CHAPTER - VII

FINANCIAL ANALYSIS

1.1. BACKGROUND IN FINANCIAL ANALYSIS

Financial Analysis provides an overview of the plan to use the source of the budget
owned, so that it can be known the rate of return on costs to be invested. Thus, the owner /
investor can see the level of profit that may be obtained. The financial aspects that will be
analyzed consist of:
1. Investment Plan and Source of Funds
2. Projected Revenue and Costs
3. Cash Flow Projection
4. Financial Analysis: Break Event Point (BEP), Internal Rate of Return (IRR), and Net
Present Value (NPV)

1.2. ESTIMATED WORKING CAPITAL

The first step in reviewing economic and financial aspects is to estimate working
capital in the development process that can be seen in table 7.1 below.
Table 7.1. Preliminary Economic Data
Project Overview
Name Construction of Haji Medan International General Hospital

Location Percut Sei Tuan District, Deli Serdang Regency

Land 60,002 m2
Building Area 22,699 m2
Project Plan Schedule
Beginning of the Planning Stage Early 2022

Development Time 3 years

Beginning of the Operational Stage Second Quarter 2024

Economic Assumptions Used

Increase in receipts per year 5%
Increase in Operating Expenses per year 6%
Tax 10%
Depreciation & Amortization straight line
Loan Description  
Loan Interest Rates 12%
Minimum Balance Rp. 2,000,000,000.00
Land prices on site It doesn't count because it already
exists.
SBI (Bank Indonesia Interest Rate) 8%
Funding Structure = Loan 80 % and Investor Equity 20%
1.3. PATIENTS WHO USE THE SERVICES OF RSU HAJI MEDAN
 For other medical services such as pharmacy at RSU Haji Medan, the details are as
follows:
Table 7.2. Outpatient Data 2016-2019
Number (people)
No. Polyclinic/ Service 2016 2017 2018 2019
1 Surgery 4.445 4.068 3.763 1,605
2 Plastic Surgery 106 167
3 Paediatrics 2.645 2.786 2.553 2,092
4 Internal Medicine 9.799 11.503 8.570 5,043
5 Obstetrics and Obstetric 3.093 2.640 1.441 989
diseases
6 Eye 3.198 3.228 2.733 1,418
7 Skin and Genitals 1.741 1.862 1.505 874
8 Neurology 5.496 6.053 4.618 2,890
9 Psychiatry 1.227 1.514 1.672 969
10 Lung 4.214 4.796 3.720 2,086
11 Tooth 1.134 1.118 1.016 719

12 ENT 4.418 4.858 4.039 2,880

13 Heart 3.716 5.803 4.891 2,936
14 Physioteraphy 10.475 11.360 9.020 7,614
15 Orthopedics 1.711 1.602 1.416 1,365
16 TB Dots 271 265 -
17 VCT (Voluntary Conseling and 1.541 1.085 1.060 1,275
Testing)
18 IGD 1,717 173 2.152 5,229

19 Haemodialysis 2.558 2.392 2.724 3,457

20 Gubsu Polyclinic 2.554 2.632 -
21 Endocrine - - - -
22 Geriatric - - - -
Jumlah 59.609 62.948 66.630 43,608
 Table 7. 3 Number of Medical Support Patient Visits
Average jml Jml Day /
No. MEDICAL SUPPORT Unit
patient/day Year
1 Laboratory Unit 20 300
2 CT Scan Unit 2 300
3 Radiology (X-RAY) Unit 12 300
4 Pharmaceutical Unit      
5 Clinic Unit 80 300
6 Hospitalization Unit 80 360
7 Others      
8 Rent Canteen Parcel 10 12
9 Vehicle Parking Unit 150 360

Table 7. 4. Tahun Outpatient Insurance Type 2016 - 2020

No Jenis Insurance Years/ people
2016 2017 2018 2019
1 Personal 6133 7.531 9.535 10. 381
2 BPJS 55.255 62.779 50.717 32. 432
3 Company 143 52 32 0
4 Jamkesda 58 871 15 0
5 Free of charge - - - -

