Utilization Indices of Advanced Medical Imaging Equipment in the Public Healthcare Facilities of Tamil Nadu: A Multicenter Time-Motion Observational Study

Background: Advanced imaging modalities, such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) scanners, are indispensable tools in modern diagnostics, enabling early disease detection and informed clinical decision making. However, in resource-limited public healthcare settings, the operational efficiency and actual utilization of such costly equipment often remain uncertain. This study aimed to systematically evaluate the efficiency of imaging equipment in public hospitals using established industrial performance metrics: Overall Equipment Effectiveness (OEE) and Total Effective Equipment Performance (TEEP). Methods: A multicenter time-motion observational study was conducted across 23 public healthcare facilities in Tamil Nadu, India, encompassing 56 imaging scanners (CT, MRI, and PET) selected through stratified random sampling. Equipment utilization data were collected and analyzed using OEE and TEEP indices, which assess the availability, performance, and quality of equipment use in real-world clinical settings. Results: Among 64,783 observed operational minutes, CT and MRI scanners demonstrated high availability (87.9% and 90.0%) and near-perfect quality (about 100%), but relatively low performance efficiency (45.6% and 81.0%). PET scanners exhibited the lowest availability (57.8%) and performance (61.8%). Overall, MRI achieved the highest OEE (70.7%), followed by CT (62.3%), while PET showed the lowest efficiency (35.7%). TEEP analysis indicated significant underutilization across all modalities, particularly PET (20.8%). Conclusion: Despite satisfactory availability and quality, imaging equipment in public hospitals remains underutilized. Optimizing scheduling, preventive maintenance, and operator training could substantially enhance equipment efficiency and service delivery in resource-constrained healthcare systems.