Hospital Feasibility Study _500 Bed_indon

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Hospital Project Feasibility Study

Introduction

Government Impetus

Medical Profession in Bangladesh

Clinics & Hospitals

Demand-Supply Scenario

Policies and Regulations

Prospects of New Hospitals in Bangladesh

Operating Plan

Clinical Specialties

Non Clinical Specialties

Proposed Facilities

Departments and Facilities

Other Medical Facilities

Emergency and Day Care facilities

Revenue Model

Capacity Utilization (5 Yrs. analysis)

Projected Income Statement

Revenue Projections

Registration

Consultation

Bed revenue

Surgery and Procedure

Consumables and Pharmacy

Diagnostics and Imaging Services

Overhead Budget

Direct operating cost

Manpower Budget

General and Admin Overhead Budget

Depreciation

Finance Cost

Project Cost

Medical Equipments

Radiology & Imagine

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Cardiology

Neurology

Nephrology

Urology

Dermatology

Orthopedics

Gastroenterology

Obstetrics & Gynecology

ENT

Ophthalmology

Oncology

Bio Chemistry Lab

Clinical Pathology

Hematology Lab

Microbiology

Histopathology

Blood Bank

Operation Theaters

Cardiothoracic, Coronary, Medical ICU

Emergency

Physiotherapy

Cath Lab

MHC

Wards IPD

Laundry

Kitchen

CSSD

Waste Management

Central Services

Plumbering & Sanitary works

Water treatment plant & storage

Sewerage treatment plant & disposal

Internal electrification

Substation

Generator

Air Conditioning

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Boiler & hot water system

Fire fighting system

Elevators

Hospital Services

Medical Gases, 2points / Bed

Mortuary

Workshop

Incinerator

Pharmacy

Store/Medical Record

Miscellaneous Fixed Assets

IT & PABX

Server & Networking

Computer

System software

Hospital software

Peripherals

Nurse Call System

PA system

TV/Audio

Vehicles

Ambulance

Cars -

Furniture

Land and Land development

Projected Working Capital Requirement

Projected Income Statement (5 Yrs.)

Marketing Plan

Target Market

Competitors Revenue Analysis

Pricing

Competitive Strategy

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Introduction

In Bangladesh, the government is primarily responsible for the provision of healthcare. The

government institutions principally cater to the needs of mass population at subsidized rates. Since the patients are in great numbers, and there is a shortage of the facilities available, the quality of

healthcare provided by the Government is not satisfactory. Efforts have been made to expand and

improve the healthcare systems, but even with support from the donor community, this has never been

successful to the desired level, because of the huge population. The resulting structural deficiency of the public healthcare system has created a vacuum in the supply of quality medical services,

especially in relation to the demands of the upper-and-middle-class segments of the population.

Although there exists a considerable number of private hospitals and clinics, facilities within these institutions have hardly met international standards of excellence. Added to this, there continues to be

a mass exodus of people who wish, and have the ability, to avail healthcare of a higher "international"

standard. This is evidenced by the large number of people traveling to destinations such as India,

Thailand and Singapore every year. Moreover, not all the people going abroad are from the upper class, but are from the middle class as well.

Since independence, the government has been pursuing a policy of health development ensuring basic services to the people of the country. To achieve this goal, a number of development programs have

been undertaken in the health sector during the past years. Among others the main constraints were

lack of proper control and monitoring system, allocation of budget and skilled manpower. However, government has formulated national health policy providing strategy directives on major health issues

including basic healthcare and services of acceptable quality; improvement in medical education,

nutritional status, strengthening of planning and management capabilities. Bangladesh, characterized by its historical legacy of poverty and illiteracy, is challenged with many health problems.

Seeing this trend and feeling that there was a local need for few standard healthcare, the sponsors of UHSRL embarked on the Hospitals project.UHSRL an emerging private sector entrepreneur had been

a vision to contribute something in improving the countrys terrible healthcare situation. In view of that the promoters of this group have agreed to build up a hospital to cater to the needs of mass people and started building up this most modern 210 beded hospital with all important medical facilities.

Capacity:

The Hospital will have initially 210 beds with an expandable capacity up to 300 bed as described

below:

Bed Category Number Location General Ward 49 8th,9th and 10th

Semi Private 68 8th,9th,10th and 11th

Single Cabin 2 11th ICU(Intensive Care Unit) 10 6th

CCU(Coronary Care Unit) 10 7th

Recovery bed 4 6th Step down 8 7th

Post Operative 11 6th

Labor Observation 7 8th Nursery/Neo Natal 17 8th

OT 8 6th,7th,8th

Emergency bed 6 Ground floor

Cath Lab 2 7th

Total 202

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Medical Specialties:

Internal medicine Respiratory Medicine General Surgery Anesthesia Orthopedics Hematology Cardiology Interventional Cardiology Cardiothoracic Surgery Pulmonary ENT Dental and Maxi facial Surgery Ophthalmology Neurology Neurosurgery Diabetes and Endocrinology Nephrology Renal Transplant Urology Hematology Dermatology and Venereology Rheumatology Medical Oncology Obstetrics and Gynecology Pediatrics and Neonatology Pediatric Surgery Plastic & Cosmetic Surgery Physical therapy Psychiatry Emergency Medicine Dietary counseling Diagnostic and Imaging Lab Medicine Blood Bank.

Support Services:

The hospital is expected to provide the following support system for increasing efficiency.

Medical Records Room 24 Hours Pharmacy Ambulances Reception cum call centre Biomedical Engineering Services Sterile Supplies Department (CSSD) Food & Beverage Section Communication & Software Systems Mortuary

Medical and Other Equipment:

Most modern and latest equipment will be procured from the reliable suppliers according to the

specification suggested by the experts in the field. The list of all such medical equipment for the

proposed hospital is given under Medical Equipment list. The general equipment required for the building, such as the escalators, power substation, gas generator set, elevators, air conditioning

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system, fire fighting system etc. will also be soured as per the specification obtained from the

electrical consultants.

Power Supply:

The hospital will have adequate supply of power, which will ensure that all the possibilities of failure will be curbed.PDB connection for supply of power for daily operations and it will be supplied from a

1000 KVA LT transformer from DESA.A captive power generation from gas based generator is also

considered for backup power of 1000 KVA, which will ensure the hospital un-interrupted and continuous power supply.

Water Supply:

Water for the hospital will be sourced from the ground of the project site. The hospital will require

about 200,000 liters of treated water and a small quantity of untreated water every day. A water

treatment plant will be installed to obtain soft and pure water. Equipment, protecting water against bacterial infections will also be part of the water supply system. Necessary arrangement for deionizer

water supply for dialysis ward will also be made.

Gas Supply:

Gas generator, kitchen and cleaning room of the hospital would use natural gas to be supplied through an underground pipeline by the utility provider.

Other Facilities

The hospital will be equipped with disinfecting rooms, incinerator for combustible wastes, infectious

wastes and human tissues, treatment and disposal of sewerage of the hospital. Fumigation of operation

theaters, communication services, vacuum and compressed air facility, medical gas facility, hospital workshop will also be taken care of. Bio-medical workshop for repairs, maintenance and the upkeep

of hospital equipment and instruments is also going to be provided.

Government Impetus

Government is increasingly encouraging private sectors to invest in health care sectors. In this respect,

government has decided to allow direct foreign investment and joint venture projects to establish hospitals in the country for the development of the Medicare services. The Government has also

decided to allow appointment of foreign specialists in a proportionate rate in these hospitals.

Therefore, UHSRL will be able to maintain the required standards in managing the hospital by employing foreign consultants/Trainer as and when required.

In order to encourage investment in the health-care sector, the government has declared five- (5) year

tax-exemption for hospitals to be established between July 1995 to June 2010 for those that have more than 200 beds. The License Fee, Infrastructure Development Surcharge (IDSC), Value Added Tax

(VAT) and Advance Income Tax (AIT) on hospital equipment an import stage have also been

removed. However, customs duty @5% is payable on some specific equipment.

