The need for engineering talent in health-care delivery is increasing. One of the prime considerations is the cost of employing highly trained engineering personnel. In an effort to determine the costs now being paid by hospitals for engineering services, primarily for repair and maintenance of patient-oriented equipment, a study was conducted in 11 Cleveland area hospitals.Twenty-one common types of equipment were included in the study. This study covered a total of 2,720 items in the 11 hospitals. The average yearly repair frequency and cost per repair was determined for each type of equipment. Depending on a hospital's equipment inventory, the hospital can calculate its expected repair costs and compare these to the cost of an in-house clinical engineering department. Many services other than repair can be provided by the clinical engineering department and more accurate analysis may be computed by considering the required man-hours of service.A discussion and comparison of costs per man-hour for in-house service ($10/man-hour) versus outside services ($30/man-hour) is presented in this article. Two actual examples of costs for a 300-bed and 500-bed hospital are briefly described.SummaryDepending on the amount of equipment in the hospital and the number of repairs being made, a clinical engineering department might be established without increased cost. Even if added expense is needed, it must be weighed against the advantages of having more rapid repairs of critical equipment, less downtime, more accurate and reliable equipment, and a marked reduction in frustration and lost time of hospital personnel because of equipment malfunction.Certain manufacturers and outside service groups have provided excellent service and will continue to do so. While in-house clinical engineering services may not be justified for all hospitals, engineering is an increasingly important part of health-care delivery; and with the computed cost differences, as shown in Figure 2, its in-house implementation should be carefully evaluated.