Mathematical modeling of clinical engineering approach to evaluate the quality of patient care

  • Md. Anwar HossainEmail author
  • Mohiuddin Ahmad
  • Md. Rafiqul Islam
  • Yadin David
Original Paper


At present, the patient care delivery system (PCDS) in a hospital/medical institute/clinic is absolutely medical technology-dependent and this tendency is found to increase day by day. To ensure the quality of patient care (QPC) appropriate implementation of the patient care technology management system (PCTMS) is necessary. Unfortunately, it is found to be absent in the healthcare delivery system in most of the countries in the world. The situation is very much severe, particularly, in medium- and low-income countries like Malaysia, India, Sri Lanka, Bangladesh, Pakistan, etc. The opposite scenario is found in high-income countries, specifically, in Japan where QPC has been improved significantly by adopting the clinical engineering approach (CEA) in their PCDS. Up to now, QPC is determined based on prediction as there are no mathematical ways to evaluate it properly. In this study, we for the first time, propose a mathematical model to evaluate the QPC quantitatively based on feedback control analogy taking into account of CEA in PCTMS, particularly, for clinical and surgical equipment. The model consists of three subsections: the clinical engineering department (CED), PCTMS, and health care engineering directorate (HCED). The correlation among the subsections and their performance parameters are defined and standardized. Multiple linear regression method is applied to derive the least square normal equations for each of the subsections and then the regression coefficients are solved by the standard data taken from 1000 beds hospitals of different countries. The model is applied to reveal the present status of QPC for 18 different countries including high-, middle-, and low-income countries of the world. The results obtained from the model demonstrate that the present status of QPC in Japan is 84.69% and in Pakistan, it is only 0.20%. This huge discrepancy is identified to be caused by the inclusion of CEA in PCDS of Japan. The proposed model can be applied to evaluate the QPC of a hospital/in a country and hence to take necessary steps accordingly for establishing the proposed research methodology. It is to be mentioned here that the proposed model cannot be applied to evaluate the QPC in some countries like Bangladesh, Bhutan, Nepal, etc. due to the unavailability of data related to the model parameters.


CED PCDS PCTMS QPC Modern hospital Medical and surgical equipment patient safety and cost-effective care 



This research work was partially supported by CASR grants, Khulna University of Engineering & Technology (KUET), Khulna-9203, Bangladesh. We acknowledged this research work to Dept. of BME, KUET, Bangladesh; NEMEMW & TC, Ministry of Health & Family Welfare, Dhaka, Bangladesh; Hospitals of Bangladesh for their supports related to data collection that greatly improved the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Md. Anwar Hossain
    • 1
    • 2
    Email author
  • Mohiuddin Ahmad
    • 3
  • Md. Rafiqul Islam
    • 3
  • Yadin David
    • 4
  1. 1.Department of Biomedical EngineeringKhulna University of Engineering & Technology (KUET)KhulnaBangladesh
  2. 2.National Electro-Medical Equipment Maintenance Workshop & Training CenterMoH & FWDhakaBangladesh
  3. 3.Department of Electrical and Electronic EngineeringKhulna University of Engineering & Technology (KUET)KhulnaBangladesh
  4. 4.Biomedical Engineering Consultants, LLCHoustonUSA

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