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
2
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 country’s 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 Semi Private Single Cabin ICU(Intensive Care Unit) CCU(Coronary Care Unit) Recovery bed Step down Post Operative Labor Observation Nursery/Neo Natal OT Emergency bed Cath Lab Total
49 68 2 10 10 4 8 11 7 17 8 6 2 202
8th,9th and 10th 8th,9th,10th and 11th 11th 6th 7th 6th 7th 6th 8th 8th 6th,7th,8th Ground floor 7th
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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 organization’s environment consists of forces and conditions that surround in it. An organization’s 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 organization’s 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 patient’s 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 authority’s 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 longterm 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 Medical & Surgical Equipment Electrical Installations, Air Conditioning, Generator, Lift etc. Computer & IT Systems Furniture & Fixture Office Equipment Vehicle Medical & Surgical Equipment Diagnostic And Imaging Biochemistry Hematology Histopathology Clinical Pathology Microbiology Lab Cardiology Gastroenterology Neurology Emergency Master Health Check Blood Bank Ward Neonatal ICU Labor Ward Dermatology Department Respiratory Medicine Urology Dept. Nephrology Dept. Oncology Department General Ot(6 Nos) Anesthesia Unit Surgical ICU Physiotherapy Dept. Ct Ot Coronary Care Unit Cath Lab Ophthalmic Opd Dental Dept. Ent Opd Pediatric Opd Obs/Gyn
Taka 906,994,779 143,630,000 22,275,000 30,000,000 2,500,000 25,000,000 1,130,3999,799 906,994,779 235,988,450 17,592,000 10,150,750 4,559,000 3,166,000 9,663,034 22,190,000 10,376,160 5,270,729 5,000,000 12,000,000 8,398,968 2,500,000 8,624,761 1,500,000 10,000,000 3,555,058 50,000,000 31,445,532 202,266,980 100,000,000 11,003,591 7,500,000 3,887,842 35,000,000 10,000,000 75,000,000 4,732,064 3,125,986 1,797,874 200,000 500,000
10
DIAGNOSTIC AND IMAGING MACHINE NAME CT Scan Machine, Work Station,Monitor,Injector,console Bon Dencito Meter BP Apparatus (CT Scan) Defibrillator MRI Machine,Console,Injector(1.5 Tesla) Anesthesia Ventilator (Datex) Patient Monitor (Cardiac) BP Apparatus (MRI) 1000mA Digital X-Ray machine 800 mA X-ray Machine Mammography machine OPG Machine CR System (XG-5000) Fuji. BP Apparatus 4D Color Doppler -Ultrasound Machine, Antrase PACS(Picture Archiving and Communication System) BIOCHEMISTRY Bio-Chemistry Analyzer (Beckman Coulter CX9 or CX7) Dade Behring Max Rxi Immulite 2500 Water Purification System Blood Gas Analyzer(Rapid Lab 1200Gas Analyzer) Centrifuge Machine Electronic Balance Hot air Oven PH meter Pipette(different Range) Refrigerator for Reagent Freezer -20 degree Celsius HEMATOLOGY MACHINE NAME Hematology cell counter Centrifuge Coagulation analyzer (CA-550) Electra Lab (Auto ESR) Hot air Oven Incubator Microscope Olympus BX-41 Microscope CX-21 Spectra Photo Meter Water Bath Roller Blood Mixer BP Apparatus Vortex Mixer
11
235,988,450 Quantity 1 1 1 1 1 1 1 1 2 2 1 1 1 2 2 4 17,592,000 1 1 1 1 1 2 1 1 1 2 2 1 10,150,750 Quantity 2 2 1 2 1 1 1 1 1 1 1 1 1
Capillary Hb electrophoresis Micropipette 05-20 micro liter 50-100 micro liter 100-1000 micro liter 1000 micro liter Refrigerator HISTOPATHOLOGY MACHINE NAME Rotary Microtome (Thermo Shandon, Leica) Tissue Embedding System (Thermo Shandon, Lexica) Tissue Processor (Thermo Shandon, Lexica) Tissue Floating Bath (Thermo Shandon, Lexica) Cryostat (Thermo Shandon, Lexica) Electronic Weight Machine Hot Air Oven (Thermo Shandon, Lexica) Microscope (Olympus, Nikon, Zeiss) Ph Meter Refrigerator (Lg) Centrifuge (Heraeus-Labofuge-300) Cytosine (Centrifuge) Thermo Shandon, Lexica. CLINICAL PATHOLOGY MACHINE NAME Microscope Urine Analyzer Centrifuge (8 Hole) Water Bath Micropipette (20-50 micro liter,100-1000 micro Litr.) Refrigerator MICROBIOLOGY LAB MACHINE NAME Biological safety Cabinet Class ii Automated Blood culture & TB Culture Autoclave Machine Automated Antibiotic Zone Reader Slide Heater CO2 incubator Centrifuge Machine Labofuge 300(heraeus) Electronic Balance(Meter Toledo) Anaerobic Jar(Oxide) Micropipettes(Eppendorf) Multi channel Micropipettes(Eppendorf) Hot air Oven Incubator-1 Microscope Olympus CX41,with DGI
12
1 5 2 2 2 2 2 4,559,000 Quantity 1 1 1 1 1 2 1 2 1 1 1 1 3,166,000 Quantity 2 1 2 1 4 2 9,663,034 Quantity 2 1 1 1 1 1 2 1 1 10 1 1 2 2
PH meter VDRL Rotor Water Bath Needle and loop Steam Sterilizer Neflowmeter Pipette stand Motorized pipette aid Vortex Mixer CARDIOLOGY MACHINE NAME ECG Machine TMT/ETT System Color Doppler Echocardiography System Hand Carried Color Doppler Echocardiography Machine with Cart Holter Analyzer Defibrillator Ambulatory BP Recorder Glucometer (Accu-Check) Printer-Laser color Printer-Thermal B/W Printer-Thermal color Halter Recorder Printer-Normal Pulse Oximeter BP Apparatus GASTROENTEROLOGY MACHINE NAME Complete Vedioscope(set) Upper G I Scope Colonoscopy Duodenoscope(set) Bronchoscope(set) Sony Color Video Printer Leakage Tester Trolley ORTHOPAEDICS MACHINE NAME Universal Drill Machine(Hand operated) Drill Machine(Electric) Hacksaw with Blade Amputation saw Bone saw(Electric) Interlocking nailing Set Bone Skid T-extractor for femoral head Humpy skin grafting knife
1 1 1 1 1 2 1 1 22,190,000 Quantity 2 2 2 1 2 2 2 5 1 2 1 4 1 1 5 10,376,160 Quantity 1 2 2 1 1 1 2 2 15,000,000 Quantity 4 2 2 2 2 5 2 2 2
13
Electric plaster cutter saw Arthroscopy Machine with Accessories C-Arm Machine Halter Cervical traction set Sterilizer High pressure electric suction apparatus Infusion pump Syringe Pump Other Instrument Set Plaster Cutter Large Joint Arthroscopic with cannula & obturator Orthopedic Accessories NEUROLOGY MACHINE NAME Niclet Vita port 16 Channel Ambulatory EEG System EMG Laryngoscope Defibrillator EMERGENCY MACHINE NAME Patient Monitor Defibrillator ECG Machine Ventilator-Critical Care Ventilator-Transport Syringe Pump Infusion Pump O.T. Light Pulse Oximeter Suction Machine Ophthalmoscope Auto scope Laryngoscope Spot Light Nebulizer BP Apparatus
2 2 2 2 2 1 2 2 1 2 2 2 5,270,729 Quantity 1 1 1 1 5,000,000 Quantity 4 2 1 1 1 4 1 1 1 2 1 1 1 1 1 6
MASTER HEALTH CHECK MACHINE NAME X-ray Machine ECG Machine Ultrasound Machine
12,000,000 Quantity 1 1 1 1 1 1 1 1
TMT/ETT System Color Doppler Echocardiography System Mammography machine Printer-Thermal B/W Laryngoscope
14
BP Apparatus
4 BLOOD BANK
8,398,968 Quantity 1 1 3 1 3 3 1 1 1 1 1 2 1 1 1 2 1 1 2 1 1