1.4. Assumptions and Projections of Patients using RSU Haji Medan Services
In this RSU Haji Medan project, the main income is the patient as a user of his
services. To be able to estimate the amount of revenue of RSU Haji Medan per year, of
course, it is necessary to determine first how much the market will be absorbed by this
project.
The assumptions used are as follows:
1. The number of births in Medan – Deli Serdang in 2019 was 29,694 births.
If the percentage absorbed by RSU Haji Medan is 35%, then the number of births in RSU
Haji Medan is 35%.
= 35% x 38,864 births = 13,602 births
2. The number of beds available is 219 beds of various classes available. Then the
assumption per day = 13602/219 = average bed filled 62 or bed or each class assumed
daily Bed Occupancy Ratio (BOR) is 62%.
3. Clinic
In this Medan Hajj Hospital there are 22 polyclinic rooms that are assumed to be the
number of patient visits as follows:
Table 7.5. Number of Poly Clinics and Assumptions of Patient Visits
 Number of patients /
No. Polyclinic
day
1 Obgyn 10
2 Children's 10
3 Mental Disorders 10
4 Internistg 10
5 Cardiac 10
6 Pulmonary 10
7 Neurosurgeon 10
8 Dental 10
9 Eye 10
10 Ear, Nose & Throat (ENT) 10
11 Skin and Genitals 10
12 Medical Rehab 5
13 General Surgical 10
14 Neurosurgery 10
15 Heart Surgery 10
16 Urological Surgery 5
17 Plastic Surgery 10
18 Oncology Surgery 10
19 Oral Surgery 5
20 Vesicular Surgery 10
21 Pediatric 5
22 Physiotherapy 5

As for other medical services such as pharmacy, the details are as follows:

Table 7.6. Number of Medical Support Patient Visits

Average jml Jml Day /
No. MEDICAL SUPPORT Unit
patient/day Year
1 Laboratory Unit 20 300
2 CT Scan Unit 2 300
3 ESWL Unit 1 300
4 Radiology (X-RAY) Unit 12 300
5 Pharmaceutical Unit      
  Clinic Unit 80 300
  Hospitalization Unit 80 360
6 Others      
  Cafetaria Rent Parcel 10 12
  Vehicle Parking Unit 150 360

1.5. ESTIMATED COST OF INVESTMENT

 Cost of Land Purchase
 Based on information on the stages of market aspects, it is known that the price of
land in the district of Percut sei tuan precisely on the road of Haji Medan Hospital is
Rp. 5,000,000,-
 Building Construction Costs
For The Estimated Cost of Construction Is Used Estimates at the Conceptual Stage
(Decree of the Minister of Settlements and Regional Infrastructure Number: 332 / Kpts / M /
2002 About Technical Guidelines for The Construction of State Buildings). Important
information that needs to be known is:
o The average Hospital Construction Unit Price from consultant experience reaches
Rp.12,000,000/m2
o Then coupled with non-standard physical construction such as:
 Architectural Work:
 Interior Design Work
 Landscaping & Parking Jobs
 Structural work:
 Roof Frame Work (steel)
 Concrete Dak Work
 Deep Foundation Work
 Building Work Generator, PLN, TPS, etc.
 STP jobs
 Anti-termite work
 Electrical &Mechanical Work:
Electrical:
 Generator Set = 300 kVA complete with assistive devices
 Telephone network work/PABX
 Special Lightning Rod
 Elevator (4 units) @ capacity of 15 people
Mechanical:
 Air/AC
 Firefighting installation
 Medical Gas Installation
From the calculation then obtained the cost of building the Hajj Hospital is Rp
12,000,000 m2 x 25,744 m2 = Rp308,928,000,000
 Consulting Fees
In the construction of this hospital, many parties are involved in the consultation,
including:

Table 7.7. Consulting Fees

No. Consulting Unit Unit Sum Cost
1 Environmental impact analysis Consultant LS 1 Rp 100,000,000
 2 Engineering Consultant      
  a Feasibility Study
  b Mapping / Soil Measurement
  c Land Research
  d Architecture, Interior, Planner
LS 1 Rp 3,089,280,000
  e Civil and Structural
  f Mechanical / Electrical
  g Construction Management
  h Milieu
3 Hospital Consultant LS 1 Rp 400,000,000
  Total Rp 3,589,280,000

 Cost of Information System (Hospital Management System)

The cost of this information system consists of the purchase of software,
complementary hardware, and its network.
 Ambulance Car
To complete medical services to the community, RSU Haji Medan is equipped with
ambulance cars that contain the best quality equipment.
 Cost of Tool Investment
At the stage of technical and technological aspects, it is known what equipment is
needed by RSU Haji Medan., for the financing of tool investment in general can be
calculated with a ratio of 0.75 : 1 to the price of the building, so if the building price
is Rp308,928,000,000, then the price of tool investment is ± Rp231,696,000,000.

