Economic optimization of MRI facilities in Chinese hospitals through cost, productivity, and revenue analysis

Magnetic resonance imaging (MRI) facilities represent one of the largest capital expenditures in Chinese public hospital infrastructure, yet rigorous frameworks for jointly optimizing cost structure, operational productivity, and revenue performance are scarce. This study develops and applies an integrated cost-productivity-revenue (CPR) analytical framework to a six-year panel dataset of 286 hospital-year observations drawn from 74 public hospitals spanning six provincial regions (2018-2023). A translog total cost function estimated via system Generalized Method of Moments (GMM) identifies minimum efficient scale (MES) at approximately 8500 annual examinations per machine, below which the average cost per scan exceeds the efficient benchmark by up to 19.7%. A polynomial maintenance lifecycle model demonstrates that the maintenance-to-procurement cost ratio (MCR) reaches 1.6 times the manufacturer-projected level by year five of operation. A quadratic revenue function incorporating daily operating hours and payment regime reveals that revenue-maximizing scanner utilization is 13.7 h per day under fee-for-service (FFS), falling to 11.8 h under the national diagnosis-related group (DRG) bundled payment system, which simultaneously compresses average MRI department revenue margins by 11.4 percentage points. Policy simulations quantify that centralized procurement consortia, preventive maintenance scheduling, and advanced-sequence reimbursement differentiation generate a combined ten-year net present value (NPV) of RMB 5.01 million per machine at a 2.3-year payback period. These findings provide hospital administrators and national health system planners with an evidence-based economic roadmap for optimizing MRI facility performance within China's evolving healthcare financing environment.