Technology and Cost Benefit Considerations

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1 Matching Technology with Health Care Needs and Infrastructure Carlos E dealmeida Ph.D. ABMP, FAAPM Full Professor in Medical Physics Chairman, Radiological Sciences Laboratory State University of Rio de Janeiro

2 ex: IN RADIATION ONCOLOGY First question! What shall one consider to ensure the appropriate use of new technology by the developing countries from: safety, economical and societal viewpoint

3 PUBLIC SAFETY ENVIRONMENT WORKERS

4 LICENCING PROCESS BASED ON BSS PUBLIC SAFETY ENVIRONMENT WORKER ANNUAL COMPLIANCE

5 SAFETY PATIENT

6 STAFF TRAINING PROFESSIONAL ACCREDITATION SAFETY PATIENT

7 STAFF TRAINING PROFESSIONAL ACCREDITATION SAFETY PATIENT CLINICAL PROCEDURES and QA WELL ESTABLISHED

8 STAFF TRAINING PROFESSIONAL ACCREDITATION SAFETY PATIENT CLINICAL PROCEDURES and QA WELL ESTABLISHED INDEPENDENT EXTERNAL AUDIT

9 SOCIETY POINT OF VIEW ARE ALL OUR PATIENTS BEING TREATED??!!!

10 SOCIETY POINT OF VIEW ARE OUR PATIENTS TREATED AS THEY SHOULD??

11 STANDARDIZED CLINICAL AND PHYSICAL PROCEDURES SOCIETY POINT OF VIEW ARE OUR PATIENTS TREATED AS THEY SHOULD??

12 STANDARDIZED CLINICAL AND PHYSICAL PROCEDURES SOCIETY POINT OF VIEW ARE OUR PATIENTS TREATED AS THEY SHOULD?? PATIENT FOLLOW-UP IS EFFICIENT??

13 STANDARDIZED CLINICAL AND PHYSICAL PROCEDURES SOCIETY POINT OF VIEW ARE OUR PATIENTS TREATED AS THEY SHOULD?? PATIENT FOLLOW-UP IS EFFICIENT?? DO WE HAVE ADEQUATE STAFF FOR THE EXISTING TECHNOLOGY?

14 Matching technology with health care one must consider the The Cost-Benefit aspects involved.

15 Some of the cost-benefit considerations! ADEQUATE STAFF?!!!!! MAINTENANCE COSTS?? INVESTMENT COSTS?? HOW MANY PATIENTS WILL BENEFIT???

16 HIGH TECHNOLOGY IMPLIES: HIGHER INITIAL COSTS

17 HIGH TECHNOLOGY IMPLIES: HIGHER INITIAL COSTS SMALLER NUMBER OF PATIENTS P/ MACHINE 1. More complex treatment techniques. 2. More QA time 3. Maintenance time

18 HIGH TECHNOLOGY IMPLIES: HIGHER OPERATIONAL COSTS SMALLER NUMBER OF PATIENTS P/ MACHINE 1. More complex treatment techniques. 2. More QA time 3. Maintenance time HIGHER LEVEL OF STAFF TRAINING

19 KEY ISSUE! EFFICIENT DIAGNOSIS ECONOMICAL FEASIBILITY TRAINING EFFICIENT TREATMENT SAFE TREATMENT

20 How to answer the difficult question of much technology is needed to correctly treat our patients???

21 THERE IS NOT ONE SINGLE ANSWER!!!!!! BUT,

22 It is fair to say that Countries with limited resources must consider: Evidences of Real Benefits in terms of the specific cancer scenario of each country.

23 For simple scenarios: Good pilots + well organized and scientifically sounded procedures MAY BE IN SOME CASES BETTER THAN sophisticated technology!!

24 Thank you! T H A N K S!!

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