For easier, the recapitulation of the results of the calculation of investment costs in the Haji
Medan RSU Project can be seen in Table 7.8. As follows:

Table 7.8. Investment Recapitulation

No. Work Items Volume Unit Unit Price Total Price
 Land Purchase Fee
(assumed not to be purchased
1   m2 - -
anymore for using existing
land)

Cost of Building a hospital

2        
(new tower)
12.000.0
Building Construction Costs 25.744 m2 308.928.000.000
00
 
3.589.280.0
Consulting Fees 1 LS 3.589.280.000
00
Information Systems Cost
3        
(HIS)
105.600.0
Software 1 Ls 105.600.000
00
400.000.0
  Hardware 1 Ls 400.000.000
00
350.000.0
Network 1 Ls 350.000.000
00
4 Medical Device Investment 1 LS 308.928.000.000 308.928.000.000
TOTAL 622.300.880.000

Project Investment in Medan Hajj General Hospital

The total investment of Rp622,300,880,000, the amount of funds is borne by two parties,
namely:
 Equity investors, in this case concurrently as owners; and
 Lenders
The financing structure in the RSU Haji Medan project can be seen as follows:
Table 7.9. Financing structure in RSU Haji Medan project
Funding Structure
Equity 30% 186.690.264.000
Foreign Loans 70%

1.6. ESTIMATED REVENUE AND OPERATING EXPENSES

The revenue and operating expenditure of RSU Haji Medan in 2019 are as follows:
 Table 7. 10. Details of Revenue Realization (in rupiah) in 2019

Description of Income Type Revenue Realization

Outpatient Installation Revenue 13.178.647.277

Inpatient Installation Income 50.923.291.151

Medical Support Income 721.220.679

Cooperation Revenue 1.740.733.425

Other Legitimate Income 186.496.743

Amount of Revenue 66.750.389.275

Meanwhile, the cost of RSU Haji Medan oada Operational Expenditure in 2019 is known as
follows:
Table 7. 11. Operating Expenses for 2019
 FIXED COST ITEMS SUM

Non-civil servants' expenses 24,484,334,539

Cost of Experts (Doctors) 10,468,660,585

Cost of Insurance Premiums 1,669,417,378

Cost of Cleaning Services 849,108,670

Referral Maintenance Service Fee 550,096,850

Print and Doubling Costs 539,325,375

Food and Drink Activities 169,375,600

Cost of RegionalLy Owned Insurance Premiums 51,492,517

Bank Service Fees 17,636,587

Vehicle Registration Fee 14,785,711

TOTAL FIXED COST 38,814,233,812

VARIABLE COST ITEMS

Burden of Drug Ingredients 13,525,842,090

Basic Food Load 2,396,902,581

Cost of Consumables 1,096,292,839

Household Logistics Materials Load 194,623,160

Cost of Building Materials Needs 149,110,570

Publication and Documentation Costs 111,542,200

Souvenir fee 47,580,325

AC Maintenance Costs 44,905,000

Office Equipment and Equipment Rental Expenses 25,740,000

TOTAL VARIABLE COST 17,592,538,765

TOTAL 56,406,772,577

Based on Table 7. 10 and 7.11, obtained operating income of Rp. 66,750,389,275.

Based on the 2019 revenue amounted to Rp. 66,750,389,275 and the amount of operating
expenses in 2019 amounted to Rp. 56,406,772,557, then obtained Net Income (Surplus)
amounting to = Rp. 66,750,389,275 - Rp. 56,406,772,557 = Rp 10. 343. 616. 698,-.