MACHINE NAME Platelet Agitator Microscope-Diagnostic Refrigerator Centrifuge Digital blood Shaker Doner Couch ELISA Reader ELISA Incubator ELISA Washer Hamo Control Hot Air Oven Tube Sealer Plasma Expresser Plasma Thawing Bath Refrigerated Centrifuge Plasma Expresser Lab Rotator Water Bath BP Apparatus Incubator-Path Weighting Machine Ward
2,500,000 Quantity 6 6 6 6 6 6 20 6
Neonatal ICU
8,624,761 Quantity 2 3 2 6 6 1
MACHINE NAME ECG Machine Defibrillator Infusion Pump Syringe Pump Pulse Oximeter Ophthalmoscope BP Apparatus Nebulizer MACHINE NAME Auto scope Baby Incubator CPAP-Bubble Infant Warmer Laryngoscope
Light Source-Halogen Nebulizer Ophthalmoscope
2 2
15
Patient Monitor Phototherapy Unit Phototherapy Unit-Reflective Pulse Oximeter Syringe Pump Transport Incubator Ventilator-Neonate
6 4 1 2 6 2 4
MACHINE NAME Fetal Monitor Patient Monitor Defibrillator Pulse Oximeter Infusion Pump Syringe Pump Suction Machine Laryngoscope Spot Light BP Apparatus Nebulizer
LABOR WARD
1,500,000 Quantity 3 1 1 1 1 1 1 1 1 2 1
DERMATOLOGY DEPARTMENT MACHINE NAME Laser Machine Cooling Device Diathermy Machine Electro Therapy Unit Spot Light Diagnostic Lamp Spot Light UV therapy unit-Partial body UV therapy unit UV therapy unit-Whole Body Woods Light O.T. Table O.T. Light BP Apparatus
10,000,000 Quantity 1 1 2 1 3 1 1 2 1 1 1 1 1 1
RESPIRATORY MEDICINE MACHINE NAME PFT System Nebulizer BP Apparatus
3,555,058 Quantity 2 2 2
UROLOGY DEPT. MACHINE NAME Urodynamic system Adult cyst scope with Accessories Adult Reset cope with Accessories
50,000,000 Quantity 1 1 1
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Paedtric cyst scope with Accessories Paedtric Reset cope with Accessories Flexible Cityscape with accessories Pneumatic Lithotripter with accessories End vision Digital Single Chip Camera BP Apparatus NEPHROLOGY DEPT. MACHINE NAME BP Apparatus CRRT Machine Defibrillator Dialysis Machine Laryngoscope Nebulizer Patient Chair-Dialysis Pulse Oximeter Weighting Machine WRO Plant
1 1 1 1 1 1 31,445,532 Quantity 10 2 2 20 2 2 2 2 2 2
ONCOLOGY DEPARTMENT MACHINE NAME Linear Accelerator : - 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)
202,266,980 Quantity 1
HDR (Brachytherapy) : - 24 channel Brachytherapy - Different Applicators - Radiation Source
1
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)
17
- Intercom system (2 way communication) GENERAL OT(6 Nos) Machine Name Air Darmatone Automatic Tourniquet System Bipolar Coagulator Bipolar ESU Unit Bipolar Irrigation Module Blood/Fluid Warmer Bp Apparatus Bronchoscope Camera Head C-Arm Machine C-Arm Trolley With Video Monitor Cauvery Machine Co2 Endoflator-Electronic Drill Machine-Ent Drill-Neuro With Foot Switch Drill-Orthopedics Dvd Recorder Harmonic Scalpel Irrigation & Suction Laryngoscope Laser Machine Light Source-Halogen Light Source-Xenon Lipoplasty Device Lithoclast Micro Motor-ENT Microscope-Operating O.T. Light O.T. Table Patient Monitor Patient Warming System Phaco Emulsifier Plaster Cutter Power Control Unit Printer-Thermal B/W Printer-Thermal Color SAW & Drill Drive Unit Saw-Ortho Skin Masher System Suction Pump Suction-Vacuum (Gomco) Syringe Pump Ventilator-Anesthesia
100,000,000 Quantity 2 3 3 2 2 5 6 3 6 2 2 5 2 1 2 5 4 2 2 5 1 6 6 1 1 1 4 6 6 6 2 1 6 4 4 4 6 2 2 4 2 6 6
18
Video Monitor Video Processor Anesthesia Unit 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)
6 6 11,003,591
Surgical ICU
7,500,000 Quantity 8 6 1 1 1 1 1 4 1 15 4 1 2
Physiotherapy Dept.
3,887,842 Quantity 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Machine Name Patient Monitor Ventilator-Critical Care Blood Gas Analyzer Bi-Pap Machine Cpap Machine Defibrillator Ecg Machine Infusion Pump Pulse Oximeter Syringe Pump Bp Apparatus Ophthalmoscope Nebulizer Machine Name Bed For Manual Therapy Bp Apparatus Cervical Traction Unit Chilling Unit Cpm Machine Electro Stimulator Emg Equipment Instrument For Resistance Exercise, Laser Machine Microwave Therapy Unit Nerve Stimulator Pack Heaters Parallel Bar Quards Exercise Table Short Wave Therapy Standing Frame-Adult Standing Frame-Pediatric Static Bi-Cycle Tilting Table Traction Unit Treadmill- Physio
19
Ultrasound Unit-Physio Wall Wheel Bar Wax Bath
1 1 1 CT OT
Machine Name Act Machine Auto Clave Machine- Table Top Baloon Pump Cautery Machine Defibrillator Fabricator Harmonic Scalpel Heart Lung Machine Hemo Therm Light Source-Xenon O.T. Table Pacemaker Patient Monitor Patient Warming System Saw-Manman Saw-Sternal Suction Machine Suction-Vacuum (Gumbo) Syringe Pump Syringe Pump-Dps Base Ventilator-Anesthesia
35,000,000 Quantity 2 1 2 2 2 2 1 2 2 3 2 2 3 1 1 2 5 4 6 2 2
CORONARY CARE UNIT MACHINE NAME Patient Monitor Ultrasound Machine Ventilator-Critical Care Defibrillator ECG Machine Infusion Pump Pulse Oximeter Syringe Pump Pacemaker Ophthalmoscope Laryngoscope BP Apparatus Nebulizer
10,000,000 Quantity 10 1 6 3 1 6 1 8 1 1 1 4 2
CATH LAB
75,000,000 Quantity 2 4 2
MACHINE NAME ACT Machine Patient Monitor Cathlab Machine
20
Injector-Cathlab Defibrillator Pacemaker Pulse Oximeter Syringe Pump BP Apparatus Nebulizer
2 2 2 2 3 2 2 4,732,064 Quantity 4 2 1 2 2 2 1 2 2 3 2 3 1 1 2 1
OPTHALMIC OPD MACHINE NAME Topcon Ophthalmic Chair Topcon Slit Lamp With Electric Instruments A - B Scan Applanation Tonometer Auto chart projector Auto Kerato - Refract meter BP Apparatus Lens meter Microscope-Slit lamp Ophthalmoscope Ophthalmic Unit Ophthalmic-Electric Instrument Table Printer-Thermal B/W Retinoscope Trial lenses set & trial frame Visual Field Analyzer
3,125,986 Quantity 1 2 1 1 1 1
Dental Dept. MACHINE NAME X-ray machine Micro motor-Dental Scalar Machine Compressor Unit Diagnosis and Therapy Unit-Dental BP Apparatus
1,797,874 Quantity 1 1 1 1 1 1 1 3 2 3 1
ENT OPD MACHINE NAME Diagnosis and Therapy Unit-ENT Doctors Chair Unit Clinical Audiometer Clinical middle Ear analyzer Microscope-Operating Video Processor Camera Head Light Source-Halogen Suction Machine Auto scope BP Apparatus
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PEDIATRIC OPD
200,000 Quantity 5 1 1
OBS/GYN
500,000 Quantity 1 1 8 1
MACHINE NAME BP Apparatus Nebulizer Auto scope MACHINE NAME Fetal Doppler Ultrasound Machine BP Apparatus Fetal Doppler
Computer and IT Systems: Computer & IT Systems HIS Software System Hardware System 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
22,275,000 5,000,000 10,000,000
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. Description
143,630,000 Qty
22