Health Care Challenges:

No health care system in the world is stable, and all systems would undergo considerable change in

the next 10 years. The drivers of change in the industrialized nations are reaching the limits of welfare

state, exhausting traditional methods and tools for containing costs and experiencing increased

consumer sophistication and demands. Change is being driven in the developing world by the growth of the middle class, greater demands

from that middle class, and the globalization of economics. The following factors will influence more

changes in health care system:

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Health transition demographic, epidemiological, emergence of infectious diseases Latest advances in the technology diagnostic, therapeutic, preventive Discovery and innovation in organ transplantation Robot and computer assisted medical interventions Molecular biology Genetic engineering and therapy Information super highway Total quality management Consumerism Cost-effectiveness Ethical and legal issues Research and development Evidence-based medicine

The Environment

An organizations environment consists of forces and conditions that surround in it. An organizations success or failure is wholly dependent on how effectively it copes with the competing demands of its environment. A typical hospital has two environmental components: one external and

the other internal. The external environment can be further subdivided into two: the general, and the

task environment. The general environment consists of political legal dimension, economic dimension, socio- culture dimension, technological dimension, the organizations internal dimension. These dimensions might affect its activities and pose a threat or opportunity to it.

The task environment includes those external groups and forces with which an organization has direct contact and transactions competitors, suppliers, regulators, patients, health care professionals and agencies, unions, and professional associations.

The primary components of the internal environment consist of the self, the tasks, the process and

skills the formal organizational design, the organizational culture, the individual employees or people

system, together with the leadership function and shared vision of the organization. Bay analyzing the

forces in the general environment and determining the interactive effects these have on the task and internal environments, management can be develop appropriate strategies and structures to meet these

demands.

Demographic

The main problem faced by hospital services is their increasing costs or the changes needed to make

them more efficient. This always seems to come back to the lot of caring for and treating elderly

people and the burden that such treatment imposes on the hospital services. There is a feeling that the

combination of increasing demands from elderly people and increasing severity of their disabilities will require more and more hospital services and that little of this can be substituted for by services in

the patients home. Quite a high preparation of the hospital beds for the acute specialties is occupied by elderly people.

Economic

Health care is a common concern for every country. The USA spends about 14 per cent its gross

domestic product on health care. This compares with 9 per cent in Canada, France and Germany,

about 6 per cent in Japan and the UK. And less then 2 per cent in India. The price of hospitals and

other institutional care has been rising very rapidly in all countries. Interestingly, New Zealand and the UK have felt driven to make rapid and extensive changes to the administrative structure of its

health services by splitting it into two groups: purchasers of health services, who plan the service and

providers, provide the service itself (consultation, operations), employ staff, thus having an effect on

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the individual and the society, on the country and on patients they live longer and better. There are

many types of managed internal market throughout the world, each with different approaches, different external limits, and different methods of funding. In the UK, each purchasing group is based

on a geographical area and is given fields according to the population in that area. Each health

authority decides which providers to purchase its society from. The essence of the managed market in

the UK is that there is competition between the NHS Trusts, the public providers, private health providers and others, including voluntary groups for the health authoritys finance. Patients are expected to exercise a choice of what services they want through their general practitioner who is

expected to act as their advocate in finding the best quality services. The pressures on health services to develop new approaches have come, in the main, from a combination of the medical profession and

industry developing complex equipment or drugs. The pressure to find new solutions is fed, on the

one hand, by professionals and their need to do research into new methods and on the other by private industry requiring developing new market.

Technological

The full development of scientific knowledge in medicine depends on:

The existence of knowledge which can be applied; People with the skills to apply the knowledge ; Social and political acceptability of the advance Financial backing for its development ; Marketing skills for the development ; and Financial spread for widespread manufacture.

The speed of development of scientific ideas and making them into useful products is affected by social, economic, and political conditions. Pressure on hospitals to use new technology has often been

driven by industry where developing these technologies may be a spin-off from other work. Several

advances in technology have been taken up by the medical profession for the development of home and community based of care. Developments in management methods are as useful to health service as any manufacturing company. Telecommunications and computer technology are good examples

of this. Many of the new technologies will help with the development of a less institutionalized health

service. The development of monoclonal antibodies will be especially useful in reducing the need for in-patient care. Some other technologies that will lessen the need for inpatient service in future

include diagnostic kits and desk top analyses, assessment systems using personal computers, new

vaccines, laparoscopy and endoscopy. Vascular catheters with or without lasers, laser microsurgery and vaporization (e.g. for tumors), computer-controlled prosthesis, treatment and drug delivery

systems. Technology can provide more in training.

Consumer Choice

One of the most powerful ways of deciding whether the quality of care is reasonable is to ask the patients who have been treated by that service as to how it affected them. This is not simply because

of a desire to please, or to boost the reputation of a service and, therefore, the people providing it.

Patient satisfaction is important because satisfied patients are more likely to cooperate with the people giving them health care. They are more likely to take advice they have been given.

Future Trends

The proportion and types of surgical operations carried out in day units, in contrast to conventional

care in a hospital is increasing steadily. The use of conventional care is spread to virtually all the

specialties. Some surgeons have gone so far as to suggest that virtually all minor and moderately complex surgery can be performed on a day basis with considerable financial savings. Surgery is

gradually giving way to medical care in a number of specialties, including cardiovascular,

gastrointestinal, treatment of cancers, etc. Developments in immunological control will allow specific

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treatment to be given to destroy abnormal cells using medical, rather than surgical techniques. For

other diseases, such as diabetes, given gene therapy is likely to be important in cutting down the long-term reliance on specialist help.

Quality Management

Quality health care has emerged as a watchword in the 1990s. Major concern to improve the quality

of care includes:

Concern for the consumer Concern for the quality of care Concern for the quality of management.

The introduction of total quality management (TQM) assumes that in organizations every one will

continually strive for improvement by removing the need for error detection, striving to get it right first time, every time; by being better able to define priorities for action by providing agree care at the

lowest cost; by identifying and removing patient dissatisfaction; by increasing consumer satisfaction;

by improving processes and out-come and by increasing productivity. TQM is a management philosophy that requires total commitment from all levels in the hospital. Its main objectives are:

Strong customer focus Scientific approach Continues process improvement Total participation at all levels.

Quality begins with the values held by the organization providing the care. The people providing the

service may spend time concentrating on the particular and processes which can be monitored, giving

less time other, less tangible and therefore less measurable of the work. The development of clinical guidelines is an approved to improving the quality of care. It may concentrate the positive side of

setting out best practice in some detail. It relies on experts to help set up the guidelines. The best

guidelines have the advantage of cutting across different specialty boundaries, given by general

practitioners and which need specialist care. Some basic measures to show the quality of care given include:

Hospital mortality Adverse events (e.g. nosocomial infection) Malpractice suits Disciplinary action against doctors Sanction from peer reviews Doctor's performance in treating specific disease Number of services available External evaluations Specialization of doctors Patients assessment of their care.

Quality management systems include medical audit surgical audit, nursing audit, clinical quality circle

TQM, etc.

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Project Cost:

The break up of the estimated project cost of hospital is as follows which has been computed as

follows:

Project Cost Taka

Medical & Surgical Equipment 906,994,779

Electrical Installations, Air Conditioning, Generator, Lift etc. 143,630,000

Computer & IT Systems 22,275,000

Furniture & Fixture 30,000,000

Office Equipment 2,500,000

Vehicle 25,000,000

1,130,3999,799

Medical & Surgical Equipment 906,994,779

Diagnostic And Imaging 235,988,450

Biochemistry 17,592,000

Hematology 10,150,750

Histopathology 4,559,000

Clinical Pathology 3,166,000

Microbiology Lab 9,663,034

Cardiology 22,190,000

Gastroenterology 10,376,160

Neurology 5,270,729

Emergency 5,000,000

Master Health Check 12,000,000

Blood Bank 8,398,968

Ward 2,500,000

Neonatal ICU 8,624,761

Labor Ward 1,500,000

Dermatology Department 10,000,000

Respiratory Medicine 3,555,058

Urology Dept. 50,000,000

Nephrology Dept. 31,445,532

Oncology Department 202,266,980

General Ot(6 Nos) 100,000,000

Anesthesia Unit 11,003,591

Surgical ICU 7,500,000

Physiotherapy Dept. 3,887,842

Ct Ot 35,000,000

Coronary Care Unit 10,000,000

Cath Lab 75,000,000

Ophthalmic Opd 4,732,064

Dental Dept. 3,125,986

Ent Opd 1,797,874

Pediatric Opd 200,000

Obs/Gyn 500,000

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DIAGNOSTIC AND IMAGING 235,988,450

