Medical Equipment Maintenance Cost Analysis

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Questions and Answers

What is the average device lifetime for the centrifuge as listed in the table?

9.0 years (correct)

7.5 years

10.0 years

8.0 years

Which equipment type has the highest total value as shown in the analysis?

X-ray imaging (correct)

Monitoring equipment

Laboratory equipment

Ultrasound imaging

How many devices were classified under monitoring equipment?

21 (correct)

What was the total number of corrective services reported across all devices?

161 Signup and view all the answers

What is the mean standard deviation for the analyzers in laboratory equipment?

0.6 Signup and view all the answers

Which device category has an average value closest to 500,000 I$ [PPP]?

Microscope Signup and view all the answers

How many total devices were analyzed in the study?

223 Signup and view all the answers

What was the mean standard deviation reported for ultrasound imaging devices?

1.07 Signup and view all the answers

What is included in the fixed costs associated with equipment maintenance?

Establishing a central administrative unit Signup and view all the answers

How is equipment downtime defined in the context of this analysis?

The time a device is unavailable for services due to technical defects Signup and view all the answers

What additional operational cost component is considered in the model?

Lost hospital revenues due to lower operational device shares Signup and view all the answers

What discount rate is assumed for calculating the net present value of total costs during the pilot?

5% Signup and view all the answers

What is a significant challenge noted when assessing request filing for corrective maintenance?

Requests are often filed too late Signup and view all the answers

What role do inflation adjustments and local currency conversions play in this analysis?

To benchmark downtime under no maintenance scenarios Signup and view all the answers

Which of the following is NOT part of the operating costs calculated in this model?

Advertising for increased hospital services Signup and view all the answers

What is the primary outcome indicator used to evaluate the financial impact of the pilot?

Net present value of total costs during the pilot Signup and view all the answers

What is the total operational maintenance cost per hospital for a no maintenance approach?

264,675 I$ PPP Signup and view all the answers

How much does Nepal's contracted-out maintenance scheme require in initial investments?

670,288 I$ PPP Signup and view all the answers

What is the amount of operational maintenance cost for a contracted-out maintenance scheme after three years?

493,762 I$ PPP Signup and view all the answers

What percentage of total program cost does operational maintenance represent after three years?

11.0% Signup and view all the answers

What flat rate is assumed for scheduled maintenance inspections in the recalculations?

A reasonable flat rate Signup and view all the answers

How does the total equipment-related program cost for no maintenance and contracted-out scheme evolve over a ten-year period?

No maintenance initially is cheaper, but variance occurs later Signup and view all the answers

What is the assumption regarding hospitals' contributions to operational management costs?

Hospitals do not contribute at all Signup and view all the answers

What is the fixed and operational cost of contracted-out maintenance compared to in-house maintenance after three years?

It is 129,566 I$ PPP less Signup and view all the answers

What is a significant consequence of equipment downtime in hospitals according to the information provided?

Missed hospital revenue Signup and view all the answers

What is included in the costs of in-house maintenance?

Building a workshop and tools Signup and view all the answers

What percentage of total maintenance cost may equipment-based downtime revenues represent?

About 2% Signup and view all the answers

Why do Nepali public hospitals struggle with equipment maintenance?

Absence of a maintenance scheme Signup and view all the answers

What is a potential main goal of minimizing equipment downtime as viewed by health systems planners?

Improving quality of care Signup and view all the answers

What does the comparative cost assessment primarily focus on?

Cost between different maintenance approaches Signup and view all the answers

How does the maintenance cost of hardware compare to the cost of in-house maintenance staff?

Staff costs more than hardware Signup and view all the answers

What is a significant factor that can lead to variability in quality from management information systems?

Underlying data entering procedures Signup and view all the answers

Which limitation is highlighted regarding the applicability of results from this study?

The limited geographic scope of the pilot catchment area Signup and view all the answers

What role did the KfW organization have in the study?

They conducted the independent evaluation of the maintenance pilot Signup and view all the answers

What did the authors use to ensure the integrity of their data?

Quality and plausibility checks Signup and view all the answers

Which of the following is a key aspect of the pilot mentioned in the context of maintenance?

It covers a population of roughly seven million people Signup and view all the answers

How did the authors characterize their data collection process?

The process involved strict control and revision by all authors Signup and view all the answers

What is one expected outcome of scaling up the maintenance to the country level?

Improved performance of contracted-out maintenance Signup and view all the answers

What do the authors caution about the data from the management information system?

It might not accurately reflect the reality on the ground Signup and view all the answers

Study Notes

Maintenance Cost Comparison

There are three main medical equipment maintenance scenarios: contracted-out maintenance, in-house maintenance, and no maintenance.
The study focuses on comparing contracted-out maintenance versus no maintenance.
Researchers calculated cost using a model with fixed and operating costs over a three-year period.
Fixed costs include establishing a central administrative unit and either building in-house workshops or setting up the contracted-out scheme.
Operating costs include central maintenance system management, device replacements, maintenance, and downtime.
Researchers used a discount rate of 5% to calculate net present value.

Downtime Calculation

Downtime is defined as the number of days a device is unavailable for services due to technical defects.
Downtime is calculated from the time between a corrective maintenance request and task completion.
Researchers added 15% of the time between a corrective maintenance job request and the equipment's last inspection as additional downtime.
Downtime from the year before the maintenance pilot was used as a benchmark for downtime under no maintenance.

Costs in Nepali Hospitals

Nepal's contracted-out maintenance scheme requires an initial investment of 670,288 I$ PPP for infrastructure.
After three years, operational maintenance costs amount to 493,762 I$ PPP (11% of total cost).
In-house maintenance includes building a workshop and equipping it with tools, costing about 799,855 I$ PPP.
Maintenance cost for in-house maintenance includes staff and hardware costing about 474,205 I$ PPP.
Costs for no maintenance and contracted-out maintenance are 264,675 IPPPand236,925I PPP and 236,925 IPPPand236,925I PPP, respectively.

Contracted Maintenance vs. No Maintenance Over Time

The cost comparison over a ten-year period shows that no maintenance is initially cheaper than contracted-out maintenance.
However, over a ten-year period, contracted-out maintenance becomes more cost-effective due to reduced downtime.
Contracted-out maintenance effectively reduces downtime cost compared to no maintenance.
Although downtime cost represents less than 2% of total cost, it is a significant factor for improving healthcare quality and reducing treatment risks.

Limitations of the Study

The study relies heavily on data from management information systems.
The study's scope is limited to the pilot catchment area in Nepal, which covers only seven million people.
Researchers acknowledge the potential for data quality issues.
The study's findings may not be easily generalizable to other locations.

Importance of the Study

Provides a comprehensive cost comparison of medical equipment maintenance scenarios in Nepal.
Emphasizes the importance of downtime reduction to improve healthcare quality and reduce treatment risks.
Offers valuable insights for health systems planners in prioritizing equipment management strategies.

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Description

This quiz explores the comparison of maintenance costs for medical equipment, focusing on contracted-out maintenance versus no maintenance. It examines fixed and operating costs over a three-year period and includes the calculation of downtime for devices. Test your understanding of the key concepts and data used in this research study.