Comparative Evaluation of Annual and Comprehensive Maintenance Contracts for Reducing Medical Equipment Downtime in a Tertiary Care Hospital: An Observational Audit.

BACKGROUND: Medical equipment availability is essential for safe, continuous, and efficient care delivery in tertiary care hospitals. Downtime of diagnostic, operative, monitoring, and life-support equipment can disrupt clinical services, delay procedures, and compromise patient safety. Maintenance models such as Annual Maintenance Contracts (AMC), Comprehensive Maintenance Contracts (CMC), warranty coverage, and in-house repair systems differ in scope, cost predictability, and risk protection. OBJECTIVE: This study aimed to comparatively evaluate maintenance-contract coverage and equipment functionality patterns associated with AMC, CMC, warranty, and no active contract status in a tertiary care hospital. It also assessed departmental vulnerability and maintenance gaps to support risk-based planning and clinical service continuity. METHODOLOGY: A cross-sectional observational audit was conducted using biomedical equipment inventory records from selected clinical and diagnostic departments. Equipment entries were assessed for department, contract status, warranty status, and functional condition. Contract coverage was categorised as protected, partially protected, or unprotected, and descriptive analysis was used to identify departmental maintenance gaps and non-functional equipment clusters. RESULTS: The audit demonstrated that the absence of active maintenance coverage was associated with greater vulnerability to equipment non-functionality, particularly among high-value and clinically critical devices. CMC offered broader protection through preventive service, corrective repair, and spare-part inclusion. CONCLUSION: Risk-based maintenance planning is required, with CMC prioritised for critical equipment and structured AMC or in-house systems used for lower-risk assets.