MACHINE NAME Quantity

CT Scan Machine, Work Station,Monitor,Injector,console 1

Bon Dencito Meter 1

BP Apparatus (CT Scan) 1

Defibrillator 1

MRI Machine,Console,Injector(1.5 Tesla) 1

Anesthesia Ventilator (Datex) 1

Patient Monitor (Cardiac) 1

BP Apparatus (MRI) 1

1000mA Digital X-Ray machine 2

800 mA X-ray Machine 2

Mammography machine 1

OPG Machine 1

CR System (XG-5000) Fuji. 1

BP Apparatus 2

4D Color Doppler -Ultrasound Machine, Antrase 2

PACS(Picture Archiving and Communication System) 4

BIOCHEMISTRY 17,592,000

Bio-Chemistry Analyzer (Beckman Coulter CX9 or CX7) 1

Dade Behring Max Rxi 1

Immulite 2500 1

Water Purification System 1

Blood Gas Analyzer(Rapid Lab 1200Gas Analyzer) 1

Centrifuge Machine 2

Electronic Balance 1

Hot air Oven 1

PH meter 1

Pipette(different Range) 2

Refrigerator for Reagent 2

Freezer -20 degree Celsius 1

HEMATOLOGY 10,150,750


Hematology cell counter 2

Centrifuge 2

Coagulation analyzer (CA-550) 1

Electra Lab (Auto ESR) 2

Hot air Oven 1

Incubator 1

Microscope Olympus BX-41 1

Microscope CX-21 1

Spectra Photo Meter 1

Water Bath 1

Roller Blood Mixer 1

BP Apparatus 1

Vortex Mixer 1

12

Capillary Hb electrophoresis 1

Micropipette 5

05-20 micro liter 2

50-100 micro liter 2

100-1000 micro liter 2

1000 micro liter 2

Refrigerator 2

HISTOPATHOLOGY 4,559,000


Rotary Microtome (Thermo Shandon, Leica) 1

Tissue Embedding System (Thermo Shandon, Lexica) 1

Tissue Processor (Thermo Shandon, Lexica) 1

Tissue Floating Bath (Thermo Shandon, Lexica) 1

Cryostat (Thermo Shandon, Lexica) 1

Electronic Weight Machine 2

Hot Air Oven (Thermo Shandon, Lexica) 1

Microscope (Olympus, Nikon, Zeiss) 2

Ph Meter 1

Refrigerator (Lg) 1

Centrifuge (Heraeus-Labofuge-300) 1

Cytosine (Centrifuge) Thermo Shandon, Lexica. 1

CLINICAL PATHOLOGY 3,166,000


Microscope 2

Urine Analyzer 1

Centrifuge (8 Hole) 2

Water Bath 1

Micropipette 4

(20-50 micro liter,100-1000 micro Litr.)

Refrigerator 2

MICROBIOLOGY LAB 9,663,034


Biological safety Cabinet Class ii 2

Automated Blood culture & TB Culture 1

Autoclave Machine 1

Automated Antibiotic Zone Reader 1

Slide Heater 1

CO2 incubator 1

Centrifuge Machine Labofuge 300(heraeus) 2

Electronic Balance(Meter Toledo) 1

Anaerobic Jar(Oxide) 1

Micropipettes(Eppendorf) 10

Multi channel Micropipettes(Eppendorf) 1

Hot air Oven 1

Incubator-1 2

Microscope Olympus CX41,with DGI 2

13

PH meter 1

VDRL Rotor 1

Water Bath 1

Needle and loop Steam Sterilizer 1

Neflowmeter 1

Pipette stand 2

Motorized pipette aid 1

Vortex Mixer 1

CARDIOLOGY 22,190,000


ECG Machine 2

TMT/ETT System 2

Color Doppler Echocardiography System 2

Hand Carried Color Doppler Echocardiography Machine

with Cart 1

Holter Analyzer 2

Defibrillator 2

Ambulatory BP Recorder 2

Glucometer (Accu-Check) 5

Printer-Laser color 1

Printer-Thermal B/W 2

Printer-Thermal color 1

Halter Recorder 4

Printer-Normal 1

Pulse Oximeter 1

BP Apparatus 5

GASTROENTEROLOGY 10,376,160


Complete Vedioscope(set) 1

Upper G I Scope 2

Colonoscopy 2

Duodenoscope(set) 1

Bronchoscope(set) 1

Sony Color Video Printer 1

Leakage Tester 2

Trolley 2

ORTHOPAEDICS 15,000,000


Universal Drill Machine(Hand operated) 4

Drill Machine(Electric) 2

Hacksaw with Blade 2

Amputation saw 2

Bone saw(Electric) 2

Interlocking nailing Set 5

Bone Skid 2

T-extractor for femoral head 2

Humpy skin grafting knife 2

14

Electric plaster cutter saw 2

Arthroscopy Machine with Accessories 2

C-Arm Machine 2

Halter Cervical traction set 2

Sterilizer 2

High pressure electric suction apparatus 1

Infusion pump 2

Syringe Pump 2

Other Instrument Set 1

Plaster Cutter 2

Large Joint Arthroscopic with cannula & obturator 2

Orthopedic Accessories 2

NEUROLOGY 5,270,729


Niclet Vita port 16 Channel Ambulatory EEG System 1

EMG 1

Laryngoscope 1

Defibrillator 1

EMERGENCY 5,000,000


Patient Monitor 4

Defibrillator 2

ECG Machine 1

Ventilator-Critical Care 1

Ventilator-Transport 1

Syringe Pump 4

Infusion Pump 1

O.T. Light 1

Pulse Oximeter 1

Suction Machine 2

Ophthalmoscope 1

Auto scope 1

Laryngoscope 1

Spot Light 1

Nebulizer 1

BP Apparatus 6

MASTER HEALTH CHECK 12,000,000


X-ray Machine 1

ECG Machine 1

Ultrasound Machine 1

TMT/ETT System 1

Color Doppler Echocardiography System 1

Mammography machine 1


Laryngoscope 1

15

BP Apparatus 4

BLOOD BANK 8,398,968


Platelet Agitator 1

Microscope-Diagnostic 1

Refrigerator 3

Centrifuge 1

Digital blood Shaker 3

Doner Couch 3

ELISA Reader 1

ELISA Incubator 1

ELISA Washer 1

Hamo Control 1

Hot Air Oven 1

Tube Sealer 2

Plasma Expresser 1

Plasma Thawing Bath 1

Refrigerated Centrifuge 1

Plasma Expresser 2

Lab Rotator 1

Water Bath 1

BP Apparatus 2

Incubator-Path 1

Weighting Machine 1

Ward 2,500,000


ECG Machine 6

Defibrillator 6

Infusion Pump 6

Syringe Pump 6

Pulse Oximeter 6

Ophthalmoscope 6

BP Apparatus 20

Nebulizer 6

Neonatal ICU 8,624,761


Auto scope 2

Baby Incubator 3

CPAP-Bubble 2

Infant Warmer 6

Laryngoscope 6

Light Source-Halogen

1

Nebulizer 2

Ophthalmoscope 2

16

Patient Monitor 6

Phototherapy Unit 4

Phototherapy Unit-Reflective 1

Pulse Oximeter 2

Syringe Pump 6

Transport Incubator 2

Ventilator-Neonate 4

LABOR WARD 1,500,000


Fetal Monitor 3

Patient Monitor 1

Defibrillator 1

Pulse Oximeter 1

Infusion Pump 1

Syringe Pump 1

Suction Machine 1

Laryngoscope 1

Spot Light 1

BP Apparatus 2

Nebulizer 1

DERMATOLOGY DEPARTMENT 10,000,000


Laser Machine 1

Cooling Device 1

Diathermy Machine 2

Electro Therapy Unit 1

Spot Light 3

Diagnostic Lamp 1

Spot Light 1

UV therapy unit-Partial body 2

UV therapy unit 1

UV therapy unit-Whole Body 1

Woods Light 1

O.T. Table 1

O.T. Light 1

BP Apparatus 1

RESPIRATORY MEDICINE 3,555,058


PFT System 2

Nebulizer 2

BP Apparatus 2

UROLOGY DEPT. 50,000,000


Urodynamic system 1

Adult cyst scope with Accessories 1

Adult Reset cope with Accessories 1

17

Paedtric cyst scope with Accessories 1

Paedtric Reset cope with Accessories 1

Flexible Cityscape with accessories 1

Pneumatic Lithotripter with accessories 1

End vision Digital Single Chip Camera 1

BP Apparatus 1

NEPHROLOGY DEPT. 31,445,532


BP Apparatus 10

CRRT Machine 2

Defibrillator 2

Dialysis Machine 20

Laryngoscope 2

Nebulizer 2

Patient Chair-Dialysis 2

Pulse Oximeter 2

Weighting Machine 2

WRO Plant 2

ONCOLOGY DEPARTMENT 202,266,980


Linear Accelerator : 1

- 6 and 15 MV (dual) photon energy

- 4 electron (6,9,12,15)

