An analysis of the functional state and costs of maintenance and repiar of capital medical equipment at Dr Yusuf Dadoo hospital

Abstract

BACKGROUND: Medical equipment is used in the diagnosis, treatment and monitoring of patients and their maintenance is a fundamental part of managing these technologies in hospitals. Over the recent years equipment down-time has been an increasing concern within the delivery of health care services. This study focussed on the analysis of the functional state and costs of maintenance and repair of all capital medical equipment (CME) at a district hospital in the Gauteng Province. AIM: To analyse the functional state and purchasing and service costs of CME at the DYD Hospital during ten year study period (April 2001 to March 2011) METHODOLOGY: The setting of this study was Dr Yusuf Dadoo Hospital (DYD Hospital) a district hospital situated in the West Rand District in the Gauteng Province. A cross-sectional retrospective record review study of all CME was done in OPD, In-patient units, Radiology and Surgical Theatre. The data for this study was extracted from the records which were captured and kept by the asset management department, finance and maintenance divisions of the Hospital. RESULTS: Most of the CME (196, 97%) procured during the study period was still functional and only seven (3%) was condemned. Nearly a quarter of them (24%) were in a good condition. However, a high proportion (73%) was in a fair condition requiring replacement within three to four years and only a small proportion (3%) was in a poor condition nearing the end of its life expectancy benchmark. There were significant differences in terms of condition of equipment among different departments of the Hospital (Chi-square test, p<0.001). The actual lifespan of CME was significantly lower than the expected useful lifespan (Mann Whitney’s U test, p<0.001). The total purchasing costs for all four departments were R 8,217,760.36 (median R 18,500, IQR R 9,690 – R 100,500). The individual purchasing cost of CME in the Radiology department was significantly higher than the other departments (ANOVA, p<0.01). The total service costs for all four departments were R 1,454,566.85 (median R3,500, IQR R1,250 - R10,075). There was no significant differences in service costs among the four departments (ANOVA, p=0.10). CONCLUSION: DYD Hospital had adequate numbers of CME and they were well maintained. However, significant replacement was likely to be required by the Hospital in the near future as the majority of CME was nearing the end of its life expectancy benchmark. These findings were reported as a research report which was submitted to the University of the Witwatersrand and the Gauteng Department of Health. The detailed findings were also presented and explained to all staff of DYD Hospital in a workshop that was held in the Hospital for implementation of the recommendations from this study.