Planning and Managing of Diagnostic Imaging Technologies in Healthcare: The Introduction of Managed Equipment Service (MES) for the System’s Sustainability


The lack of resources has driven healthcare management studies to recognise Private and Public Partnerships (PPP) as the solution in managing efficiency, effectiveness and profitability of technological innovation. Recent researchers have identified the buying model called Managed Equipment Service (MES), in which purchaser and seller share the risks of technology’s management and use, as an optimal problem-solving method. The aim of this research is to analyse the potential economic-financial and organizational benefits of MES introduction in healthcare, in particular for the acquisition of the diagnostic imaging technologies. The research applies the case study method. We have examined a representative Italian Local Health Authority for its dimensions, managerial characteristics and case-mix offered but, especially, for its high health standards. In the study we have involved the strategic figure of radiographer in diagnostic imaging. The data has been elaborated through statistical analysis to observe the correlations. Evidence demonstrates that MES costs are lower than all the other planning and purchasing methods analysed (between 11% - 239%). When correlations between age of facilities and effectiveness of provided services is strong, MES grants the maintenance of a lower average age of technologies and a more efficient use of resources and significant margins of profitability. The emerging model of PPP is a possible solution to the current issues surrounding economic and financial sustainability of healthcare systems, considered the fewer resources and the technological progress. MES in healthcare appears to be a highly efficient way of managing innovation, in particular for diagnostic imaging technologies.

Keywords: Public Private Partnership (PPP), Managed Equipment Service (MES), middle-high technologies, diagnostic imaging.

[1] Pontarollo E. (2000). “La gestione del parco tecnologico elettromedicale tra “outsourcing” e integrazione verticale”, Issue 3 ‘Industry’, July-September 2000, Webjournal “Il Mulino”;

[2] Cincotti F., V.Glorioso, Z. Guennouna, V. Tamborini (2014). “Il quadro economico e finanziario 2009- 2018: dal Servizio Sanitario Nazionale alla Spesa Pubblica in dispositivi medici”, N. 23, December 2014 for Centro Studi Assobiomedica (CSA) and Centro Europa Richerche (CER).

[3] Borgonovi E., P. Adinolfi, R. Palumbo, G. Piscopo (2018). “Framing the shades of sustainability in health care: pitfalls and perspectives from Western EU Countries”, Journal Sustainability, 10, 4439;

[4] Mihaylova B., A. Briggs, A. O’Hagan, S. G. Thompson (2011). “Review of statical methods for analysing Healthcare Resouces and Costs” in Health Economics, 20, 897-916 (2011).

[5] Katz L., R. V. Fink, S. R. Bozeman, B. J. McNeil (2014). “Using Health Care Utilization and Publication Patterns to Characterized the research portfolio and to plan future research investments”, PLoS ONE 9 (12);

[6] Andreoni A. (2017). “Strategies for emerging technologies and strategic sectors: evidence from OECD countries and some critical reflections on the Italian case”, Issue 1 ‘Industry’, January-March 2017, Webjournal “Il Mulino”;

[7] Giorgi C, I. Pavan (2018). “‘Un sistema finito di fronte a una domanda infinita’. Le origini del Sistema sanitario nazionale italiano”, Issue 2 ‘Paper and history’, December 2018, Webjournal “Il Mulino”;

[8] McKee M., N. Edwards, R. Atun (2006). “Public-private partnerships for hospitals”, Bulletin of the World Health Organization, November 2006, 84 (11);

[9] Tekin P. S. (2012). “Public-private partnership and the healthcare sector,” Turkish Review 2, no. 4 (2012): 48-55;

[10] Hoppe E. I., P. W. Schmitz (2013). “Public-private partnerships versus traditional procurement: Innovation;

[11] Bizzotto G., V. Codazzi (2016). “Produzione, ricerca e innovazione nel settore dei dispositivi medici in Italia. Rapporto 2016.” By Centro Studi Assobiomedica in collabortion with Centro Europa Richerche (CER);

[12] Egan P. (2018). “Managed equipment service – Is it all it’s cracked up to be?”, European journal of medical physics, Volume 52, 165;

[13] Eisenhardt K. M. (1989). “Building theories from case study research.” Academy of Management Review, October, 14 (4), 532-550;

[14] Yin R. (1994). “Case study research: Design and methods (2nd ed.).” Thousand Oaks: Sage Publishing.

[15] Parri E. (2015). “The installed machinery of diagnostic imaging equipment in Italy: the state of the art between adequacy, obsolescence and innovation with a view to sustainability of the system”, N∘ 32 of Assobiomedica Study;

[16] COCIR REPORT (2016). “Indicators targeting EU heathcare sustainability goals”;

[17] Progress Consulting S.r.l. and Living Prospects Ltd (2012). “La gestione dei sistemi sanitari negli Stati membri dell’UE. Il ruolo degli enti locali.”.