiency and cost containment. Medical technology diffusion management de facto needs policy instruments in both supply and demand sides.