For the estimated revenue of RSU Haji Medan, it can be seen in Table 7.12 as
follows:
Table 7.12. Estimated Revenue from the Room

Average
Jml
jml
No. Item Business Day / Rates/days Total Rev / Year
patient/da
Year
y
HOSPITALIZATION        
1 Suite Room 1 360 900.000 324.000.000
2 Super VIP Room 5 360 600.000 1.080.000.000
3 VIP Room 15 360 450.000 2.430.000.000
4 Class 1 -A 15 360 300.000 1.620.000.000
5 Class 1 -B 15 360 250.000 1.350.000.000
6 Class 2 20 360 150.000 1.080.000.000
7 Class 3 20 360 100.000 720.000.000
8 ICU Room 5 360 600.000 1.080.000.000
9 ICCU Room 5 360 750.000 1.350.000.000
10 NICU Treatment 3 360 600.000 648.000.000
11 PICU Treatment 3 360 600.000 648.000.000
12 Operating Room 2 360 750.000 540.000.000
13 Emergency Room 5 360 500.000 900.000.000
14 Birthing Room 5 360 500.000 900.000.000
15 Hemodialysis space 5 360 300.000 540.000.000
  SUB TOTAL 124     14.886.000.000

Apart from the room the source of income also comes from medical services, following the
assumption of income from medical services.

Table 7.13. Estimated Revenue from Medical Services

Concessions
Jml
Consulting for rs
Average jml Day
No. Medical Services Rates/ (per Total Rev / Year
patient/day /
Actions patient) =
Year
30%
1 Obgyn 10 300 150.000 45.000 135.000.000
  Ultrasound Print 10 300 200.000 60.000 180.000.000
3 Children's 10 300 150.000 45.000 135.000.000
4 Mental disorders 10 300 150.000 45.000 135.000.000
5 Internist 10 300 150.000 45.000 135.000.000
6 Cardiac 10 300 150.000 45.000 135.000.000
7 Pulmonary 10 300 150.000 45.000 135.000.000
8 Neurology 10 300 150.000 45.000 135.000.000
9 Dental 10 300 150.000 45.000 135.000.000
  Medical treatment 10 300 300.000 90.000 270.000.000
 Jml Consulting Concessions
Average jml
No. Medical Services Day Rates/ for rs Total Rev / Year
patient/day
10 Eye 10 /
300 Actions
150.000 45.000 135.000.000
  Medical treatment 5 Year
300 3.000.000 900.000 1.350.000.000
11 Ear, Nose & Throat (ENT) 10 300 150.000 45.000 135.000.000
  Medical treatment 10 300 500.000 150.000 450.000.000
12 Skin and Genitals 10 300 150.000 45.000 135.000.000
  Medical treatment 5 300 200.000 60.000 90.000.000
13 Medical Rehab 10 300 150.000 45.000 135.000.000
14 General Surgical 10 300 250.000 75.000 225.000.000
15 Neurosurgery 5 300 250.000 75.000 112.500.000
16 Heart Surgery 10 300 250.000 75.000 225.000.000
17 Urological Surgery 5 300 250.000 75.000 112.500.000
18 Plastic Surgery 5 300 250.000 75.000 112.500.000
19 Ongkology Surgery 5 300 250.000 75.000 112.500.000
20 Oral Surgery 5 300 250.000 75.000 112.500.000
21 Vesicular Surgery 5 300 250.000 75.000 112.500.000
22 Pediatric 5 300 250.000 75.000 112.500.000
23 Physiotherapy 5 300 250.000 75.000 112.500.000
24 General Check Up          
  Package 1 3 360 1.500.000   1.620.000.000
  Package 2 3 360 900.000   972.000.000
  Non-Package 5 360 150.000   270.000.000
18 Emergency Department 15 365 150.000   821.250.000
19 General Surgery Unit 10 365 10.000.000   36.500.000.000
20 Cardiac Surgery Unit 0,1 365 80.000.000   2.920.000.000
21 Neurosurgery Unit 0,1 365 40.000.000   1.460.000.000
22 Urology Surgical Unit 0,1 365 15.000.000   547.500.000
23 Plastic Surgery Unit 0,1 365 10.000.000   365.000.000
24 Ongkology Surgery Unit 0,1 365 15.000.000   547.500.000
25 Oral Surgery Unit 0,5 365 5.000.000   912.500.000
26 Vesicular Surgery Unit 0,2 365 10.000.000   730.000.000
28 Physiotherapy Unit 1 365 1.500.000   547.500.000
29 Midwifery Unit          
  Give birth normally 3 365 5.000.000   5.475.000.000
  Surgery (caesarean) 3 365 8.000.000   8.760.000.000
  SUB TOTAL 264,2       67.758.250.000

Other sources that can provide additional income for Hajj Hospitals are from Medical
Support, as stated in the table below.