- Dose rate for photon and electron energy up to 400Mu/min

- 120 leafs Multiyear Collimator

- Portal vision

- ARIA (Oncology Information System)

HDR (Brachytherapy) : 1

- 24 channel Brachytherapy

- Different Applicators

- Radiation Source

Treatment Planning System (TPS) :

- TPS for Linear Accelerator / Eclipse

- TPS for Brachytherapy

Simulator :

- 3D Digital Simulator with CT facility

OR

- CT Simulator

Treatment facilities :

2D, 3DCRT, IMRT (with Rapid Arc) and IGRT

Other Supporting facilities :

- Laser system (3-4 units)

- Water phantom and Dosimeter system

- Immobilization sets

- On line UPS (150-160 kva)

- Off line UPS for all the relevant computers

- Water Chiller with capacity 11-12 metric ton (2 units)

18

- Intercom system (2 way communication)

GENERAL OT(6 Nos) 100,000,000

Machine Name Quantity

Air Darmatone 2

Automatic Tourniquet System 3

Bipolar Coagulator 3

Bipolar ESU Unit 2

Bipolar Irrigation Module 2

Blood/Fluid Warmer 5

Bp Apparatus 6

Bronchoscope 3

Camera Head 6

C-Arm Machine 2

C-Arm Trolley With Video Monitor 2

Cauvery Machine 5

Co2 Endoflator-Electronic 2

Drill Machine-Ent 1

Drill-Neuro With Foot Switch 2

Drill-Orthopedics 5

Dvd Recorder 4

Harmonic Scalpel 2

Irrigation & Suction 2

Laryngoscope 5

Laser Machine 1

Light Source-Halogen 6

Light Source-Xenon 6

Lipoplasty Device 1

Lithoclast 1

Micro Motor-ENT 1

Microscope-Operating 4

O.T. Light 6

O.T. Table 6

Patient Monitor 6

Patient Warming System 2

Phaco Emulsifier 1

Plaster Cutter 6

Power Control Unit 4


Printer-Thermal Color 4

SAW & Drill Drive Unit 6

Saw-Ortho 2

Skin Masher System 2

Suction Pump 4

Suction-Vacuum (Gomco) 2

Syringe Pump 6

Ventilator-Anesthesia 6

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Video Monitor 6

Video Processor 6

Anesthesia Unit 11,003,591

7900, 7100 Ventilation Complete With Aestiva/5 And Accessories

7900 Ventilation Complete With Aestiva/5 MRI Software

And Accessories

Neonatal Ventilator(DEAR CUB 750PSV) With

Humidifier (Fisher & Paykel Mr410)

Surgical ICU 7,500,000


Patient Monitor 8


Blood Gas Analyzer 1

Bi-Pap Machine 1

Cpap Machine 1

Defibrillator 1

Ecg Machine 1

Infusion Pump 4

Pulse Oximeter 1

Syringe Pump 15

Bp Apparatus 4

Ophthalmoscope 1

Nebulizer 2

Physiotherapy Dept. 3,887,842


Bed For Manual Therapy 1

Bp Apparatus 2

Cervical Traction Unit 1

Chilling Unit 1

Cpm Machine 1

Electro Stimulator 1

Emg Equipment 1

Instrument For Resistance Exercise, 1

Laser Machine 1

Microwave Therapy Unit 1

Nerve Stimulator 1

Pack Heaters 1

Parallel Bar 1

Quards Exercise Table 1

Short Wave Therapy 1

Standing Frame-Adult 1

Standing Frame-Pediatric 1

Static Bi-Cycle 1

Tilting Table 1

Traction Unit 1

Treadmill- Physio 1

20

Ultrasound Unit-Physio 1

Wall Wheel Bar 1

Wax Bath 1

CT OT 35,000,000


Act Machine 2

Auto Clave Machine- Table Top 1

Baloon Pump 2

Cautery Machine 2

Defibrillator 2

Fabricator 2

Harmonic Scalpel 1

Heart Lung Machine 2

Hemo Therm 2

Light Source-Xenon 3

O.T. Table 2

Pacemaker 2

Patient Monitor 3

Patient Warming System 1

Saw-Manman 1

Saw-Sternal 2

Suction Machine 5

Suction-Vacuum (Gumbo) 4

Syringe Pump 6

Syringe Pump-Dps Base 2

Ventilator-Anesthesia 2

CORONARY CARE UNIT 10,000,000


Patient Monitor 10



Defibrillator 3

ECG Machine 1

Infusion Pump 6

Pulse Oximeter 1

Syringe Pump 8

Pacemaker 1

Ophthalmoscope 1

Laryngoscope 1

BP Apparatus 4

Nebulizer 2

CATH LAB 75,000,000


ACT Machine 2

Patient Monitor 4

Cathlab Machine 2

21

Injector-Cathlab 2

Defibrillator 2

Pacemaker 2

Pulse Oximeter 2

Syringe Pump 3

BP Apparatus 2

Nebulizer 2

OPTHALMIC OPD 4,732,064


Topcon Ophthalmic Chair 4

Topcon Slit Lamp With Electric Instruments 2

A - B Scan 1

Applanation Tonometer 2

Auto chart projector 2

Auto Kerato - Refract meter 2

BP Apparatus 1

Lens meter 2

Microscope-Slit lamp 2

Ophthalmoscope 3

Ophthalmic Unit 2

Ophthalmic-Electric Instrument Table 3


Retinoscope 1

Trial lenses set & trial frame 2

Visual Field Analyzer 1

Dental Dept. 3,125,986


X-ray machine 1

Micro motor-Dental 2

Scalar Machine 1

Compressor Unit 1

Diagnosis and Therapy Unit-Dental 1

BP Apparatus 1

ENT OPD 1,797,874


Diagnosis and Therapy Unit-ENT 1

Doctors Chair Unit 1

Clinical Audiometer 1

Clinical middle Ear analyzer 1

Microscope-Operating 1

Video Processor 1

Camera Head 1

Light Source-Halogen 3

Suction Machine 2

Auto scope 3

BP Apparatus 1

22

PEDIATRIC OPD 200,000


BP Apparatus 5

Nebulizer 1

Auto scope 1

OBS/GYN 500,000


Fetal Doppler 1


BP Apparatus 8

Fetal Doppler 1

Computer and IT Systems:

Computer & IT Systems 22,275,000

HIS Software System 5,000,000

Hardware System 10,000,000

HP COMPAQ DC5100, INTEL P4 3.0GHZ WITH 17"

LCD MONITOR

HP Laser Jet 1015 Printer with cable

EPSON LQ-2180 PRINTER (24 PIN/480 CPS/136

COLUMN)

UPS 1500 VA ( SENDON CHINA)

Sendon 1200 VA UPS

TAPE BACKUP DRIVE

CISCO SWITCH 48 PORT with 2 GBIC

NETWORK INFRASTRUCTURE 5,000,000

PA SYSTEM, CONSISTS OF - SPEAKER ;

AMPLIFIER ; SPEAKER CABLE ; POWER CABLE 500,000

Multimedia Projector 500,000 Brand : Hitachi

Model CPX-880

Origin : Japan

EPABX System 1,000,000

EPABX System With Std Accessories

Operator Console Model Enhanced AC - WIN V 4.0

Digital Key Phones Opti point 500 STD

BARCODE LABEL PRINTER 200,000

Javeline J310 C Card Printer 75,000

Electrical Installations, Air

Conditioning,Generator,Lift etc. 143,630,000

Description Qty

23

Boiler (Hot water generating and distribution system) 7,880,000

Hot Water Generator 2,500,000

Re-Circulating Pump 350,000

Copper Pipe 3,000,000

GI Pipe 75,000

Gate Valve 1,500,000

Ball Valve 5,000

Check Valve 75,000

Pressure Reducing Valve 300,000

Pressure Gauge, Testing and commissioning 75,000

External Electrification 25,000,000

SUPPLY OF SWITCH GEAR:

INCOMING FEEDER: 500,000

OUTGOING FEEDER 1,000,000

Transformer 5,000,000

SUPPLY & INSTALLATION OF L.T. PANEL: 3,000,000

EL.T. PANEL 3,000,000

SUPPLY & INSTALLATION OF AUTOMATIC PFI

PLANT: 2,500,000

SUPPLY & INSTALLATION OF BUSBAR TRUNKING SYSTEM: 3,000,000

CABLE WORKS: 2,000,000

Cable Tray/Ladder 3,000,000

Connection fee and Security 2,000,000

HVAC Systems 18,700,000

Chiller(Cooling Capacity 200 Ton) 5,000,000

Cooling Tower 800,000

Air Handling Units(10 Nos) 3,000,000

Centrifugal Pumps (2 Nos.) 500,000

Pipe Accessories 400,000

Metering Devices 300,000

Automatic Control System 800,000

Hepa Filter with Hood 400,000

Installation with Local Accessories 7,500,000

Medical Gas System 20,000,000

Oxygen Storage Tank(5,000 Ltr.) 3,000,000

Nitrous Oxide 800,000

Compressed Air 3,000,000

Vacuum System 3,500,000

Copper Pipe 5,500,000

Alarm Panel for Medical gas 2,000,000

OT Pendant 2,000,000

Ball Valve for Medical Gas 200,000

Titas Gas Network 2,000,000

24

Gas connection for the Hospital building including Electrical

Panel

Fire Fighting Equipment Systems 5,000,000

Diesel Genset(1 MW) 12,500,000

Kitchen Equipment 1,000,000

Integrated Cantilever Cooking System 1

3 Burner Gas Range (1700*500*850) 1

Single Burner Range (400*500*850) 1

3 Burner Gas Range ( 1800*500*850) 1

Wet Grinder 2

Cantilever Chef Cooking Unit 1

2 Burner High Presses. Work Range (1500*750*850) 2

1 Burner High Press. Work Range (750*750*850) 1

Banquet Trolley food warmer 10 GN 2/1(75*64*166) 1

Fly Catch Machine 1

CSSD 10,000,000

i. Steam Sterilizer HS 6613 AR-2 1

ii. Rails For Baskets 6613 1

iii. Manual Basket Feeder 6613 2

iv. Loading Trolley Fixed 6613 2

v. Basket Spri 585*395*195 MM 6613 18

vi. Steam Sterilizer HS 6617 AR-2 1

vii. Rails For Baskets 6617 1

viii. Manual Basket Feeder 6617 2

ix. Loading Trolley Fixed 6617 2

x. Basket Spri 585*395*195 Mm 6617 18

xi. Decomat Model 4656 G3d 1

xii. Op-Cart, 4 Levels 4656 1

xiii. An-Care Without Cassettes 1

xiv. Cassette For Hoses 20 Mm 1

xv. Cassette For Hoses 5-25 Mm 1

xvi. Cassette For 4 Bellows 1

xvii. Rack For 14 Kidney Bowls 1

xviii. Instr. Tray 340*250*70 Mm Hs33 8

xix. Drying Cab. S-363-E S/S Door 1

xx. Ultrasonic DTH 8510 1

xxi. Tank Cover, Stainless 8510 1

xxii. Tray, Stainless, 450*240*150 Mm 1

xxiii. Contingency Parts 1

Electrolux Laundry Systems 3,500,000

Table With Wash Up Sink With Drain and Overflow

Washer Extractor Model W 3250 N, 250 Liters Drum

Washer Extractor Model W 3600X 600 Liters Drum

Washer Extractor Model W 3330 N 330litres Drum

Tumble Dryer Model T 3650, 650 Liters Drum

Steam Ironer Model IC44821

25

Rolltainer RT 511 For Transportation And Storage

Steam Irons Finishing Table F3ABI

Air Operated Laundry Press Wet Work

Garment Rack KS150

JFC Roll Container 25OL, PT02

Auxiliary Plant For Use With Steam Boiler 3,500,000

Feed Water Tank

Pressure gauge with siphon

Pressure reducing station for steam

Sptrax Thermodynamic stream trap

Sptrax Automatic air vent module

Sptrax Float trap Module

Instantaneous Hot water generator

Sptrax Flash vessel

Steam operated condenser

Thermometer, Pressure Gauge

Waste Water Treatment Plant 4,000,000

1 Set mixing jet aerator 3.0 kw

1 Set mixing jet aerator 3.0 kw, 1 set of a IOTA Cyclic

clarifier iii. tube, s sets level switches, 1 sludge pump

& discharge pipe to sludge holding tank.2 effluent

pumps, 3 sets of level switches

Electrical control panel, 1 lots electrical cable, 1 lots of

internal piping and fitting, 1 chlorine tank, 2 metering pumps

Installation, Commission & delivery

Riello UPS 7,500,000

Riello RT 12000 120KVA online UPS 2

Riello RT 6000 60KVA online UPS 2

Riello MDM1500 15 KVA online UPS 2

Waste Disposal System 1,600,000

Horizontal cylindrical autoclave, Capacity-50 Ltr. 1

Plastic shredder HS-25, Capacity- 25 Kg/Hr. 1

Destronix needle-cum-syringe destroyer 40

Puncture proof containers, Capacity-55 Ltr. 60

Fully Automatic High Speed Sterilizer 2

Water Purification Equipment 500,000

Reverse Osmosis system 12M3 /Day 1

Ultraviolet System Model UV. A-400 1

Incinerator 2,000,000

Capacity 50KG/HR, Origin-India 1

PEDROLLO WATER PUMP, 0.6HP, 240V, 50HZ, MODEL

- 3CRM 80

Refrigerator 750,000 Brand: Toshiba

a) Model : GR-E9 25

Lift 22,500,000

26

Capacity 1000 Kgs/ 13 person 2,000,000

MATV 500,000

Television (CRT)

Plasma TV

Cabling work

Dish antenna

control panels

EXTERNAL WATER SUPPLY 8,700,000

Deep Tube Well 6,500,000

Chlorination Plant 1,000,000

Water Supply Centrifugal Pump and other accessories 500,000

2 Units of Submersible Pump 700,000

CC TV 500,000

Camera with color monitor

Mortuary 1,000,000

8-Body Mortuary Chambers

Furniture & Fixture 30,000,000

Description Qty

Manual Bed 100

Electric Bed 100

Patient Attendant Bed 100

Bed Matress 300

TV with Trolley 100

Stretcher trolley 25

Ambulance Stretcher 2

Cupboard QL 960-2 25

Baby Trolley 10

Orthopedics Bed 15

Cupboard QL 860 2

Transitional Stretcher Trolley 1

Trolley For Oxygen Bottle 15

Appliances Trolley QL 811 10

Adjustable Stool For Surgical 10

Over Bed Table 175

Medical Material Trolley 10

Model DC 1011 Bassinet Cot 5

Model CA 3000 Medical Emergency Cart 20

Model WM 542 Doctor Surgical Stool Technology 10

Banquet trolley 8

Service trolley 4

3 Seater Sofa 50

2 Seater Sofa 50

1 Seater Sofa 25

27

Nurses Locker 100

Doctors Locker 25

Medicine Shelve 12

Office Table For Directors With Side Table 3

Coffee Table 100

Discussion Table 15

Conference Table 1

Executive Dining Table 15

Staff Dining Table W/4 - Fixed Chairs 50

Chairs For Reception And Nurse Station 50

Chairs For General Staff 50

Chairs For Doctors And Department Heads 65

Chairs For Doctors And Executive Dining 50

Chairs For Director 3

Storage cabinet/shelve for director, CEO 5

Stool For Laboratory 25

Stool For Patient 50

Executives Table 50

Executive Chair 100

Visitor Chair 400

Nursing Trolley 25

X-RAY View Box (800*580*80 MM) 50

X-RAY View Box (1160*580*80 MM) 50

Appliance Trolley 50

Fan Shape Appliance Trolley 25

Dressing Trolley 25

Dressing Waste Trolley 18

Anesthetist Trolley 16

Surgical Instrument Trolley 16

Medication Material Trolley 16

Trays For Material Trolley 100

Iv Pump Stand 30

Patient Record Cabinet 25

Four Sections Screen 100

Three Sections Screen 100

Baby's Scale For Height 2

SS Revolving Stool 50

Scrub Station 8

Pharmacy cabinet 10

Consultants Chamber Cabinet 50

Examination Bed(Patient) 50

Steel Almirah 25

Steel Cabinet 50

Shoe Rack 50

Cafetaria Table 50

Cafeteria Chair 200

28

Counter 2,000,000

Nurse Station 1,000,000

Dialysis 1

ICU/CCU. 2

Sick-nicu 1

Pre-Term Nicu 1

Labor & Delivery 1

Semi Private Room 1

Day Care Word 1

Surgical Step Dn. 1

Surgical I.C.U. 1

Pre-Operative Ward 1

Post-Operative Word 1

Neuro Medical/Surgical IC 1

CT-Post Operation 1

Pre-Post Angiography 1

Reception Counter 500,000

Information(Ground floor) 1

Diagnostic 1

O.P.D. (Cardiology) 1

O.P.D. 1

M.H.C 1

Blood Bank 1

Emergency recap 1

Endoscopy 1

Radiology & Imagine 1

Nuclear Medicine 1

Main entrance Lobby 1

Labor & delivery (F.F) 1

Billing 1

Work Counters in different locations: 500,000

Sample Collection 1

Sterilizer 1

TD Lab 1

Component Store 1

Serology 1

Dark-Room 1

Sample Collection 1

Sub-Sterile 1

Clean-Utility 1

Decontamination 1

Radio-Pharmacy 1

Office Equipment 2,500,000 Banknote counting Machine 5

PAPER SHREDDING MACHINE 1

29

ELECTRONIC CASH REGISTER MACHINE 2

SONY DIGITAL CAMERA 1

Plain paper fax machine 1

Panasonic fax modem 3

Plain Paper Copier 3

LAMINATING MACHINE 1

SPIRAL BINDING MACHINE 1

Vehicle 25,000,000 Description Qty.