Boiler (Hot water generating and distribution system) Hot Water Generator Re-Circulating Pump Copper Pipe GI Pipe Gate Valve Ball Valve Check Valve Pressure Reducing Valve Pressure Gauge, Testing and commissioning External Electrification
7,880,000 2,500,000 350,000 3,000,000 75,000 1,500,000 5,000 75,000 300,000 75,000 25,000,000
SUPPLY OF SWITCH GEAR: INCOMING FEEDER: OUTGOING FEEDER Transformer SUPPLY & INSTALLATION OF L.T. PANEL: EL.T. PANEL SUPPLY & INSTALLATION OF AUTOMATIC PFI PLANT: SUPPLY & INSTALLATION OF BUSBAR TRUNKING SYSTEM: CABLE WORKS: Cable Tray/Ladder Connection fee and Security
500,000 1,000,000 5,000,000 3,000,000 3,000,000 2,500,000 3,000,000 2,000,000 3,000,000 2,000,000
HVAC Systems Chiller(Cooling Capacity 200 Ton) Cooling Tower Air Handling Units(10 Nos) Centrifugal Pumps (2 Nos.) Pipe Accessories Metering Devices Automatic Control System Hepa Filter with Hood Installation with Local Accessories
18,700,000 5,000,000 800,000 3,000,000 500,000 400,000 300,000 800,000 400,000 7,500,000
Medical Gas System Oxygen Storage Tank(5,000 Ltr.) Nitrous Oxide Compressed Air Vacuum System Copper Pipe Alarm Panel for Medical gas OT Pendant Ball Valve for Medical Gas Titas Gas Network
20,000,000 3,000,000 800,000 3,000,000 3,500,000 5,500,000 2,000,000 2,000,000 200,000 2,000,000
23
Gas connection for the Hospital building including Electrical Panel Fire Fighting Equipment Systems Diesel Genset(1 MW) Kitchen Equipment Integrated Cantilever Cooking System 3 Burner Gas Range (1700*500*850) Single Burner Range (400*500*850) 3 Burner Gas Range ( 1800*500*850) Wet Grinder Cantilever Chef Cooking Unit 2 Burner High Presses. Work Range (1500*750*850) 1 Burner High Press. Work Range (750*750*850) Banquet Trolley food warmer 10 GN 2/1(75*64*166) Fly Catch Machine CSSD i. Steam Sterilizer HS 6613 AR-2 ii. Rails For Baskets 6613 iii. Manual Basket Feeder 6613 iv. Loading Trolley Fixed 6613 v. Basket Spri 585*395*195 MM 6613 vi. Steam Sterilizer HS 6617 AR-2 vii. Rails For Baskets 6617 viii. Manual Basket Feeder 6617 ix. Loading Trolley Fixed 6617 x. Basket Spri 585*395*195 Mm 6617 xi. Decomat Model 4656 G3d xii. Op-Cart, 4 Levels 4656 xiii. An-Care Without Cassettes xiv. Cassette For Hoses 20 Mm xv. Cassette For Hoses 5-25 Mm xvi. Cassette For 4 Bellows xvii. Rack For 14 Kidney Bowls xviii. Instr. Tray 340*250*70 Mm Hs33 xix. Drying Cab. S-363-E S/S Door xx. Ultrasonic DTH 8510 xxi. Tank Cover, Stainless 8510 xxii. Tray, Stainless, 450*240*150 Mm xxiii. Contingency Parts Electrolux Laundry Systems 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
24
5,000,000 12,500,000 1,000,000 1 1 1 1 2 1 2 1 1 1 10,000,000 1 1 2 2 18 1 1 2 2 18 1 1 1 1 1 1 1 8 1 1 1 1 1 3,500,000
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 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 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 Riello RT 12000 120KVA online UPS Riello RT 6000 60KVA online UPS Riello MDM1500 15 KVA online UPS Waste Disposal System Horizontal cylindrical autoclave, Capacity-50 Ltr. Plastic shredder HS-25, Capacity- 25 Kg/Hr. Destronix needle-cum-syringe destroyer Puncture proof containers, Capacity-55 Ltr.
3,500,000
4,000,000
7,500,000 2 2 2 1,600,000 1 1 40 60
Fully Automatic High Speed Sterilizer Water Purification Equipment
2
Reverse Osmosis system 12M 3 /Day Ultraviolet System Model UV. A-400
1 1
Incinerator
2,000,000
Capacity 50KG/HR, Origin-India PEDROLLO WATER PUMP, 0.6HP, 240V, 50HZ, MODEL - 3CRM 80
1
Refrigerator
750,000
500,000
Brand: Toshiba a) Model : GR-E9
25
Lift
22,500,000 25
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 Chlorination Plant Water Supply Centrifugal Pump and other accessories 2 Units of Submersible Pump CC TV Camera with color monitor
6,500,000 1,000,000 500,000 700,000 500,000
Mortuary 8-Body Mortuary Chambers
1,000,000
Furniture & Fixture
30,000,000
Description Manual Bed Electric Bed Patient Attendant Bed Bed Matress TV with Trolley Stretcher trolley Ambulance Stretcher Cupboard QL 960-2 Baby Trolley Orthopedics Bed Cupboard QL 860 Transitional Stretcher Trolley Trolley For Oxygen Bottle Appliances Trolley QL 811 Adjustable Stool For Surgical Over Bed Table Medical Material Trolley Model DC 1011 Bassinet Cot Model CA 3000 Medical Emergency Cart Model WM 542 Doctor Surgical Stool Technology Banquet trolley Service trolley 3 Seater Sofa 2 Seater Sofa 1 Seater Sofa
26
Qty 100 100 100 300 100 25 2 25 10 15 2 1 15 10 10 175 10 5 20 10 8 4 50 50 25
100 25 12 3 100 15 1 15 50 50 50 65 50 3 5 25 50 50 100 400 25 50 50 50 25 25 18 16 16 16 100 30 25 100 100 2 50 8 10 50 50 25 50 50 50 200
Nurses Locker Doctors Locker Medicine Shelve Office Table For Directors With Side Table Coffee Table Discussion Table Conference Table Executive Dining Table Staff Dining Table W/4 - Fixed Chairs Chairs For Reception And Nurse Station Chairs For General Staff Chairs For Doctors And Department Heads Chairs For Doctors And Executive Dining Chairs For Director Storage cabinet/shelve for director, CEO Stool For Laboratory Stool For Patient Executives Table Executive Chair Visitor Chair Nursing Trolley X-RAY View Box (800*580*80 MM) X-RAY View Box (1160*580*80 MM) Appliance Trolley Fan Shape Appliance Trolley Dressing Trolley Dressing Waste Trolley Anesthetist Trolley Surgical Instrument Trolley Medication Material Trolley Trays For Material Trolley Iv Pump Stand Patient Record Cabinet Four Sections Screen Three Sections Screen Baby's Scale For Height SS Revolving Stool Scrub Station Pharmacy cabinet Consultants Chamber Cabinet Examination Bed(Patient) Steel Almirah Steel Cabinet Shoe Rack Cafetaria Table Cafeteria Chair
27
2,000,000
Counter Nurse Station Dialysis ICU/CCU. Sick-nicu Pre-Term Nicu Labor & Delivery Semi Private Room Day Care Word Surgical Step Dn. Surgical I.C.U. Pre-Operative Ward Post-Operative Word Neuro Medical/Surgical IC CT-Post Operation Pre-Post Angiography
1,000,000 1 2 1 1 1 1 1 1 1 1 1 1 1 1
Reception Counter
500,000
Information(Ground floor) Diagnostic O.P.D. (Cardiology) O.P.D. M.H.C Blood Bank Emergency recap Endoscopy Radiology & Imagine Nuclear Medicine Main entrance Lobby Labor & delivery (F.F) Billing
1 1 1 1 1 1 1 1 1 1 1 1 1
Work Counters in different locations:
500,000
Sample Collection Sterilizer TD Lab Component Store Serology Dark-Room Sample Collection Sub-Sterile Clean-Utility Decontamination Radio-Pharmacy
1 1 1 1 1 1 1 1 1 1 1
Office Equipment
2,500,000
Banknote counting Machine PAPER SHREDDING MACHINE
5 1
28
ELECTRONIC CASH REGISTER MACHINE SONY DIGITAL CAMERA
2 1 1 3
Plain paper fax machine Panasonic fax modem Plain Paper Copier LAMINATING MACHINE SPIRAL BINDING MACHINE
3 1 1
Vehicle
25,000,000
Description
Qty.
