Structuring of service centres for economic and equipment efficiency.

Increasing costs in healthcare have stimulated discussions on whether installation of competent in-house service groups for equipment management could eventually aid in reducing expenditure. In the Federal Republic of Germany, a four-year programme was initiated in 1979 with the purpose of investigating the feasibility, efficiency and profitability of a clinical engineering service within hospitals. The results of this programme formed the foundation on which we developed guidelines for structuring such service centres, to enable other hospitals to profit from the experience gained and possibly to avoid repeating mistakes. Service groups must have sufficient personnel to be successful. As a rough estimate, approximately one service staff member per 100 beds is needed. A more sophisticated structuring demands analysis of the repair accounts to elucidate additional parameters. An optimised service centre can reduce the maintenance costs to about 60 per cent of their original value without in-house service. Structuring of service centres for cost-effectiveness requires a simultaneous increase in service quality, which should be the highest motivation in clinical engineering.