Cardiac (Life Support) Ambulance 1

Toyota Ambulance (2000CC) 1

Car (Chairman/MD/CEO/DMS/MKTG.) 5

MICRO BUS (Office Pool) 1

Revenue:

Revenue forecasts are based on capacity utilization basis market dynamics and size. Overall growth

has been projected compared to immediate preceding year is 20%, 20%, 20%, 20%,10%,10% and 10% in the year 2013, 2014, 2015,2016,2017,2018,2019 and 2020 respectively. While calculating

revenue the industry average has been taken into consideration basis data collected from the top five

hospitals/diagnostic centre of the city through interview. Projected counts (number of times) in

different service types like consultations, investigations, Surgery & procedures and others, except pharmacy, has been estimated based on the capacity utilization of services while pharmacy sales

based on the average prescription generated daily, monthly and yearly basis.

Capacity utilization:

There will be 49 clinical consultants chamber in the hospital where there will be two shifts. During day time from 9.00 am to 5pm one group will work while the second group will start from 5.30 pm

and continue till 11.30 pm.At the initial years we are expecting to utilize capacity @ of 50%,55%

60%, 65%,70%,75%,80%,85% in the year 2012, 2013, 2014, 2015,2016,2017,2018,2019 and 2020

respectively.

Projected Income Statement(2014-2020) 2014 2015 2016 2017 2018 2019 2020 2021

Net revenue Taka Taka Taka Taka Taka Taka Taka Taka

Revenue from

Healthcare Services

829,046,5

37

983,975,3

69

1,206,634,6

68

1,460,702,0

00

1,692,225,4

45

1,859,524,7

42

2,089,366,3

37

2,319,562,5

03

Direct operating

expenses

Food & beverages

9,730,350

10,503,00

0

11,275,650

13,099,500

13,061,850

13,845,450

14,618,100

15,390,750

House keeping 2,925,005

2,955,717

2,986,752

3,018,113

3,049,803

3,081,826

3,114,186

3,146,885

Sterilization

973,035

1,102,815

1,243,140

1,516,431

1,587,676

1,767,069

1,958,965

2,165,633

Medical Gas 4,865,175

5,514,075

6,215,702

7,582,154

7,938,380

8,835,346

9,794,826

10,828,165

Consultants fees

213,257,9

87

263,374,4

41

343,420,74

6

418,056,02

4

498,971,44

5

554,011,06

6

647,110,16

9

729,550,41

4

231,751,5

52

283,450,0

48

365,141,99

1

443,272,22

2

524,609,15

5

581,540,75

8

676,596,24

6

761,081,84

7

Power & energy

Gas expenses for

hospitals

4,265,632

4,478,914

4,702,859

4,938,002

5,184,902

5,444,147

5,716,355

6,002,173

Hospitals electricity 3,656,256

3,839,069

4,031,022

4,232,573

4,444,202

4,666,412

4,899,733

5,144,719

30

7,921,888

8,317,982

8,733,882

9,170,576

9,629,104

10,110,560

10,616,088

11,146,892

Other direct

expenses

Laundry expenses

324,345

367,605

414,380

505,477

529,225

589,023

652,988

721,878

Linen for hospital & patient

810,863

919,013

1,035,950

1,263,692

1,323,063

1,472,558

1,632,471

1,804,694

Security Services

4,590,000

4,819,500

5,060,475

5,313,499

5,579,174

5,858,132

6,151,039

6,458,591

5,725,208

6,106,118

6,510,805

7,082,668

7,431,462

7,919,713

8,436,498

8,985,163

Hospitals supplies

Reagent Cost

40,593,75

8

48,712,50

9

58,455,011

70,146,013

84,175,216

92,592,737

101,852,01

1

112,037,21

2

Consumables

50,496,71

7

60,596,00

2

72,715,143

87,258,113

104,709,67

6

115,180,61

4

126,698,64

6

139,368,48

1

Medicine

53,913,60

0

68,428,80

0

82,114,560

101,088,00

0

105,131,52

0

117,573,12

0

127,526,40

0

146,188,80

0

Outsourced Test Expenses

1,800,000

1,890,000

1,984,500

2,083,725

2,187,911

2,297,307

2,412,172

2,532,781

146,804,0

75

179,627,3

11

215,269,21

4

260,575,85

1

296,204,32

3

327,643,77

8

358,489,22

9

400,127,27

4

Direct operating cost

392,202,7

22

477,501,4

59

595,655,89

2

720,101,31

7

837,874,04

5

927,214,80

9

1,054,138,0

61

1,181,341,1

76

Gross Profit

436,843,8

15

506,473,9

10

610,978,77

6

740,600,68

3

854,351,40

0

932,309,93

3

1,035,228,2

76

1,138,221,3

27

GP %

53

51

51

51

50

50

50

49

General Admin

Expenses

Salary and Allowances

182,993,200

213,873,303

276,777,215

304,454,937

334,900,430

368,390,473

405,229,520

445,752,473

Training &

development

36,598,64

0

38,428,57

2

1,921,429

2,017,500

2,118,375

2,224,294

2,335,508

2,452,284 Traveling and

Conveyance

1,829,932

1,921,429

2,017,500

2,118,375

2,224,294

2,335,508

2,452,284

2,574,898

Ambulance and Car

Expenses

1,200,000

1,260,000

1,323,000

1,389,150

1,458,608

1,531,538

1,608,115

1,688,521

Entertainment

600,000

630,000

661,500

694,575

729,304

765,769

804,057

844,260

Legal and audit fees

1,000,000

1,050,000

1,102,500

1,157,625

1,215,506

1,276,282

1,340,096

1,407,100

Repair & maintenance

500,000

550,000

605,000

5,000,000

5,500,000

6,050,000

6,655,000

7,320,500

Printing & stationery

2,400,000

2,520,000

2,646,000

2,778,300

2,917,215

3,063,076

3,216,230

3,377,041

Communication

3,000,000

3,150,000

3,307,500

3,472,875

3,646,519

3,828,845

4,020,287

4,221,301

Insurance premium

1,800,000

1,890,000

1,984,500

2,083,725

2,187,911

2,297,307

2,412,172

2,532,781

Marketing Expenses

30,000,00

0

24,000,00

0

19,200,000

15,360,000

20,000,000

20,000,000

20,000,000

20,000,000

Other admin expenses 2,500,000

2,625,000

2,756,250

2,894,063

3,038,766

3,190,704

3,350,239

3,517,751

264,421,7

72

291,898,3

03

314,302,39

4

343,421,12

4

379,936,92

7

414,953,79

5

453,423,50

8

495,688,91

0

EBITD

172,422,0

43

214,575,6

07

296,676,38

2

397,179,55

9

474,414,47

3

517,356,13

8

581,804,76

7

642,532,41

7

EBITD % 21

22

25

27

28

28

28

28

Depreciation

173,419,1

97

177,494,1

97

181,569,19

7

185,644,19

7

183,825,44

7

180,325,44

7

183,325,44

7

186,325,44

7

Financing charges

75,623,15

4

71,174,99

7

49,392,967

47,012,324

42,046,710

34,432,526

27,099,263

11,102,749

EBT

(76,620,3

08)

(34,093,5

87)

65,714,218

164,523,03

8

248,542,31

6

302,598,16

5

371,380,05

7

445,104,22

1

Other Income

9,249,600

9,676,080

10,123,164

10,591,868

11,083,258

11,598,453

12,138,629

12,705,018

Income [email protected]% 0

0

0

0

0

86,404,070

105,467,63

9

125,897,54

1

Earnings After

Tax(EAT)

(67,370,7

08)