Cardiac (Life Support) Ambulance Toyota Ambulance (2000CC) Car (Chairman/MD/CEO/DMS/MKTG.) MICRO BUS (Office Pool)
1 1 5 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) Net revenue
2014 Taka
2015 Taka
2016 Taka
2017 Taka
2018 Taka
2019 Taka
2020 Taka
2021 Taka
Revenue from Healthcare Services Direct operating expenses
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
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
213,257,9 87 231,751,5 52
263,374,4 41 283,450,0 48
343,420,74 6 365,141,99 1
418,056,02 4 443,272,22 2
498,971,44 5 524,609,15 5
554,011,06 6 581,540,75 8
647,110,16 9 676,596,24 6
729,550,41 4 761,081,84 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
Consultants fees
29
7,921,888
8,317,982
8,733,882
9,170,576
9,629,104
10,110,560
10,616,088
11,146,892
Laundry expenses Linen for hospital & patient
324,345
367,605
414,380
505,477
529,225
589,023
652,988
721,878
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
40,593,75 8 50,496,71 7
48,712,50 9 60,596,00 2
58,455,011
70,146,013
72,715,143
87,258,113
84,175,216 104,709,67 6
92,592,737 115,180,61 4
101,852,01 1 126,698,64 6
112,037,21 2 139,368,48 1
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
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 % General Admin Expenses
53
51
51
51
50
50
50
49
Salary and Allowances
182,993,2 00
213,873,3 03
276,777,21 5
304,454,93 7
334,900,43 0
368,390,47 3
405,229,52 0
445,752,47 3
Training & development Traveling and Conveyance Ambulance and Car Expenses
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
1,829,932
1,921,429
2,017,500
2,118,375
2,224,294
2,335,508
2,452,284
2,574,898
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
Other direct expenses
Hospitals supplies Reagent Cost Consumables
Medicine Outsourced Test Expenses
Income
[email protected]% Earnings After Tax(EAT)
0 (67,370,7 08)
0 (24,417,5 07)
0
0
0
86,404,070
105,467,63 9
125,897,54 1
75,837,382
175,114,90 6
259,625,57 4
227,792,54 8
278,051,04 7
331,911,69 8
30
Summary of Projected Revenue Calculation
Segment
2013
2014
2015
2016
2017
2018
2019
2020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
4,212,000
2,939,328
2,125,440
2,436,480
391,910,400
478,224,000
578,664,000
Registration
11,232,000
7,128,000
5,132,160
4,380,480
Consultation
112,320,000
171,072,000
222,393,600
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
362,880,207
399,168,228
439,085,051
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
294,840,000
274,909,248
328,536,000
329,891,098
Diagnistic and
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
Count
2013
2014
2015
2016
2017
2018
2019
2020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
224,640
285,120
342,144
421,200
438,048
489,888
531,360
609,120
50.00
25.00
15.00
10.00
5.00
3.00
2.00
2.00
112,320
71,280
51,322
42,120
21,902
14,697
10,627
12,182
100
100
100
100
200
200
200
200
11,232,00
7,128,00
4,380,48
2,939,32
2,125,44
2,436,48
0
0
5,132,160
4,212,000
0
8
0
0
Ratio to Consultations Capacity Utilized Revenue Per Count
Registration
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
31
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
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
52
60
66
75
78
81
82
94
30
30
30
30
30
30
30
30
Consultants Consultation slots
Per day/consultant
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 Capacity Utilized Percentage Utilized Revenue Per Count
Count
449,280
518,400
570,240
648,000
673,920
699,840
708,480
812,160
Count
224,640
285,120
342,144
421,200
438,048
489,888
531,360
609,120
50.00%
55.00%
60.00%
65.00%
65.00%
70.00%
75.00%
75.00%
500
600
650
700
750
800
900
950
112,320,000
171,072,000
222,393,600
294,840,000
328,536,000
391,910,400
478,224,000
578,664,000
Consultation
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
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
32
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
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
256
256
256
256
256
292
292
292 2,172
Single Private
Emergency Bed Labor Observation
1,278
1,405
1,533
1,661
1,789
1,916
2,044
Nursery/Neo Natal
3,125
3,438
3,750
4,063
4,375
4,688
5,000
5,313
32,435
35,010
37,586
43,665
43,540
46,152
48,727
51,303
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
Bed Occupancy(days) Bed Charges
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
112,579,20 0
101,142,80 0
115,042,05 0
123,059,000
127,790,95 0
49
49
49
49
49
49
49
49
Ward Bed No. of Beds Number of Days Total Capacity Capacity Utilized
365 17,885 17,885
Percentage Utilized Occupancy Revenue Per Count Revenue from Ward Bed
365 17,885 17,885
0.50 8,943
365 17,885 17,885
0.55
365 17,885 17,885
0.60
9,837
10,731
365 17,885 17,885
0.65 11,625
365 17,885 17,885
0.70 12,520
365 17,885 17,885
0.75 13,414
365 17,885 17,885
0.80 14,308
0.85 15,202
800
1,000
1,200
1,200
1,200
1,500
1,500
1,500
7,154,000
9,836,750
12,877,200
13,950,300
15,023,400
20,120,625
21,462,000
22,803,375
68
68
68
68
68
68
68
68
Semi private No. of Beds 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 Occupancy Revenue Per Count
0.50
0.55
0.60
0.65
0.70
0.75
0.80
0.85
12,410
13,651
14,892
16,133
17,374
18,615
19,856
21,097
1,500
1,700
2,000
2,000
2,000
2,200
2,200
2,200
18,615,000
23,206,700
29,784,000
32,266,000
34,748,000
40,953,000
43,683,200
46,413,400
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
Revenue from Semi Private
Single Private No. of Beds
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 Revenue fromER Bed
5,000
5,500
5,500
5,500
6,000
6,000
6,000
6,000
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
33
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 Occupancy
0.80
0.80
0.80
0.80
0.90
0.90
0.90
0.90
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
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
ICU
Percentage Utilized Occupancy
0.80
0.80
0.80
0.80
0.90
0.90
0.90
0.90
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
6
6
6
6
6
6
6
6
365
365
365
365
365
365
365
365
Emergency Bed No. of Beds Number of Days 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 Revenue from Standard Bed
1,800
1,800
2,000
2,000
2,400
2,400
2,400
2,400
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
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
Number of Days
Percentage Utilized Occupancy Revenue Per Count Revenue from Labor Observation
0.50
0.55
0.60
0.65
0.70
0.75
0.80
0.85
1,278
1,405
1,533
1,661
1,789
1,916
2,044
2,172
800
1,000
1,200
1,200
1,200
1,500
1,500
1,500
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
2,500,000
3,437,500
4,500,000
4,875,000
5,250,000
7,031,250
7,500,000
7,968,750
Revenue from Neo Natal
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
34
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%
64,790,900
100%
Total
REVENUE PROJECTIONS Annu al Volu me
Surgery
2013
2014
2015
2016
2017
2018 Revenue
2019 Reven ue
Revenue
Revenue
Revenue
Revenue
Revenue
Taka
Taka
Taka
Taka
Taka
2020 Revenue
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
35
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 SURGERY
5,017,655
6,021,18 6
7,225,42 3
8,670,50 8
10,404,6 09
11,445,0 70
12,589 ,577
13,848,5 35
ORTHO SURGERY
23,224,275
27,869,1 30
33,442,9 56
40,131,5 47
48,157,8 57
52,973,6 42
58,271 ,007
64,098,1 07
PEDIATRIC SURGERY
6,153,763
7,384,51 6
8,861,41 9
10,633,7 02
12,760,4 43
14,036,4 87
15,440 ,136
16,984,1 50
PLASTIC SURGERY
12,302,866
14,763,4 39
17,716,1 27
21,259,3 52
25,511,2 23
28,062,3 45
30,868 ,580
33,955,4 38
UROLOGY SURGERY
20,456,701
24,548,0 41
29,457,6 49
35,349,1 79
42,419,0 15
46,660,9 17
51,327 ,008
56,459,7 09
Surgery
138,740,044
166,487, 757
199,785, 013
239,741, 721
287,689, 770
316,458, 599
348,10 4,311
382,914, 595
Hospital earn mostly from the Surgery and procedures. Department wise detail calculation including the standard tariff and the number of surgery to be done by a specialty are shown in the annexed schedule. We have projected a growth of 20%on year to year basis till 2017 while it is 10%effective 2018 till 2020.Year wise revenue have been projected to be Taka 138,740,044,Taka 166,487,757.Taka 199,785,013,Taka 239,741,721,Taka 287,689,770,Taka 316,458,599,Taka 348,104,311 and Taka 382,914,595 for the years 2013,2014,2015,2016,2017,2018,2019 and 2020 respectively.
