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Table 2 Maintenance scenarios and corresponding program cost

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

Cost scenario:

A

B

C

No maintenance

Contracted-out maintenance: Intervention

In-house maintenance

Assumed equipment lifetime reduction:

39%

0%

0%

0%

(1)

(2)

(3)

(4)

Fixed Cost (in t = 0)

Management, contracted

  IT-System

181,196

181,196

181,196

  Transport

71,199

71,199

71,199

  Office Space

6875

6875

6875

Investment, in-house

  Workshops

421,830

  Tools

118,754

Preventive maintenance, contracted

  Rapid inventory assessment

251,355

251,355

  Mobilization phase

159,663

159,663

Total fixed cost

0

670,288

670,288

799,855

Operating Cost (in t = 1,2,3)

    

Management, contracteda

  IT-System

71,094

71,094

71,094

  Car

17,977

17,977

17,977

  Annual salaries

 

178,720

178,720

178,720

Replacement cost

4,924,275

3,003,808

3,003,808

3,003,808

Maintenance cost

  Invoiced program cost, contracted

   Preventive maintenance

465,777

   Spare parts

27,914

27,985

  Calculated program cost, contracted

   Preventive maintenance

72,168

   Corrective maintenance

14,286

  Calculated program cost, in-house

   Annual salaries

288,856

   Spare parts and tests

185,349

Total operating cost

4,924,275

3,765,360

3,386,037

3,745,804

Downtime Cost

    

Total downtime costb

104,547

65,925

not applicable

Total program cost (NPV)

5,028,823

4,501,574

4,056,325

4,545,658

  1. Notes: Each cell reports net present value of total cost in 2016 I$ PPP over three years, calculated for the sum of 19 district hospitals from the two pilot regions. aAs maintenance management responsibilities do not include the procurement of new equipment, we do not include it in the management cost estimates. bAs we have no reliable estimate for downtime cost under inhouse maintenance, it is only considered for the comparison of replacement with contracting out scenarios. We assume downtime cost to be equal between full in-house and contracted out maintenance