Distribution and Utilisation of Radiotherapy Units in Greece

Abstract

Biomedical Engineering is playing a leading role in the development of medical technology which is one of the pillars of Modern medicine, or as differently expressed at the European Economic and Social Committee (EESC) opinion paper: “Biomedical Engineering is not simply a subset of modern medicine. Modern medicine predominantly secures important advances through the use of the products of biomedical engineering”1. Health technology, according to World Health Organization (WHO), refers to the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives. Therefore, Medical Devices (MDs) belong to the Health Technologies, and Radiotherapy (RT) is an important subgroup of them. Radiotherapy refers to high-tech medical devices that are of high capital value both in terms of initial investment and operation, requiring specially trained personnel for its use and needs regular quality control, preventive maintenance and management procedures, to function properly and safely. Clinical Engineering plays a major role in facing of the afore mentioned challenges. The present paper provides an overview of the results of a study under the WHO action on Strengthening Capacity for Universal Coverage Greece/Phase 2 (SCUC2)2aiming to: Assess the sufficiency and equity in the distribution of RT and its use in Greece Identify eventual inequalities in terms of geographical coverage, specific needs and lack of RT Asses the current status of staffing in RT units Estimate the costs for the use of High Value Capital Medical Equipment (HVCME) Since a country-wide medical equipment inventory for Greece does not exist, various sources were used to obtain a clear picture of the installed units in public Greek hospitals and private clinics. As a result, it came out that, in terms of number of units the per million population the number of RT units rose by 23% from 4.3 in 2009 to 5.3 in 2017. In terms of number of acts, a general increasing trend is noticed, resulting to a total cost increase of 25% from 2013 to 2016. The study revealed that in Greece, there are quite pronounced inequalities in terms of availability of RT technologies in different regions. Long term strategic planning is needed based on evidence, such as updated inventory of MDs, acts performed, associate costs etc , which are unfortunately lacking in Greece. Additionally, the role of clinical engineers in the effective management and safe use of this technology should be widely recognised and regulated.