Procedure ANESTHESIA PROCEDURE CATH LAB OTHER PROCEDURE
845,510
1,014,612
1,116,074
1,227,681
1,350,449
3,372,000
4,046,400
4,855,680
5,826,816
6,992,179
7,691,397
8,460,537
9,306,591
DENTAL PROCEDURE
4,519,200
5,423,040
6,507,648
7,809,178
9,371,013
10,308,114
11,338,926
12,472,818
EAR NOSE AND THROAT GASTRO ENTEROLOGY
489,300
4,712,500
5,655,000
6,786,000
8,143,200
9,771,840
10,749,024
11,823,926
13,006,319
29,021,400
34,825,680
41,790,816
50,148,979
55,163,877
60,680,265
66,748,291
1,818,700
BODY MIND MEDICINE
596,400
OPD TREATMENT ROOM
770,500
PHYSIO THERAPY VACCINATION CENTRE
704,592
24,184,500
HOLISTIC MEDICINE
ORTHODONTIC PROCEDURE
587,160
1,357,350 4,350,000
2,182,440
3,142,714
3,771,256
4,148,382
4,563,220
5,019,542
858,816
1,030,579
1,236,695
1,360,365
1,496,401
1,646,041
924,600
1,109,520
1,331,424
1,597,709
1,757,480
1,933,228
2,126,550
1,628,820
1,954,584
2,345,501
2,814,601
3,096,061
3,405,667
3,746,234
7,516,800
9,020,160
9,922,176
10,914,394
12,005,833
340,070
408,084
448,893
493,782
543,160
21,470,400
25,764,480
28,340,928
31,175,021
34,292,523
2,096,410
2,515,692
2,767,261
3,043,987
3,348,385
1,250,640
1,500,768
1,650,845
1,815,929
1,997,522
40,883,098
44,971,407
49,468,548
54,415,403
715,680
5,220,000
2,618,928
6,264,000
196,800
236,160
283,392
12,425,000
14,910,000
17,892,000
1,213,200
1,455,840
723,750
868,500
1,042,200
DSA LAB PROCEDURE
19,716,000
23,659,200
28,391,040
GASTRO ENTEROLOGY
1,838,400
2,206,080
MEDICAL ONCOLOGY
2,959,100
3,550,920
MISC. PROCEDURE
534,036
640,843
NEONATALOGY PROCEDURE
479,100
574,920
NEPPHROLOGY PROCEDURE
18,343,000
22,011,600
359,500
431,400
2,170,695
2,604,834
CATH LAB PROCEDURES DERMATOLOGY PROCEDURE DRAINAGE PROCEDURE
NEURO PROCEDURE OBS/GYN OPTHALMOLOGY PROCEDURE PLASTIC AND COSMETIC PROCEDURE
1,747,008
2,647,296
34,069,248 3,176,755
3,812,106
4,193,317
4,612,649
5,073,913
4,261,104
5,113,325
6,135,990
6,749,589
7,424,548
8,167,002
769,012
922,814
1,107,377
1,218,115
1,339,926
1,473,919
827,885
993,462
1,092,808
1,202,089
1,322,298
689,904
31,696,704
38,036,045
41,839,649
46,023,614
50,625,976
517,680
26,413,920
621,216
745,459
820,005
902,006
992,206
3,125,801
3,750,961
4,501,153
4,951,268
5,446,395
5,991,035
1,104,600
1,325,520
1,590,624
1,908,749
2,290,499
2,519,548
2,771,503
3,048,654
1,274,063
1,528,875
1,834,650
2,201,580
2,641,896
2,906,086
3,196,694
3,516,364
RADIATION ONCOLGY
12,775,000
15,330,000
18,396,000
UROLOGY PROCEDURE
3,024,600
3,629,520
4,355,424
234,000
280,800
336,960
PSYCHIATRY PROCEDURE
36
26,490,240
29,139,264
32,053,190
35,258,509
5,226,509
22,075,200
6,271,811
6,898,992
7,588,891
8,347,780
404,352
485,222
533,745
587,119
645,831
PULMONARY FUNCTION LAB RESPIRATORY MEDICINE PROCEDURE Procedure GRAND TOTAL OF SURGERY AND PROCEDURE
61,800
74,160
88,992
369,600
443,520
532,224
113,743,544
136,492,252
252,483,587
302,980,009
106,790
128,148
140,963
155,060
170,566
766,403
843,043
927,347
1,020,082
196,548,843
235,858,612
259,444,473
285,388,920
313,927,812
436,290,564
523,548,381
575,903,072
633,493,231
696,842,407
638,669
163,790,703 363,575,716
We have projected a growth of 20%on year to year basis till 2017 while it is 10% effective 2018 till 2020.Year wise revenue have been projected to be Taka 113,743,544 Taka 136,492,252 Taka 163,790,703 Taka 196,548,843,Taka 235,858,612,Taka 259,444,473,Taka 285,388,920 and Taka 313,927,812 for the years 2013,2014,2015,2016,2017,2018,2019 and 2020 respectively.
Investigation and Diagnostic Revenue:
Investigation and Diagnostic Revenue 2,013
2,014
2,015
2,016
2,017
2018
2019
2020
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
76,579,500
91,895,400
110,274,480
132,329,376
158,795,251
174,674,776
192,142,254
211,356,479
525,000
630,000
756,000
907,200
1,088,640
1,197,504
1,317,254
1,448,980
Hematology
21,040,000
25,248,000
30,297,600
36,357,120
43,628,544
47,991,398
52,790,538
58,069,592
Histopathology
14,555,000
17,466,000
20,959,200
25,151,040
30,181,248
33,199,373
36,519,310
40,171,241
Micro Biology
32,154,500
38,585,400
46,302,480
55,562,976
66,675,571
73,343,128
80,677,441
88,745,185
Transplant Immunology
14,237,000
17,084,400
20,501,280
24,601,536
29,521,843
32,474,028
35,721,430
39,293,573
159,091,000
190,909,200
229,091,040
274,909,248
329,891,098
362,880,207
399,168,228
439,085,051
CT Scan
47,687,500
57,225,000
68,670,000
82,404,000
98,884,800
108,773,280
119,650,608
131,615,669
MRI
35,766,000
42,919,200
51,503,040
61,803,648
74,164,378
81,580,815
89,738,897
98,712,787
Ultra Sound
16,197,500
19,437,000
23,324,400
27,989,280
33,587,136
36,945,850
40,640,435
44,704,478
X-Ray
Department Bio Chemistry Clinical Pathology
Lab Medicine
11,883,050
14,259,660
17,111,592
20,533,910
24,640,692
27,104,762
29,815,238
32,796,762
Diagnostic 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
Grand Total
270,625,050
324,750,060
389,700,072
467,640,086
561,168,104
617,284,914
679,013,405
746,914,746
Lab medicine and diagnostic imaging services contribute a major part of hospital revenue in any corporate hospital. We have surveyed locally few diagnostic centres including hospital to form an idea about the monthly and yearly turnover of this centre. In order to be on the safe side we have conservatively calculated the monthly and yearly earnings of the Diagnostic and Lab medicine and have projected for Taka 270,625,Taka 324,750,060,Taka 389,700,072,Taka 467,640,086,Taka 561,168,104,Taka
617,284,914,Taka
679,013,405
and
2013,2014,2015,2016,2017,2018,2019 and 2020 respectively.
Pharmacy: 37
Taka
746,914,746
for
the
years
Pharmacy 2013
2014
2015
2016
2017
2018
2019
2020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Consultants
52
60
66
75
78
81
82
94
Consultation slots
30
30
30
30
30
30
30
30
6
6
6
6
6
6
6
6
Week Month/ Year
48
48
48
48
48
48
48
48
Capacity
449,280
518,400
570,240
648,000
673,920
699,840
708,480
812,160
Capacity Utilized
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
300
300
300
300
300
300
300
300
67,392,000
85,536,000
102,643,200
126,360,000
131,414,400
146,966,400
159,408,000
182,736,000
Pharmacy
Average sales @ Taka 300 per patient have been assumed taking 50% visited customer will be buying medicine from us. The volume will increase @ 5% per annum.
Costs: Reagent Cost PROJECTED REVENUE
SL No.
Department
Annual Volume
2,013
2,014
2,015
2,016
2,017
2018
2019
2020
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Revenue Taka
Bio Chemistry
76,579,500
91,895,400
110,274,480
132,329,376
158,795,251
174,674,776
192,142,254
211,356,479
Clinical Pathology
525,000
630,000
756,000
907,200
1,088,640
1,197,504
1,317,254
1,448,980
Haematology
21,040,000
25,248,000
30,297,600
36,357,120
43,628,544
47,991,398
52,790,538
58,069,592
Hostopathology
14,555,000
17,466,000
20,959,200
25,151,040
30,181,248
33,199,373
36,519,310
40,171,241
Micro Biology
32,154,500
38,585,400
46,302,480
55,562,976
66,675,571
73,343,128
80,677,441
88,745,185
Transplat Immunology
14,237,000
17,084,400
20,501,280
24,601,536
29,521,843
32,474,028
35,721,430
39,293,573
CT Scan
47,687,500
57,225,000
68,670,000
82,404,000
98,884,800
108,773,280
119,650,608
131,615,669
MRI
35,766,000
42,919,200
51,503,040
61,803,648
74,164,378
81,580,815
89,738,897
98,712,787
Ultra Sound
16,197,500
19,437,000
23,324,400
27,989,280
33,587,136
36,945,850
40,640,435
44,704,478
X-Ray
11,883,050
14,259,660
17,111,592
20,533,910
24,640,692
27,104,762
29,815,238
32,796,762
Revenue
270,625,050
324,750,060
389,700,072
467,640,086
561,168,104
617,284,914
679,013,405
746,914,746
15
15
15
Cost % applied Cost
40,593,758
48,712,509
58,455,011
15
15
70,146,013
84,175,216
15 92,592,737
15 101,852,011
15 112,037,212
Reagent cost of Lab services have been calculated @ 15% on sales. The detail costing has been verified along with the comparative numbers from a reputed hospital uses reagent for such lab services.