Table 7.14. Medical Support Income

Jml
Average jml Average
No. MEDICAL SUPPORT Unit Day / Total Rev / Year
patient/day Rates
Year
1 Laboratory Unit 20 300 125.000 750.000.000
2 CT Scan Unit 2 300 2.000.000 1.200.000.000
3 ESWL Unit 1 300 7.500.000 2.250.000.000
 4 Radiology (X-RAY) Unit 12 300 120.000 432.000.000
5 Pharmaceutical Unit          
  Clinic Unit 264,2 300 80.000 6.340.800.000
  Hospitalization Unit 124 360 80.000 3.571.200.000
6 Others          
  Cafetaria Rent Unit 10 12 2.500.000 300.000.000
  Vehicle Parking Unit 150 360 4.000 216.000.000
  SUB TOTAL         15.060.000.000

Here is a recapitulation of the caught by RSU Haji during the year, as stated in the following
table.

Table 7.13. Recapitulation of RSU Haji Medan Revenue Per-year

Service Type Total
Hospitalization 14.886.000.000
Medical Services 67.758.250.000
Medical Support 15.060.000.000
Collaborate
Others Legitimate
Total 97.704.250.000

1.7. OPERATING EXPENSES (projected)

Operational costs consist of electricity costs, water costs, telephone costs, office
operating costs, hospital staff salaries and building maintenance and other costs for 1 year.
The Operational Cost of Inpatient Services is estimated for year 1 (first) amounting to Rp.
45,870,000,000. Each year there will be an increase of 10%. The estimated operating
expenses can be seen in the table below:
Table 7.14. Operational Expenses Breakdown (2022)
VARIABLE COSTS
1 Unit/Pharmacy Drug Costs       6.000.000.000
2 Medical Services Costs & Incentives       4.000.000.000
3 Cost of Materials & Medical Devices Unit       2.000.000.000
4 Cost of Eating Patients       2.000.000.000
  Sub Total       14.000.000.000
FIXED COSTS
    Unit Vol. Unit Price Cost / Year
1 Salaries of non-civil servants LS 1   2.000.000.000
2 Employee Welfare LS 1   1.000.000.000
3 Electricity/Water - month 12 100.000.000 1.200.000.000
4 Post/telephone - month 12 25.000.000 300.000.000
5 Transportation - month 12 12.000.000 144.000.000
6 Hygiene - month 12 5.000.000 60.000.000
 7 Repair and Care - month 12 40.000.000 480.000.000
8 Marketing & Promotion - month 12 10.000.000 120.000.000
9 Administration and General - month 12 10.000.000 120.000.000
10 Experts & Training - month 12 25.000.000 300.000.000
11 Labour contract - month 12 20.000.000 240.000.000
12 General Cost - month 12 8.000.000 96.000.000
13 Insurance Premiums - month 12 30.000.000 360.000.000
14 Cleaning Service subcontractor - month 12 20.000.000 240.000.000
15 Security & Parking Subcontractor - month 12 17.500.000 210.000.000
  Sub Total 6.870.000.000
TOTAL 20.870.000.000

1.8. DEPRECIATION / DEPRECIATION

Depreciation is calculated under the Cost Budget Plan and grouped by type of fixed
asset, calculated using the straight line method. As for calculating depreciation values as
follows:

Depreciation Value = Investment Value – Residual value

Economic age
It is assumed that there is no residual value at the end of the project life where it is assumed
that the economic age is 10 years.