(24,417,5

07)

75,837,382

175,114,90

6

259,625,57

4

227,792,54

8

278,051,04

7

331,911,69

8

31

Summary of Projected Revenue Calculation

2013 2014 2015 2016 2017 2018 2019 2020

Segment Taka Taka Taka Taka Taka Taka Taka Taka

Registration

11,232,000

7,128,000

5,132,160

4,212,000 4,380,480

2,939,328

2,125,440

2,436,480

Consultation

112,320,000

171,072,000

222,393,600 294,840,000 328,536,000

391,910,400

478,224,000

578,664,000

Bed Charges

64,790,900

73,678,100

84,843,800

112,579,200

101,142,800

115,042,050

123,059,000

127,790,950

Surgery

138,740,044

166,487,757

199,785,013

239,741,721

287,689,770

316,458,599

348,104,311

382,914,595

Procedure

113,743,544

136,492,252

163,790,703

196,548,843

235,858,612

259,444,473

285,388,920

313,927,812

Lab Medicine

159,091,000

190,909,200

229,091,040 274,909,248 329,891,098

362,880,207

399,168,228

439,085,051

Diagnistic and

Imaging

111,534,050

133,840,860

160,609,032

192,730,838

231,277,006

254,404,707

279,845,177

307,829,695

Pharmacy

67,392,000

85,536,000

102,643,200

126,360,000

131,414,400

146,966,400

159,408,000

182,736,000

778,843,537

965,144,169

1,168,288,548

1,441,921,850

1,650,190,165

1,850,046,164

2,075,323,077

2,335,384,583

Hospital revenues can be classified mainly into 8(eight) broad categories, such as Registration,

Consultation, Bed Charges, Surgery, Procedures, Lab Medicine, Diagnostic and Imaging and from

sale of medicine. The segment wise percentage of sales in the years 2013 has been estimated to be @

1%,14%,8%,18%,15%20%,14% and 9% respectively. The net revenue of Taka 778,843,537 has been

calculated for the year 2013 on the basis of daily average sales of Taka 2,500,000.In reality hospital

projects grow rapidly in the initial years provided there is excellent customer service with quality

control in every aspects of operational activity. Basis industry trend we have projected year to year

growth to be @ of 22% till 2016 while it is @ 12% in the next following years till 2018.

Revenue from Registration:

Registration Revenue

Description 2013 2014 2015 2016 2017 2018 2019 2020

Taka Taka Taka Taka Taka Taka Taka Taka

Count

224,640

285,120

342,144

421,200

438,048

489,888

531,360

609,120

Ratio to

Consultations 50.00 25.00 15.00 10.00 5.00 3.00 2.00 2.00

Capacity

Utilized

112,320

71,280

51,322

42,120

21,902

14,697

10,627

12,182

Revenue Per

Count 100

100

100

100 200

200

200

200

Registration

11,232,00

0

7,128,00

0

5,132,160

4,212,000

4,380,48

0

2,939,32

8

2,125,44

0

2,436,48

0

Registration fee per patient for the initial 4 years has been proposed @ Taka 100.00 and Taka 200 for

the following years till 2020.This is one time payment for a patient for the life time. The number of

patient will get registered in the years 2013,2014,2015,2016,2017,2018,2019 and 2020 to be 112,320,

71,280,51,322,42,120,21,902,14,637,10,627 and 2,182 respectively. Only new patient visiting the

32

hospital will require to be registered along with the hospital system and all patient history will be

maintained in the systems basis this unique ID number for easy identification and complete medical

record. Since the repeat patient will not require to be registered the revenue might not increase year to

year unless new patient comes in to the hospital.

Consultation Revenue:

CONSULTATION REVENUE

2013 2014 2015 2016 2017 2018 2019 2020


Consultants

52

60

66

75

78

81

82

94

Consultation

slots

Per

day/consultant

30

30

30

30

30

30

30

30

Week days per week

6

6

6

6

6

6

6

6

Month/ Year Weeks/ Year

48

48

48

48

48

48

48

48

Capacity Count

449,280

518,400

570,240

648,000

673,920

699,840

708,480

812,160

Capacity

Utilized Count

224,640

285,120

342,144

421,200

438,048

489,888

531,360

609,120

Percentage

Utilized 50.00% 55.00% 60.00% 65.00% 65.00% 70.00% 75.00% 75.00%

Revenue Per

Count 500 600 650 700 750 800 900 950

Consultation

112,320,000

171,072,000

222,393,600

294,840,000

328,536,000

391,910,400

478,224,000

578,664,000

There will be both full and part time consultants in the hospital between two shifts. Full time

consultants will start their clinic at 9.00 am and continue till 5.00pm while the part time consultants

will start their clinic from 5.30 pm and continue till 11.30 pm.A total of 52 consultants (in 2013) both

full and part time basis will be in the OPD clinic who will do both OPD and IPD services for their

own patient simultaneously. Every consultant will be allowed a standard of 30 slots a day and will

work for 48 weeks in a year on 6 working day/week basis. For consultation fees calculation purpose

we have calculated 50% capacity utilization in the 1st year while this is 55%,60%,65%,65%,70%,75%

and75% in the years 2014,2015,2016,2017,2018,2019 and 2020 respectively. Consultation fee per

visit has been assumed to be Taka 500 in the year 2013 and Taka 600 in 2014,Taka 650 in 2015,Taka

700 in 2016,Taka 750 in 2017,Taka 800 in 2018,Taka 900 in 2019 and Taka 950 in 2020.Basis above

assumptions revenue have been projected for Taka 112,320,000 in 2013 ,Taka171,072,000 in

2014,Taka 222,333,600 in 2015,Taka 234,840,000 in 2016,Taka 328,536,000 in 2017,Taka

391,910,400 in 2018,taka 478,224,000 in 2019 and Taka 578,664,000.

Bed Revenue:

BED REVENUE PROJECTIONS

2013 2014 2015 2016 2017 2018 2019 2020

Revenue Revenue Revenue Revenue Revenue Revenue Revenue Revenue


33

Bed Occupancy

Ward Bed 8,943 9,837 10,731 11,625 12,520 13,414 14,308 15,202

Semi private 12,410 13,651 14,892 16,133 17,374 18,615 19,856 21,097

Single Private 584 584 584 1,168 657 657 657 657

CCU 2,920 2,920 2,920 5,840 3,285 3,285 3,285 3,285

ICU 2,920 2,920 2,920 2,920 3,285 3,285 3,285 3,285

Emergency Bed 256 256 256 256 256 292 292 292

Labor Observation 1,278 1,405 1,533 1,661 1,789 1,916 2,044 2,172

Nursery/Neo Natal 3,125 3,438 3,750 4,063 4,375 4,688 5,000 5,313

Bed Occupancy(days) 32,435 35,010 37,586 43,665 43,540 46,152 48,727 51,303

Bed Charges

Ward Bed

7,154,000

9,836,750

12,877,200

13,950,300

15,023,400

20,120,625

21,462,000

22,803,375

Semi private

18,615,000

23,206,700

29,784,000

32,266,000

34,748,000

40,953,000

43,683,200

46,413,400

Single Private

2,920,000

3,212,000

3,212,000

6,424,000

3,942,000

3,942,000

3,942,000

3,942,000

CCU

16,060,000

16,060,000

16,060,000

35,040,000

19,710,000

19,710,000

21,352,500

21,352,500

ICU

16,060,000

16,060,000

16,060,000

17,520,000

19,710,000

19,710,000

21,352,500

21,352,500

Emergency Bed

459,900

459,900

511,000

511,000

613,200

700,800

700,800

700,800

Labor Observation

1,022,000

1,405,250

1,839,600

1,992,900

2,146,200

2,874,375

3,066,000

3,257,625

Nursery/Neo Natal

2,500,000

3,437,500

4,500,000

4,875,000

5,250,000

7,031,250

7,500,000

7,968,750

Bed Charges

64,790,900

73,678,100

84,843,800

112,579,200

101,142,800

115,042,050

123,059,000

127,790,950

Ward Bed

No. of Beds

49

49

49

49

49

49

49

49

Number of Days

365

365

365

365

365

365

365

365

Total Capacity

17,885

17,885

17,885

17,885

17,885

17,885

17,885

17,885

Capacity Utilized 17,885 17,885 17,885 17,885 17,885 17,885 17,885 17,885

Percentage Utilized

0.50

0.55

0.60

0.65

0.70

0.75

0.80

0.85

Occupancy

8,943

9,837

10,731

11,625

12,520

13,414

14,308

15,202

Revenue Per Count

800

1,000

1,200

1,200

1,200

1,500

1,500

1,500

Revenue from Ward Bed

7,154,000

9,836,750

12,877,200

13,950,300

15,023,400

20,120,625

21,462,000

22,803,375

Semi private

No. of Beds

68

68

68

68

68

68

68

68

Number of Days

365

365

365

730

365

365

365

365

Total Capacity

24,820

24,820

24,820

49,640

24,820

24,820

24,820

24,820

Capacity Utilized

24,820

24,820

24,820

24,820

24,820

24,820

24,820

24,820

Percentage Utilized

0.50

0.55

0.60

0.65

0.70

0.75

0.80

0.85

Occupancy

12,410

13,651

14,892

16,133

17,374

18,615

19,856

21,097

Revenue Per Count

1,500

1,700

2,000

2,000

2,000

2,200

2,200

2,200

Revenue from Semi Private

18,615,000

23,206,700

29,784,000

32,266,000

34,748,000

40,953,000

43,683,200

46,413,400

Single Private

No. of Beds

2

2

2

2

2

2

2

2

Number of Days

365

365

365

730

365

365

365

365

Total Capacity

730

730

730

1,460

730

730

730

730

Capacity Utilized

730

730

730

1,460

730

730

730

730

Percentage Utilized

0.80

0.80

0.80

0.80

0.90

0.90

0.90

0.90

Occupancy

584

584

584

1,168

657

657

657

657

Revenue Per Count

5,000

5,500

5,500

5,500

6,000

6,000

6,000

6,000

Revenue fromER Bed

2,920,000

3,212,000

3,212,000

6,424,000

3,942,000

3,942,000

3,942,000

3,942,000

CCU

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No. of Beds

10

10

10

10

10

10

10

10

Number of Days

365

365

365

730

365

365

365

365

Total Capacity

3,650

3,650

3,650

7,300

3,650

3,650

3,650

3,650

Capacity Utilized

3,650

3,650

3,650

7,300

3,650

3,650

3,650

3,650

Percentage Utilized

0.80

0.80

0.80

0.80

0.90

0.90

0.90

0.90

Occupancy

2,920

2,920

2,920

5,840

3,285

3,285

3,285

3,285

Revenue Per Count

5,500

5,500

5,500

6,000

6,000

6,000

6,500

6,500

Revenue from CCU

16,060,000

16,060,000

16,060,000

35,040,000

19,710,000

19,710,000

21,352,500

21,352,500

ICU

No. of Beds

10

10

10

10

10

10

10

10

Number of Days

365

365

365

365

365

365

365

365

Total Capacity

3,650

3,650

3,650

3,650

3,650

3,650

3,650

3,650

Capacity Utilized

3,650

3,650

3,650

3,650

3,650

3,650

3,650

3,650

Percentage Utilized

0.80

0.80

0.80

0.80

0.90

0.90

0.90

0.90

Occupancy

2,920

2,920

2,920

2,920

3,285

3,285

3,285

3,285

Revenue Per Count

5,500

5,500

5,500

6,000

6,000

6,000

6,500

6,500

Revenue from ICU

16,060,000

16,060,000

16,060,000

17,520,000

19,710,000

19,710,000

21,352,500

21,352,500

Emergency Bed

No. of Beds

6

6

6

6

6

6

6

6

Number of Days

365

365

365

365

365

365

365

365

Total Capacity

365

365

365

365

365

365

365

365

Capacity Utilized

365

365

365

365

365

365

365

365

Percentage Utilized

0.70

0.70

0.70

0.70

0.70

0.80

0.80

0.80

Occupancy

256

256

256

256

256

292

292

292

Revenue Per Count

1,800

1,800

2,000

2,000

2,400

2,400

2,400

2,400

Revenue from Standard Bed

459,900

459,900

511,000

511,000

613,200

700,800

700,800

700,800

Labor Observation

No. of Beds 7

7

7

7

7

7

7

7

Number of Days

365

365

365

365

365

365

365

365

Total Capacity

2,555

2,555

2,555

2,555

2,555

2,555

2,555

2,555

Capacity Utilized

2,555

2,555

2,555

2,555

2,555

2,555

2,555

2,555

Percentage Utilized

0.50

0.55

0.60

0.65

0.70

0.75

0.80

0.85

Occupancy

1,278

1,405

1,533

1,661

1,789

1,916

2,044

2,172

Revenue Per Count

800

1,000

1,200

1,200

1,200

1,500

1,500

1,500

Revenue from Labor

Observation

1,022,000

1,405,250

1,839,600

1,992,900

2,146,200

2,874,375

3,066,000

3,257,625

Nursery/Neo Natal

No. of Beds

17

17

17

17

17

17

17

17

Number of Days

365

365

365

365

365

365

365

365

Total Capacity

6,205

6,205

6,205

6,205

6,205

6,205

6,205

6,205

Capacity Utilized

6,250

6,250

6,250

6,250

6,250

6,250

6,250

6,250

Percentage Utilized

0.50

0.55

0.60

0.65

0.70

0.75

0.80

0.85

Occupancy

3,125.00

3,437.50

3,750.00

4,062.50

4,375.00

4,687.50

5,000.00

5,312.50

Revenue Per Count

800

1,000

1,200

1,200

1,200

1,500

1,500

1,500

Revenue from Neo Natal

2,500,000

3,437,500

4,500,000

4,875,000

5,250,000

7,031,250

7,500,000

7,968,750

A comparative study of bed tariff analysis among the competitors was done in Dhaka city to find out

the most reasonable number that can be fixed up to start with the hospital. Special concentration was

35

given to the mid range hospital who are running in and around Dhanmondi/Green Road while

determining the bed tariff. The hospital will be having the following category of beds:

Bed Category Tariff(Taka)

Ward Bed 800

Semi-Private 1500

Single Room VIP 5000

CCU 5500

ICU 5500

ER Bed 150/Hr.

Labor Observation 800

Nursery/Neo Natal 800

Bed occupancy for Ward bed, Semi-private bed, Labor Observation,Nursey/Neo-Natal bed have been

assumed to be 50%,55%,60%, 65%,70%,75%, 80% and 85% while it is 80%,80%,80%,80%, 90%,

90%, 90%and 90% for ICU/CCU for the years 2013,2014,2015,2016,2017,2018,2019 and 2020

respectively. ER bed occupancy has been assumed to be within the range of 70-80% till 2020.

Bed Category Tariff(Tk.) Revenue(Taka) % of Total

Revenue

Ward Bed 800 7,154,000 11%

Semi-Private 1500 18,615,000 29%

Single Room VIP 5000 2,920,000 5%

CCU 5500 16,060,000 25%

ICU 5500 16,060,000 25%

ER Bed 150/Hr. 459,000 1%

Labor Observation 800 1,022,000 1%

Nursery/Neo Natal 800 2,500,000 3%

Total 64,790,900 100%

REVENUE PROJECTIONS

Annu

al 2013 2014 2015 2016 2017 2018 2019 2020

Volu

me Revenue Revenue Revenue Revenue Revenue Revenue

Reven

ue Revenue

Surgery Taka Taka Taka Taka Taka Taka Taka Taka

CARDIO THORACIC

SURGERY

15,158,980

18,190,7

76

21,828,9

31

26,194,7

17

31,433,6

61

34,577,0

27

38,034

,730

41,838,2

03

CHEST THORAX AND

VASCULAR SURGERY

4,736,890

5,684,26

8

6,821,12

2

8,185,34

6

9,822,41

5

10,804,6

57

11,885

,122

13,073,6

35

DENTAL SURGERY

5,234,345

6,281,21

4

7,537,45

7

9,044,94

8

10,853,9

38

11,939,3

32

13,133

,265

14,446,5

91

ENT SURGERY

6,741,039

8,089,24

6

9,707,09

5

11,648,5

15

13,978,2

17

15,376,0

39

16,913

,643

18,605,0

07

GENERAL SURGERY

17,737,125

21,284,5

50

25,541,4

60

30,649,7

52

36,779,7

02

40,457,6

73

44,503

,440

48,953,7

84

NEURO SURGERY 13,597,414

16,316,8

19,580,2

23,496,3

28,195,5

31,015,1

34,116

37,528,3

36

97 76 31 98 57 ,673 40

OBSTETRICS AND

GYNAECOLOGY

20,680,381

24,816,4

57

29,779,7

49

35,735,6

98

42,882,8

38

47,171,1

22

51,888

,234

57,077,0

57

OPTHALMOLOGY

Hospital Feasibility Study _500 Bed_indon

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