Consumables Cost Surgery and Procedure Revenue
252,483,587
Consumables @ 25%
63,120,897
302,980,009 75,745,002
363,575,716 90,893,929
38
436,290,564 109,072,641
523,548,381
575,903,072
130,887,095
143,975,768
633,493,231 158,373,308
696,842,407 174,210,602
Hospital require a substantial amount of consumables both billable and non- billable in the OT,wards, OPD,Lab & diagnostics area,Nurse Station,CSSD,ER,Procedure room etc.An estimated amount has been calculated to be 25% of the Surgery and procedures cost can taken as acceptable.
Medicine: Cost of Medicine
Consultants Consultation slots
2,013
2,014
2,015
2,016
2,017
2,018
2,019
2,020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
52
60
66
75
78
81
82
94
30
30
30
30
30
30
30
30
6
6
6
6
6
6
6
6
Week Month/ Year
48
48
48
48
48
48
48
48
Capacity Capacity Utilized Percentage Utilized Revenue Per Count
449,280
518,400
570,240
648,000
673,920
699,840
708,480
812,160
224,640
285,120
342,144
421,200
438,048
489,888
531,360
609,120
50.00%
55.00%
60.00%
65.00%
65.00%
70.00%
75.00%
75.00%
300
300
300
300
300
300
300
300
Revenue Cost % applied Cost of Medicine
67,392,000 80
85,536,000 80
53,913,600
68,428,800
102,643,200
126,360,000
131,414,400
146,966,400
159,408,000
182,736,000
80
80
80
80
80
80
82,114,560
101,088,000
105,131,520
117,573,120
127,526,400
146,188,800
Hospital make 20% profit (after allowing 5% discount) on MRP.This percentage can be more provided more if the sourcing can be made more smartly.Therefore 80%of sales can be treated as cost of medicine.
Consultant Fee:
Consultants Fee Revenue
2,013 Taka
2,014 Taka
2,015 Taka
2,016 Taka
2,017 Taka
2,018 Taka
2,019 Taka
2,020 Taka
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
Cost (%)
80
80
80
80
80
80
80
80
Cost
89,856,000
136,857,600
177,914,880
235,872,000
262,828,800
313,528,320
382,579,200
462,931,200
Surgery 2,013
2,014
2,015
2,016
2,017
2,018
2,019
2,020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
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
Cost (%)
35
35
35
35
35
35
35
35
Cost
48,559,015
58,270,715
69,924,755
83,909,602
100,691,419
110,760,510
121,836,509
134,020,108
Procedure
39
2,013
2,014
2,015
2,016
2,017
2,018
2,019
2,020
Taka
Taka
Taka
Taka
Taka
Taka
Taka
Taka
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
Cost (%)
50
50
50
50
50
50
50
50
Cost Consultation,Surgery &Procedure Cost
56,871,772
68,246,126
81,895,351
98,274,422
117,929,306
129,722,236
142,694,460
156,963,906
195,286,787
263,374,441
329,734,986
418,056,024
481,449,525
554,011,066
647,110,169
753,915,214
Sharing of consultant's earnings between Consultant and Hospital is 80%:20% in the case of consultation charges. While the same procedure will apply in the case of Surgery and Procedures. Hospital will allocate tariff basis certain level of the surgery and procedure which will be shared again 80%:20% basis. Basis of allocation of tariff has been clearly spelled out in the annex.However, an average of 35% for Surgery and 50% of Procedure revenue has been calculated to be the standard ratio.
Direct Operating Expenses:
The calculation of direct operating cost have done in a very systematic way taking data from the ongoing hospital operating in Bangladesh.
OPERATING EXPENSES
2013
2014
2015
2016
2017
2018
Taka
Taka
Taka
Taka
Taka
Taka
% Increas e
Food & Beverage Patients bed days
32,435
35,010
37,586
43,665
43,540
46,152
Per Bed Days
300
300
300
300
300
300
Expenses
9,730,350
10,503,000
11,275,650
13,099,500
13,061,850
13,845,450
152,344
152,344
152,344
152,344
152,344
152,344
19.20
19.4016
19.6053
19.8112
20.0192
20.2294
2,925,005
2,955,717
2,986,752
3,018,113
3,049,803
3,081,826
32,435
35,010
37,586
43,665
43,540
46,152
2.50
2.63
2.76
2.89
3.04
3.19
973,035
1,102,815
1,243,140
1,516,431
1,587,676
1,767,069
32,435
35,010
37,586
43,665
43,540
46,152
150
158
165
174
182
191
4,865,175
5,514,075
6,215,702
7,582,154
7,938,380
8,835,346
Total Count
224,640
285,120
342,144
421,200
438,048
489,888
Revenue per Count
500
600
650
700
750
800
Total Revenue
112,320,000
171,072,000
328,536,000
391,910,400
Per Count Cost(80%)
89,856,000
136,857,600
177,914,880
235,872,000
152,344
152,344
152,344
152,344
152,344
152,344
28
29
31
32
34
36
4,265,632
4,478,914
4,702,859
4,938,002
5,184,902
5,444,147
House-keeping Occupied Area Per SFT per month
1.5
Expenses Sterilization Occupancy Cost per Occupancy
1.5
Expenses Medical Gas Occupancy Cost per Occupancy
1.5
Expenses Consultants Fees
222,393,600
294,840,000
262,828,800
313,528,320
Gas expenses for hospitals Occupied Area Per SFT/Annum Expenses
1.5
40
Hospitals electricity Occupied Area Per SFT/Annum
1-.5
Expenses
152,344
152,344
152,344
152,344
152,344
152,344
24
25
26
28
29
31
3,656,256
3,839,069
4,031,022
4,232,573
4,444,202
4,666,412
Laundry Expenses Occupancy
32,435
35,010
37,586
43,665
43,540
46,152
Cost per Occupancy
10
11
11
12
12
13
Expenses
324,345
367,605
414,380
505,477
529,225
589,023
32,435
35,010
37,586
43,665
43,540
46,152
25
26
28
29
30
32
810,863
919,013
1,035,950
1,263,692
1,323,063
1,472,558
4,590,000
4,819,500
5,060,475
5,313,499
5,579,174
5,858,132
40,593,758
48,712,509
58,455,011
70,146,013
84,175,216
92,592,737
53,913,600
68,428,800
82,114,560
101,088,000
105,131,520
117,573,120
3,600,000
3,780,000
3,969,000
4,167,450
4,375,823
4,594,614
98,107,358
120,921,309
144,538,571
175,401,463
193,682,558
214,760,471
1.5
Linen for Hospitals Occupancy Cost per Occupancy
1.5
Expenses Hospital Security Services Outsourced Guard Services
1.5
Medicine and Consumables Reagent Other consumables and Medicine Outsourced Test Expenses
1.5
Total Consumables
Cost escalation have been considered to be @ 5% on year to year basis.
General and Admin Expenses:
GENERAL AND ADMIN EXP. Salary and Allowances
1.10 1.5
Employee Welfare
153,603,450
181,032,638
212,411,628
248,256,090
289,145,329
353,399,846
15,360,345
16,128,362
16,934,780
17,781,519
18,670,595
19,604,125
1,536,035
1,612,836
1,693,478
1,778,152
1,867,060
1,960,413
1,200,000
1,260,000
1,323,000
1,389,150
1,458,608
1,531,538
600,000
630,000
661,500
694,575
729,304
765,769
1,000,000
1,050,000
1,102,500
1,157,625
1,215,506
1,276,282
500,000
550,000
605,000
5,000,000
5,500,000
6,050,000
1,200,000
1,260,000
1,323,000
1,389,150
1,458,608
1,531,538
3,000,000
3,150,000
3,307,500
3,472,875
3,646,519
3,828,845
1.5 Traveling and Conveyance 1.5 Ambulance and Car Expenses 1.5 Entertainment 1.5 Legal and audit fees 1.5 Repair & maintenance 1.5 Printing & stationery 1.5 Communication 1.5 Insurance premium
1,800,000
1,890,000
1,984,500
2,083,725
2,187,911
2,297,307
Marketing Expenses
30,000,000
31,500,000
33,075,000
34,728,750
36,465,188
38,288,447
1.5 Other admin expenses
2,500,000 212,299,830
Finance Cost Interest on Syndication Loan (Capex) Interest -Working Capital
2,625,000
2,756,250
242,688,836
277,178,136
2,894,063 320,625,674
3,038,766 365,383,392
3,190,704 433,724,812
61,623,154
57,174,997
49,392,967
47,012,324
42,046,710
34,432,526
5,000,000
5,000,000
-
-
-
-
66,623,154
62,174,997
49,392,967
47,012,324
42,046,710
34,432,526
Detail manpower budget is annexed in Schedule-xxxxxx.Cost increase under payroll have considered to @ 10% while for other area it is 5% except for Marketing expenses.