1.9. CASH FLOW

Cash flow is structured by grouping cash inflows and cash outflows by projecting both
cash flows. The projected cash inflow is obtained from the revenue projection, while the
projected cash outflow is obtained from the projected cost. Then the cash flow projection is
prepared by reducing the projected cash inflow with cash outflow so as to generate the
hospital's cash flow balance. To calculate cash inflows can be used the following formula:
Cash inflows = Income (net income) + Depreciation
Previously it will be calculated the amount of net income per year, while the calculation can
be seen in the table below:
Table 7.15. Projected Financial Statements 0-5
Table 7.16. Projected Financial Statements for Years 6-10
 Based on Tables 7.15 and 7.16 above shows that with 1st year net income of
Rp1,593,617,672 and an increase of 5% annually, there is a change in net income every year.
For depreciation obtained annually Rp.3,500,000,000 assuming the life of the investment or
project for 10 years. Based on these two data, it can be obtained the value of net cash flow
per year.
1.10. BREAK-EVENT POINT (BEP) ANALYSIS
This analysis is done to find out if the investment made can break even or return the
principal. To be able to calculate the principal return of the value of the investment, data is
needed regarding fixed cost assumptions, variable cost assumptions and assumptions of
income obtained. As previously explained, the comparison between profits and those issued
is worth it if it exceeds i (> 1). To perform the calculation of Break-Event Point (BEP) it takes
several variables, namely fixed costs, variable costs, and income obtained during the time
span of the specified year. The fixed cost is in the form of depreciation costs / depreciation
of buildings and other equipment where land procurement costs are not included, while
variable costs are in the form of operational and non-depreciation costs seen in the
Appendix calculation of Break Event Point (BEP). Break Event Point is done if desired one of
the feasible calculations so that the project can be continued. If the number of comparative
results is less than one (<1) then the project cannot be continued. The results of the Break-
Event Point (BEP) calculation assuming that it is used can be seen in the year of the Break
Event Point (BEP) and the break-even point calculation as follows:

BEP = Fixed Cost of Haji Medan General Hospital

1 - Variable Cost/Income

From the data passed from cash flow, it is estimated that this development project will be
BEP in the 8th year.

CHAPTER VIII
CONCLUSION

1.1. HASIL ANALYSIS OF ELIGIBILITY ASPECTS

Based on the description and analysis of the feasibility study that has been
described in the previous chapters, it can be concluded that:
1. Market aspects, known from the data and information available, the market is still
quite large against health needs, while the existence of health services is still limited.
So that the establishment of Haji Medan General Hospital is still very necessary to be
able to provide good health services in medan city.
2. In terms of economy, the opening of Haji Medan General Hospital can help increase
public awareness of health. And if the level of health increases, it will also increase
the ability and competitiveness of the nation as a whole. This is in line with the goal
of medan city's medium and long-term development plan, which is to improve the
level of public health which is characterized by increasing the quality and reach of
 health services and universal coverage insurance, especially for low-income
community groups.
3. In terms of Law, Haji Medan General Hospital has a strong legal basis, which has a
complete AD / AR and has a legal entity, with the decree establishing the Decree of
the Governor of North Sumatra Province No. 445.05 / 712.K / 1991 dated March 7,
1991
4. In terms of Products, Haji Medan General Hospital provides special health facilities
to its patients. It consists of three main products, namely hospitalization, medical
services (polyclinic) and medical support. By favoring the aspect of comfort and
service such as at home.
5. In terms of Technology, Haji Medan General Hospital uses standard medical devices.
In addition to medical equipment machines, Haji Medan General Hospital also uses
personal touch technology where the comfort level of care to patients is more
pronounced.
6. In terms of Location, the location where Haji Medan General Hospital is a very
strategic location
7. In terms of HR Management, employing medical personnel who are experts in their
fields with salaries offered have been adjusted to the background, experience and
budget of the company.
8. In terms of supply, the level of demand is still higher compared to the existing level
of supply.
9. In terms of Promotion and Service offered, Haji Medan General Hospital offers
satisfactory health services at affordable prices, interior design such as shelter makes
its patients do not feel in the hospital which makes the comfort level even higher.
10. In terms of finance, costs, liabilities and assets used in proportion to existing capital.
11. In terms of Investment Valuation, based on investment assessment parameters, Haji
Medan General Hospital has a fairly favorable return on investment and is relatively
safe from sensitivity analysis.

1.2. COVER
Feasibility study is to determine the feasibility of a project, in this case to find out
the feasibility level of hospital development in medan city area. In the process there are
several aspects that are assessed including market and marketing aspects, technical and
technological aspects, management and organizational aspects, legal and legal aspects and
economic and financial aspects.