Optimal Medical Equipment Maintenance Service Proposal Decision Support System combining Activity Based Costing (ABC) and the Analytic Hierarchy Process (AHP)

Rocha, Leonardo; Sloane, Elliot B.; Bassani, José Wilson Magalhães

doi:10.1109/iembs.2005.1616143

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…Our findings on the comparative advantage of contracted-out over in-house maintenance contradict similar studies within an university hospital setting in the United States and Brazil [21,22]. Both these studies favor in-house maintenance over contracted-out maintenance.…”

Section: Discussioncontrasting

confidence: 96%

“…Specifically, we include detailed information on device asset values and lifetimes, maintenance activities, equipment-related service quantities and prices for 19 district hospitals and six medical devices. This compares favorably to existing empirical studies of medical equipment maintenance, which consider not more than two hospitals or investigate only incremental changes to existing maintenance programs [20][21][22][23].…”

Section: Discussionmentioning

confidence: 80%

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Maintenance versus replacement of medical equipment: a cost-minimization analysis among district hospitals in Nepal

Hillebrecht

Schmidt

Saptoka

et al. 2022

BMC Health Serv Res

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Background About half of all medical devices in low- and lower-middle-income countries are currently non-operational because equipment maintenance is lacking. Thus, choosing a cost-efficient equipment maintenance approach has the potential to increase both the quantity and quality of important health services. Between 2010 and 2014 Nepal’s Ministry of Health chose two of its development regions to pilot the contracting-out of maintenance services to the private sector. We develop a cost model and employ different data to calculate the cost of this contracted-out scheme. The latter we compare with two additional common approaches to maintenance: in-house maintenance and no maintenance. Methods We use invoiced pilot program costs, device depreciation estimates from the literature, and hospital case numbers from Nepal’s Health Management Information System. We estimate net-present values for a three-year horizon, incorporating both fixed and operational cost. Operational costs include downtime cost measured as lost revenues due to non-working equipment. Results The contracted-out maintenance scheme shows a strong relative cost performance. Its cost after 3 years amount to 4,501,574 International Dollars Purchasing Power Parity (I$ PPP), only 90% of the cost with no maintenance. The contracted-out scheme incurs 670,288 I$ PPP and 3,765,360 I$ PPP in fixed cost and operational cost, respectively. The cost for replacing broken devices is 1,920,467 I$ PPP lower with maintenance. In addition, after 3 years total cost of contracted-out maintenance is 489,333 I$ PPP (11%) below total cost of decentralized in-house maintenance. After 10 years, contracted-out maintenance saves 2.5 million I$ PPP (18%) compared to no maintenance. Conclusions We find that contracted-out maintenance provides cost-efficient medical equipment maintenance in a lower-middle income context. Our findings contrast with studies from high- and upper-middle-income countries, which reflect contexts with more in-house engineering expertise than in our study area. Since the per hospital fixed cost decrease with scheme size, our results lend support to an expansion of contracted-out maintenance to the remaining three development regions in Nepal.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 80%