41
Operational Plan The hospital will focus on almost all specialties including diagnostics and lab services and necessary arrangement will be made accordingly. There will have the arrangement for in-house consultants to practice in the hospital throughout the day. Both full time and part time consultants can practice in the hospital and the separate modalities will follow for each group of physician in terms of practice e.g. full time consultants will start practice from 9.00 am and continue till 5.00 p.m while part time consultants will start from 5.30 p.m and continue till 11.30 pm.The centre will initially start with 33 full time consultants and 19 part time consultants as per the timings mentioned above. To achieve these aims and vision, and enable values to strengthen, UHSRL will first develop and build the requisite organizational infrastructure and operational processes. To start with management should aim at ensuring alignment of services and activities operate cohesively across the continuum, with the overarching themes of: • Ensure financial and service performance • Improve quality and responsiveness of services • Putting service users first • Reducing inequalities
Manpower Planning The total number of employees of the hospital would be about 667. Detailed manpower requirement is provided in Annex 4. Association of successful and reputed specialists and general practitioners on regular roles as consultants will be an important feature of this hospital. They would undertake to, impart appropriate training to the support team of doctors, technicians and nurses.Year wise consultants planning are as follows:
Consultant: There will be both clinical and non clinical consultants in the hospital. Clinical consultants will have the arrangement to see patient in the OPD clinic and admit patient wherever necessary (as per patient's condition) in the hospital. Non clinical consultants will mostly work in the Laboratoty, Radiology (MRI, CT), X-ray, USG, Anesthesia etc. They will not see patient directly in the OPD nor can admit patient in the hospital. Normally they will work on salary basis as full timer.However, in some cases there may be alternative arrangement of payment for such consultants. Year wise (centre wise) consultants planning have summarized below:
Department wise Consultants 2013
Departments
2014
2015
2016
2017
2018
2019
2020
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
Full Time
Part Time
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
PRIMARY CARE Internal Medicine
3
2
3
3
3
42
3
3
3
3
3
3
3
3
4
3
4
Endocrinology and Diabetology Gastroentrology and Hepatology
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
1
2
2
2
2
3
3
3
3
3
3
3
3
3
3
Respitratory Medicine
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
Haematology BONE AND JOINT CENTRE
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
Orthopaedics
2
2
2
2
2
3
3
3
3
3
3
3
3
3
4
3
Rheumatology
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
Cardiology
2
2
2
2
2
3
3
3
4
3
4
4
4
4
4
4
Cardio Thoracic and Vascular
1
0
1
1
2
1
2
1
2
1
2
2
2
2
2
2
Nephrology
2
1
2
2
2
2
2
3
2
3
2
3
2
3
3
3
Urology MOTHER AND CHILD CARE
1
1
2
2
2
2
2
3
2
3
2
3
2
3
3
3
Obstetrics and Gynocology
3
2
3
2
3
3
3
3
3
3
4
3
4
3
4
4
Paediatrics
2
1
2
1
2
1
2
2
2
2
2
2
2
2
2
2
Paediatric Surgery
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
Neonatalogy
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
Dermatology and Venerelogy
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
Medical Oncology Dental and Maxilliofacial Surgery
1
1
1
1
1
1
1
2
1
2
1
2
1
2
2
2
1
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
Psychiatry
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
General Surgery
2
1
2
1
2
2
2
2
3
2
3
2
3
2
3
3
Laparoscopic surgery
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
ENT
2
1
2
2
2
2
2
2
3
2
3
2
3
2
3
3
Plastic and Cosmetic Surgery
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
33
19
35
25
36
30
40
35
43
35
44
37
44
38
48
46
HEART CENTRE
KIDNEY AND UROLOGY
THERAPEUTIC
SURGICAL CENTRE
Clinical Consultants
Nurse: The total number of nursing staff for the hospital has been projected to be 249 including 1 Nursing Superintendent and 10 Nursing Supervisor. There will be critical care nurses who will be specially trained to provide individualized nursing care according to the level of sedation the patient had or will receive for therapeutic purposes. To maximize desired sedative effect while maintaining the patient’s ability to maintain a patent airway independently and continuously, and respond purposefully to physical stimulation and/or command. Also there will be nurses for general ward, ER, Paedtric ward, OT etc.with specific skill and training on that particular subject.
Bed Vs Nurse Allocation
Emergency bed OT Cath Lab ICU CCU Recovery bed Step down Post operative
Ground floor
6th floor
7th floor
8th floor
9th floor
10th floor
11th floor
Total
Allocation of Nurse
6 0 0 0 0 0 0 0
0 4 0 10 0 4 0 11
0 2 2 0 10 0 8 0
0 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
6 8 2 10 10 4 8 11
6 48 4 15 15 4 6 6
43
Labor observation Nursery/Neonatal Male ward bed Female ward bed Semi Private Room Single VIP Room OPD MRI/CT X-Ray/USG MHC Pool Total
0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 29
0 0 0 0 0 0 0 0 0 0 0 22
7 17 9 0 12 0 0 0 0 0 0 47
0 0 8 12 20 0 0 0 0 0 0 40
0 0 8 12 20 0 0 0 0 0 0 40
0 0 0 0 16 2 0 0 0 0 0 18
7 17 25 24 68 2 0 0 0 0 0 202
6 10 18 18 43 3 15 4 4 3 10 238
Non Consultant Physician: There will be sufficient number of Non consultant Physician (NCP) in different categories to support patient both IPD and OPD.There will be initially 34 Registrar, 7 Sr.Medical officers and 34 Resident Medical officers to be in the hospital. These NCP, s will work and carry out the instructions and advise as received from the consultant concern.
Bed Distribution (Floor Wise) Vs Doctor Allocation
Emergency bed OT Cath Lab ICU CCU Recovery bed Step down Post operative Labor observation Nursery/Neo natal Male ward bed Female ward bed Semi Private Room Single VIP Room OPD MRI/CT/La b X-Ray/USG MHC Pool
Grou nd floor
6th flo or
7th flo or
8th flo or
9th flo or
10t h flo or
11t h flo or
Tota l
Consul tant
Anesthe tist
Regist rar
SM O
RM O
6 0 0 0 0
0 4 0 10 0
0 2 2 0 10
0 2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
6 8 2 10 10
1 0 0 1 1
0 3 0 0 0
0 8 1 3 3
0 0 0 3 3
4 0 0 4 4
0 0
4 0
0 8
0 0
0 0
0 0
0 0
4 8
0 0
0 0
0 1
0 1
0 3
0
11
0
0
0
0
0
11
0
0
0
0
0
0
0
0
7
0
0
0
7
0
0
2
0
3
0
0
0
17
0
0
0
17
0
0
2
0
3
0
0
0
9
8
8
0
25
0
0
0
0
0
0
0
0
0
12
12
0
24
0
0
0
0
0
0
0
0
12
20
20
16
68
0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
2 0
2 0
0 0
0 0
0 3
0 0
0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 2 0 0
0 0 0 0
7 3 1
0 0 0 0
0 0 2 15
44
0
Total
6
29
22
47
40
40
18
202
7
3
34
7
38
Management Team: It includes the CEO, Director of Medical Services, CFO, Nursing Superintendent, Operations Manager. The time schedule for these top ranking people to join in the hospital must be before 3/4 earlier i.e. before the soft opening of the hospital. Healthcare Prospects: Economy has been growing and the health consciousness among common people is increasing. Since healthcare is dependent on the size of the population served, and Bangladesh has a huge population of one hundred fifty million, this represents a big opportunity. There is a trend toward people who are spending more on healthcare and prefer private corporate health care services. There are people who are ready to spend more but they expect recognition and super class service delivery from every level of staff in the hospital. Patient Care Any corporate hospital must provide patient care in an ethical manner, and at the best quality possible, taking into consideration patient safety, patient satisfaction and efficiency in providing services. The hospital’s Medical Ethics Committee must ensure appropriate interactions and protects patients’ rights. In addition, the hospital should have department to reviews customer complaints and monitor continuously the quality of the care provided while taking into consideration patients’ needs and suggestions. Quality Control Hospital team should be committed in providing a system of Quality Management for its ongoing clinical and operational activities.Hospital need to put in place a strong Quality Management Protocol to ensure quality, safety and efficiency in all departments of the hospital and everyone should be dedicated in achieving complete patient satisfaction.If necessary a specially designated team should be formed to monitors the quality, safety and infection control related data from the various departments to ensure that they meet the hospital’s standards. Critical Incidence Report analysis with it’s corrective guidelines, advice on best practices and monitoring of patient satisfaction are among the functions which help elevate the quality of care. This team also to monitors the implementation of international standards in the hospital and conducts internal reviews and quality audits from time to time. Also a Quality Steering Committee, comprised of Senior Physicians and Management staff of the Hospital should regularly meet and review the data, consider quality related issues and make suitable recommendations for improvement. Strength
The long-term trends of aging populations and rising living standards continue to drive demand for high quality healthcare. Apollo Hospitals Dhaka was the first hospital in Bangladesh invites JCI accreditation to assure patients of its quality. It continues to measure itself against the best hospitals in this country, and advocates transparency in both business and medical practices. Value During economic uncertainty, value plays an important role in consumer decisions, including healthcare. Apollo hospitals Dhaka has taken important additional steps to meet these needs. Apollo hospitals Dhaka succeeds by offering international-standard healthcare at prices much less than those
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in Europe and the US. The hospital’s website helps people all over the world learn about Apollo hospitals Dhaka quality and value. Thousands of prospective patients visit it each week to search for a doctor, find out about a medical service, or make an appointment
Leadership Smart, experienced management has kept Apollo hospitals Dhaka well-positioned to weather difficult economic times and maintain the company’s strategic direction. The company’s solid financial position allows it to capitalize on opportunities presented in recessionary markets.
