基于系统动力学的医疗设备维修保修采购风险模型研究

Research on the risk model of medical equipment maintenance and procurement based on system dynamics

目的:研究基于系统动力学的医疗设备维修保修风险模型,以解决医疗设备维修保修采购过程中廉政风险多发、成交价格居高和采购时效低下等问题。方法:分析医疗设备维修保修采购风险形成风险矩阵,绘制风险矩阵图;围绕医疗设备维修保修采购价格风险、进度风险和廉政风险构建系统动力学模型,通过构建因果关系图和存量流量图,揭示医疗设备维修保修采购风险影响要素之间的因果关系和反馈效应。对比2022年解放军总医院采用基于系统动力学的医疗设备维修保修采购风险模型进行实践的风险变化效果。结果:基于系统动力学的医疗设备维修保修风险模型进行风险管理控制后,采购价格风险增加量从控制前的0.54降至0.27,廉政风险增加量从控制前的0.27降至0.05,进度风险增加量减小较为缓慢;降低风险阈值后,价格风险增加量和价格风险明显下降;风险阈值从60降低至40时,项目成功率比控制前提高6.52%,质疑投诉率下降6.61%。结论:基于系统动力学的医疗设备维修保修风险模型严格采购需求端管理,实行限价和审价管理,通过优化采购方式、构建谈判限价模型和完善审价定价机制,能够有效清除价格风险衍生出的廉政风险和进度风险。

Objective:To study the risk model of medical equipment maintenance and repair based on system dynamics,and to solve the problems of frequent risk of corruption,high transaction prices and low procurement timeliness in the process of medical equipment maintenance and repair.Methods:The risk matrix was formed by analyzing the procurement risk of medical equipment maintenance and warranty,and the risk matrix was drawn.The system dynamics model was constructed around the price risk,schedule risk and corruption risk of medical equipment maintenance procurement,and the causal relationship and feedback effect between the risk influencing factors of medical equipment maintenance procurement were revealed through the construction of causality diagram and stock flow diagram.The risk change effects of the PLA General Hospital's application of the system dynamics-based medical equipment maintenance and procurement risk model in practice in 2022 was compared.Results:After the application of risk management control based on system dynamics model,the increase of procurement price risk decreased from 0.54 before control to 0.27,the increase of corruption risk decreased from 0.27 before control to 0.05,and the increase of schedule risk decreased slowly.After lowering the risk threshold,the increase of price risk and price risk decrease significantly.When the risk threshold was reduced from 60 to 40,the project success rate was increased by 6.52%and the rate of doubts and complaints decreased by 6.61%.Conclusion:The medical equipment maintenance risk model based on system dynamics strictly manages the procurement demand side,implements price limit and price review management,and can effectively eliminate the corruption risk and schedule risk derived from price risk by optimizing the procurement method,building the negotiation price limit model and improving the price review and pricing mechanism.