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Contract service and shared service organizations are the two primary alternatives to in-house maintenance of medical equipment. The emphasis on manufacturer-based service has been decreasing lately for all but the most specialized equipment. This development is due to a variety of influences, chiefly related to the economy, and the need of the hospital to access broad-based technologists to service the equipment, and provide rapid technical support. The factors which must be weighed by the hospital in considering these two approaches are examined.