Innovation Developing innovative ways to better serve patients has always been a cornerstone of Apollo hospitals Dhaka success. Medical and information technologies continue to provide advanced care and productivity growth, while delivering a more satisfying patient experience. In 2009, major innovations were introduced in the hospital’s new facilities in inpatient rooms.
Marketing Plan Marketing plays a vital role in any successful business enterprise. How well we market our services will ultimately determine the degree of success or failure. The key element of a successful marketing plan is to know the customer – their liking, disliking and expectations. Identifying these factors we will develop our marketing strategy that will allow us to fulfill their needs. We will target customer identifying their age, sex, income level, educational level, residence etc. At first we should target those customers who will be visiting our centre for consultation. Secondly an attempt will be taken to sell the quality services to the renowned referral doctors in the society, medical colleges/institution, hospitals, clinics through personal visit by the marketing team and by putting ad in the print and press media. Also some investment will be required in the TV commercial initially to have the introduction. Customer base will expand with the time and hence the plan should have modification options. Target Market We should define our target market (i.e. customers) all over the country. They may be classified as indigent, medicare and private patients. Or they may even classify according to the medical cases. We will be targeting customers by product specialties/services, geographical areas (e.g. divisional and district towns), Industry (e.g. various corporate client, foreign mission, club etc.). Our target market in addition to the local patients who take services within the territory of Bangladesh and spend a lot of money for healthcare and a significant number of people with purchasing power those who go abroad, particularly India, Thailand and Singapore for better treatment. Pricing
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To improve our overall competitiveness pricing strategy should be designed keeping in mind of our competitor’s price. Any pharmacy item we are required to follow the retail pricing. For any diagnostic item we have to follow the combination of following pricing strategies:
- Competitive - Pricing
position below
competition Pricing above - Price lining Multiple
competition pricing
UHSRL will be providing international quality healthcare services and quality does not come cheap. It may be mentioned here that, a lot of Bangladeshis are on mass exodus to India and Thailand for not cheaper cost, but to get correct diagnosis, correct treatment and cordial behavior in a proper environment. UHSRL will never compromise in quality in any way- the physical set-up will be designed by well reputed architect; the technology and medical equipment will be state-of-the-art; doctors, nurses and medical technologists will a mix of locals and expatriates. Considering all these the pricing of UHSRL should not be less than any usual diagnostics or hospitals, which very often does not adhere to basic standards of service quality in most areas. However, as an internationalstandard centre, the pricing of UHSRL will be competitive. 8.4 Competitive Strategy UHSRL competitive strategies among others will be: Ensuring quality at all levels. Only quality products and quality services will help UHSRL to compete with other service providers and help it to grow sustainable. Avoid tariff war with the competitors Be the leader in introducing new products and protocols.
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Arrange agreement with the corporate sector, diplomatic organizations, and be customer friendly to growing higher middle class. Be the leader in continuing medical educations. Engage in co-branding operation with wellknown pharmaceutical companies. Ensuring a correct balance between local Bangladeshi consultants and expatriate consultants. Increase efficiency by modernizing in-house management. Continue to offer its services under the brand name of “UHSRL". Strategic Plan UHSRL has a strong commitment and dedication for the people of this country. “We will do
everything for everybody” has never been a viable value proposition for any successful business model that we know of--and yet that is the value proposition. Delivering a value proposition to do the first job requires a solution-shop business model that will ensure high quality. The second job requires a value-adding business model organized around the efficient delivery of specific services. We decided not to compete on price with the other top tier hospitals but instead to continuously improve our patient services quality in order to capture market share and ensure margin growth for our business. We will strive continuously to meet and exceed our customers’ expectations. We will act daily to sustain continuous process improvements in direct response to customer input. The leadership of Uttara Group has a conscious commitment since inception, to provide safe, quality services to the people of Bangladesh. We are also committed to routinely updating our protocols and practices based on the most current information available and through Uttara Group implementation of periodic international quality updates. The centre will provide patient care in an ethical manner, and at the best quality possible, taking into consideration patient safety, patient satisfaction and efficiency in providing services. Once this is established in the market as brand name then second option will be to start thinking for opening of a corporate hospital in the city. Risk Analysis The diagnostic business requires human resources with specific technical expertise and knowledge, including doctors,technicians,professionals. But there is a dearth of skilled professional medical staff in the health sector of Bangladesh. Across the world biggest challenge for the healthcare industry today is an acute shortage of trained personnel, ranging from doctors, nurses, technicians and even healthcare administrators. A shortage of these professionals is due to increasing demand and migration of skilled personnel to developed countries at competitively higher compensation package. Diagnostic centre use comprehensive, multidisciplinary, state-of-the-art equipment. Any change in technology will make existing medical equipments obsolete. High rate of advancement in medical technology is leading to shorter lifespan, obsolescence of medical equipment, requiring medical professionals to upgrade their skills on a constant basis. Marketing risks involved in any large-scale operation. Market growth could be lower than the projected growth or might fall greatly due to competition. Uttara Group will depend marketing essentially from three sources - the target market size of middle and high -income patients can turn out to be lower than projected, market share of Uttara Group can be squeezed through competition, and unhealthy competitive practices by the existing market players can render the whole industry unviable
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The Company is exposed to credit risk primarily with respect to trade accounts and other receivables. If there is credits allowed to any corporate client and if by any reason due to less control on policies and procedures accounts receivable might not be realized in full. Diagnostic business is subject to litigation risk attended to the provision of healthcare services by hospital staff and physicians. Patient has the opportunity to file case against hospital and doctors. This may arise future possible liability. Power is a common problem for our country and we are not out of that. Due to power crisis diagnostic centre suffers continuous load shedding. Gas pressure is very low and it can not fulfill the requirement of power generating. This unusual power supply causes the damage of our medical equipment frequently.
Strength and Weaknesses Our business model will be successful and it will start returning positive result even in the face of the initial high capital investment. Our mission will be to continuously improve the quality of healthcare services provided to the communities we serve and to strive to bring healthcare services of international standards. At the same time, we seek to generate strong financial performance and appropriate returns to our investors through disciplined and balanced execution of a comprehensive business strategy that reinforces both quality of care and financial strength. We seek to further strengthen our position as a leading diagnostic service provider by successfully differentiating our service offerings and increasing the scale of operations. Manpower turnover in the industry is a real threat in the healthcare/diagnostic business sector. It is extremely a difficult task to retain good people for long term to work for the company with full loyalty. As leaders, we’d like to think that when people leave, it has little to do with us. But the reality is that we are often the reason. Some sources estimate that as many people leaving companies do so because of their managers. We may say that people quit their job or their company, but the reality is that they usually quit their leaders. The “company” doesn’t do anything negative to them. Sometimes coworkers cause the problems that prompt people to leave. But often the people who alienate employees are their direct supervisors. Other reasons were higher package and better opportunity which causes serious threats for the business. Conclusion Making right investment decisions while planning for a diagnostic center is crucial to its long-term sustainability. From the analysis of the study we can figure out that such project is quite feasible for Bangladesh as it has an alluring opportunity. Although sometimes these projects are in red because their investment plans are not based on budgetary allocations for different infrastructural areas like general costs, equipment planning, equipment procurement, project costs, time overruns and a whole host of things on the operational side. In this study we have also seen that this project have a negative NP for the first year of its operation (which is very common in such trade) but afterwards the profit margin is getting healthy. The reality is once it kicks off and the quality of service can be ensured there is every possibility of success.
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