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The Assumptions

The Assumptions

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Published by Avani Sisodiya

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Published by: Avani Sisodiya on Aug 24, 2012
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08/24/2012

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THE ASSUMPTIONS
Healthcare services provided in the proposed hospital
There is a lack of required infrastructure in the healthcare sector in Meghalaya. The risinghealth problems like cancer, trauma and heart diseases have added to the existing problem of inadequate infrastructure.The below given facts illustrate the need for the opening up of more healthcare facilities inthe state are:
 
There has been increase in the number of cancer cases in Meghalaya with a total of 2620 reported cases during the last 5 years.
 
A
 bout 42.3 percent of the State’s population is still uncovered by health care,
according to the status paper prepared by the Health Department. It presents one of the potential target population segments for the proposed hospital.
 
According to the National Family Health Survey (NFHS) 1992-93, the percentage of children fully vaccinated in Meghalaya is very low at 10 percent and more than half of the children surveyed have received no vaccination at all. Thus, providingvaccination services will add to the outdoor revenues for the hospital.
 
46 percent of the children under age four are under-weight and more than 50 percentsuffer from under-nutrition.
 
Under 5 Mortality Rate (U5MR) which stands at 87.
 
The Maternal Mortality Rate (MMR) which is 349 also highlights the poor state of affairs.
 
The debility due to pregnancies, extreme hard work and low nutritional levels havepaved the way for an alarming rise in tuberculosis in women in the state.
 
A significant portion of women do not receive any antenatal/postnatal care and a largepercentage of deliveries are conducted by untrained birth attendants or relatives.
 
In Meghalaya, the rate of cardio vascular diseases was 3 percent. Meghalaya wouldhave 90,000 heart patients every year, which is very alarming.
National Rural Health Mission (NRHM)
is a National effort at ensuring effective healthcare through a range of intervention at individual, household, community and most criticallyat the Health System Levels.
Expected outcome of the Mission for Meghalaya:
 1.
 
Infant Mortality Rate (IMR): To be reduced to 30/1000 live births by 2012.2.
 
Maternal Mortality Rate (MMR): To be reduced to 100/100,000 live births by 2012.3.
 
Total Fertility Rate(TFR): To be reduced to 2.1 by 2012.4.
 
Malaria Mortality Reduction Rate(MMRR) - Reduced by 50% up to 2010, additional10% by 2012.
 
5.
 
Cataract Operations: Increase to 10,000 by 2012.6.
 
Leprosy Prevalence rate(LPR): Reduced from 1.8 per 10,000 in 2005 to less than 1percent thereafter.7.
 
Tuberclosis DOTS series: To maintain 85% cure rate through entire Mission Periodand also sustain planned case detection rate.8.
 
Upgradation of Facilities: All Community Health Centers to be upgraded to IndianPublic Health Standards.9.
 
First Referral Units(FRU): Increase utilization of FRUs from bed occupancy byreferred cases of less than 20% to over 75%.10.
 
Accredited Social Health Activist (ASHA): Engaging 6250 female Accredited SocialHealth Activists (ASHAs)Since there are many efforts undertaken by the government authorities and the private entitiesin Meghalaya to promote the use of healthcare services by the public, the occupancy rate of the proposed hospital, which is offering such wide range of medical treatment facilities isexpected to be approximately 60% in the initial period and will eventually increase in thefuture. It is expected to increase upto 65% by 2035 and will continue approximately at thatlevel thereon.
The OPD’s contribution to total revenue is estimated to be around 30% of the
income generated from IPD patients per day.
Other Assumptions
 1.
 
The values of the economic variables as applicable to the economy of India is takenfor: Interest rate on long term loan, corporate tax rate, dividend distribution tax, risk free rate, WPI
 – 
inflation rate, Debt-to-equity ratio, exchange rate. The salary growthrate of 4% is taken as applicable to the hospital industry in Meghalaya. Othereconomic variables are derived from these variables.2.
 
The tail period is taken as 5 years i.e. the repayment of debt will be completed 5 yearsbefore the termination of the contract. This tail period is taken to act as a buffer periodso that even if the payment is delayed or prolonged for some reasons, it can becompleted in the due course of the contract period.3.
 
The depreciation rates for various classes of assets used in the assumptions forcalculations are taken from Apollo Hospital.4.
 
The tuition fee for the medical college is taken as prevalent in the medical colleges inIndia currently.5.
 
The ratios like current assets/revenue, current liabilities/revenue, COGS/revenue,marketing expenses/revenue, miscellaneous/revenue, dividend payout ratio are takenas per our estimation after reviewing the ratios for other hospitals and modifying themby keeping in mind the kind of structure planned for the hospital, the demographics of the state, the current scenario in the state etc.6.
 
The salary for various categories of employees and the costs for various treatmentsunder IPD (Inpatient Department) is taken as per the industry average.7.
 
The room charges and nursing charges vary for various categories of rooms to cater tothe different classes of people demanding different levels of services and facilities.

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