Sustainable Procurement of Medical Technologies: Equipping 85 Modular Healthcare Systems in Argentina

Abstract

Context and objectives: This article presents the planning, construction, and equipping of 85 modular healthcare systems (MHS) in Argentina as a medium-term response to the pandemic emergency. The objective is to describe the implementation and analyze the results of this large-scale national project and its investment component for the acquisition of hospital equipment, highlighting the design, outcomes, and lessons learned in the process with a focus on long-term sustainability. Materials and methods: Nine different phases of the implementation process of the project are described and analyzed as components of the sustainable procurement methodology. Within the framework of the planning, construction, and commissioning of the NHS, data were collected and analyzed to qualitatively and quantitatively assess the experience of planning, designing, and procuring equipment for modular health centers. Data analysis was conducted by categorizing the acquired goods into active and passive medical devices (MD), furniture, support equipment, and installation equipment. Results: The analysis of the equipment acquired for the 85 MHS shows that the distribution of assets aligns with specific needs and follows similar patterns across all units. Among the 19,600 medical goods purchased, over 60% of the investment was allocated to MD, reaching 87% in centers with higher critical care activity. Visits to operating MHS confirmed their general functionality and user satisfaction with the infrastructure and equipment. Strengths identified include well-designed facilities and decentralized healthcare delivery, which has reduced the burden on central hospitals. At the same time, some lessons have been learned and risks identified, such as specific shortages of specialized personnel, minor quality issues with equipment reception, and the storage of some unused or little-used devices. The need for active post-delivery management was also observed as lessons learned for future large-scale operations. Discussion: It was highlighted that passive MD, mainly medical furniture, while accounting for 64% of the equipment, only represents 13% of the investment. However, their appropriate selection and maintenance are crucial for patient perception and quality of care. Furthermore, the high cost of medical technology was demonstrated by an analysis of investment per square meter. Conclusion: The implementation of this project focused on medical technologies, analyzing design, equipment investment, outcomes, and lessons for long-term sustainability. The high cost of medical technologies confirms the opportunity to evaluate not only the purchase price but also operational, maintenance, and disposal costs. A comprehensive approach to equipment planning and management is an essential requirement for sustainability and efficiency in LMICs. Evidence-based needs analysis, crucial for sustainable acquisition and to align the equipment with intended use, and post-implementation visits, crucial for continuous quality improvement, are recommended for the implementation of future projects. The presented lessons learned contribute to establishing a methodological base for future MD procurement projects.