| Changes in health care financing have had a dramatic effect on the entire structure of the health care delivery system, especially the field of medical instrumentation. It has been claimed that the financial health of a hospital can achieve a significant contribution from increasing the productivity and utilization of the Clinical Engineering Department. However, numerous attempts at measuring the performance of clinical engineering service have not been able to establish a single measure that is generally acceptable to clinical engineering management.;The first objective of this research is to study several measures of clinical engineering performance (as measured by the cost of the service) that have been suggested in the literature such as: cost per bed, cost per number of devices, cost per value of devices, and cost per technician. A statistical correlation and stepwise regression analysis was used, utilizing the Statistical Analysis System (SAS) and Biomedical Programs (BMDP) to analyze data gathered on clinical engineering departments from about four hundred hospitals in the United States. That data was assembled by Quest Publishing Company. The result of the analysis showed significant correlations between the clinical engineering budget and both the size of the Clinical Engineering Department (represented by total personnel in the department), and with the number of devices serviced.;The second objective is to suggest an alternate performance measure that incorporates both the cost and effectiveness aspects of the clinical engineering service. By portraying clinical engineering as a logistics support agent in the hospital environment, and applying to it those logistics engineering and management concepts developed for military applications, i.e. reliability, availability, and maintainability (RAM), it was possible to develop a system model of the service using equipment availability as a measure of clinical engineering performance. In addition, three different types of biomedical equipment i.e., a respirator, a ventilator, and a Computed Tomography (C.T.) machine were studied, and several performance evaluation measures were proposed for the clinical engineering service and equipment. |
