Medical Devices Index 2023: Access and Sourcing in Portuguese Hospitals, Challenges and Opportunities

OBJECTIVES: The objectives of this study were to Map the circuit of medical devices (MDs) in Portuguese Health Service hospitals, characterize their selection and sourcing process, identify mechanisms for cost reduction, measure and monitor their value, and identify key barriers.

METHODS: Data was collected through an online quantitative questionnaire applied to 22 Portuguese hospitals. It was assessed 4 hospital services with high usage of MDs: cardiology, gastroenterology, ophthalmology, and orthopedics. Data collected referred to 2023 period. Statistical analysis included descriptive and comparative analyses.

RESULTS: Only 37% of hospitals have an official committee responsible for selecting and sourcing MDs. Only 28% of hospitals have systems that enable cost-effectiveness analysis. The primary criteria for MDs sourcing are clinical outcomes, direct and indirect costs, and MDs training/assistance. Most hospitals use consignation mechanisms (95%) and MDs are stored in the medical service. 41% mention stock-outs as a serious problem and 29% as a relevant problem. 38% have stock-outs monthly while only 25% have no stock-outs. Consumables are the area most affected. 63% borrow MDs from other hospitals to mitigate stock-outs or to overcome bureaucratic processes. Most hospitals (79%) reprocess reusable MDs in-house (93%). There are 16% that also reprocess single-use MDs. Regarding cost reduction mechanisms, 26% of hospitals consistently implement these actions, while 53% have done so, although not frequently. Key initiatives include aggregate annual tenders and sourcing to multiple vendors. 47% state to have multiannual MDs agreements. The main barriers to access and sourcing are the significant administrative burden, lack of human resources and the sourcing process via central services (SPMS). Overall, hospitals’ perception of access to innovative MDs is average at 57%.

CONCLUSIONS: Access to MDs in Portuguese hospitals is average and still has room for improvement both in the selection and sourcing processes, to mitigate stock-outs and increase overall efficiency.