ArticleFrontiers in public health2026
Breaking the "idling dilemma" of donated medical equipment: a TDABC-based analysis of health policy failure and a pathway to reform.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Objective: This study addresses the widespread idling and premature scrapping of donated medical equipment in grassroots and remote areas, revealing a key policy flaw: the current system incentivizes "equipment quantity and value" while systematically ignoring the essential "operation and maintenance (O&M) service ecosystem" needed for long-term usability. Methods: Using a Time-Driven Activity-Based Costing (TDABC) model, we analyzed a representative case-donating portable ultrasound devices to a high-altitude county hospital with a 5-year bundled service-to precisely quantify hidden long-term O&M costs for the first time. Results: The total present value (TPV) of 5-year O&M costs amounts to CNY 324,397.89, accounting for 30.19% of the overall total investment of CNY 1,074,397.89. Sensitivity analysis indicates that this proportion fluctuates between -4.15 and +27.84%. Travel and logistics alone exceed 70% of O&M costs, underscoring how geographic barriers erode policy effectiveness through high support expenses. Conclusion: Long-term O&M is a critical yet overlooked constraint; its underestimation is a critical factor likely associated with a "donate-and-abandon" model, potentially leading to resource wastage resources. We advocate shifting health policy from "equipment delivery" to "sustainable service capacity building," proposing a life-cycle cost-based framework to institutionalize O&M costs and improve equity and efficiency in health resource allocation.
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