Feasibility Study for the Project Hospital Emergency in Aden Free Zone

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Feasibility study for the project hospital emergency in Aden Free Zone

Introduction:

Al-Buraihy Hospital Group is among the earliest private hospital the non profit which emerged in the nineties.The first hospital established in Taiz was in 1991 with the capacity of 70 beds, followed by Al-Buraihy CenterFor diseases Ear, Nose and Throat Aden 1997, which expanded to a hospital in 2000,then Alburaihy Center

emergency in Lahj Governorate.

Introduction:

Al-Buraihy Hospital Group is among the earliest private hospital the non profit which emerged in the nineties.The first hospital established in Taiz was in 1991 with the capacity of 70 beds, followed by Al-Buraihy CenterFor diseases Ear, Nose and Throat Aden 1997, which expanded to a hospital in 2000,then Alburaihy Centeremergency in Lahj Governorate.

in 2005 Which is almost free and serves as a group of villages living in the margins of society and suffersfrom different diseases anddifferent Pandemic .

The objective of establishing these hospitals has been and will be the shortage in providing health services inGovernment Hospitals, while the population progressively increasing in the main cities as the number ofGovernment Hospitals are the same, and their services are continuously retrogressing. Hence come the ideaof establishing private health utilities.

Especially the non-profit is rare that our services go beyond charity medical services in hospital to contributeto the country with facilities and charities In cases of disasters and Pandemic.

The second main reason: to enable health cadres with high and medium certificate to receive training in ashealthy proper learning circumstances as possible. The practical health approach has been sharply divertedfrom the proper direction reflecting on experiences of trainees in future.

The third main reason: Provision of job opportunities for more than one thousand five hundred families.

However, our medical services in all these utilities were limited to providing first aid carrying small andmedium operations and according to the possibilities of large operations.

This never meets only 20% of the services needed by citizens. There are group of diagnostic and therapeuticservices which we are unable to provide, and patient has one of this choice, either to travel abroad orsurrender to fate.

From here came the idea of establishing a medical institution.

First: market research

Health services in Yemen:1 - the area of health facilities:Despite the developments in the health sector, both in easing medical facilities or in the field of workforce Orto the improvement and expansion of immunization programs Aumajal development and improvement ofmedical services and preventive and curative, but Yemen is still among

As the number of public and private hospitals to (268) Hospital at the end of 2004, compared to 75 in thehospital in 1992 and the number of health centers (370) in the center in 1992 that reached to the center in

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E.N.T

sibility study for the project hospital emergency in Aden Free Zone http://www.alburaihy.com/buraihy/index.php/2010-04-09-21-09-14/81-...

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1261 in 2004The number of the family including the family of the private sector in 8150 in 1992 to 23350 beds in 2004.

2 - Agreement in the health sector

Yemen has given the state of the health sector for special attention and worked on the financing of reachingagreement on the health sector in 1997 increased by 3% of total public spending at a rate of 2.1 of GDPcompared to 7.3% of total public spending at a rate of 3.1% of GDP in the year 2003 as the per capita totalexpenditure on health has not evolved significantly It rose from 608 riyals in the year 1997 to 1536 rials in theyear 2003 and this amount is very low compared to other countries.

3- private sector investment in the health sector:

.Private sector investment has a significant development after the blessed unity in 1990, where statistics showthat the number of Medical facilities and private establishments reached 4000 in 2004, including 94 hospitals,345 clinics, 100 medical center, 615 Laboratory, 267 Status and dental clinics teeth .1164 medical clinic, 1288clinic previews / 62 radiology center Where the spread of investment in this sector without regulationscontrols certain set of infrastructure investment in this sector, the most prominent engineering and technicalconstraints and staff and the mechanism by which the organization of the private medical sector.

Also emerged as the role of the private sector through the provision of appropriate health services and theopening sections of different disciplines, easing the government-owned hospitals from the pressure of thepatients increased in addition to easing the burden of traveling abroad due to the availability potential in thissector, but the majority of private hospitals is Public hospitals is not available where the specialized natureThis is confirmed by that many patients travel to some Arab countries like Egypt and Jordan in search ofspecialized hospitals in the provision of curative services, but that after the guidance Recent guidance of HisExcellency the President of the Republic should be directed opening of the medical private sector specialistdivisions were opened in some hospitals and the use of qualified cadres and remarkable competence andexpertise at the local, regional and global.

And therefore call specialists from outside Yemen to conduct operations to ease the difficult burden on the

patients that also provides for the state treasury large sums of foreign currency due to travel for treatmentoutside the home and through those provided by the private medical sector has become the industry Plays arole, service and social and developmental as well as he has become an important sector and complementaryto the governmental sector.

The most important indicators of population demographic :

StatementCountappreciationappreciationappreciation

Total residentpopulation

The resident population by type

Male

Female

Resident population by urban situation

Urban

Outskirts

Estimates of the number of families in urban as the case may

Urban

Outskirts

Estimates of the number of urban housing as the case

Urban

Outskirts

Idea of the project components

the previous level of health service needs of the population in Yemen note to health services Especially withthe increase in population and also to increase health awareness, mostly by the proliferation of differentmedia and Hence came the idea of a modern hospital provides sophisticated health services and morespecialized, but rely on previous experience the project owner and the hospital Able to handle (300) bedsconsist of the following centers

1- Emergency Center accommodates groups of people resulting from disasters that occur from time to time toprovide the Centre contingent of ambulances equipped with equipment for various injuries and her crewsqualification.

2- Center for the treatment of burns and plastic.


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3- Cardiac disease center (diagnostic and open heart operation).

4- Centre for Nephrology (fragment stones ultrasound, dialysis, kidney transplant).

5- Centre for Blood Diseases.

6-Centre for Oncology (surgical, chemical, radiological(

7- Center for laser surgery.

8- Surgery Center different Endoscope

9 - Center for Infertility and IVF.

It will consist of three operating rooms - intensive care capacity (20) Beds - Care Children( ten incubators ) -sections diagnostic assistance(x- ray, laboratory, pharmacy )- physiotherapy.

Phase II: construction of the building back to an area of 700 m and will include six floors will be devoted latterrole staff accommodation.

Third Phase: Building Construction College of Medicine and Pharmacy, Nursing and accessories of housingfor students from other cities, and playgrounds and others, has started the dialogue with the President of theFree Zone On this stage.

place of the hospital: Reasons for choosing the city of Aden, the headquarters of the medical institution is:

- Location, It is considered crucial for patients from eight Governorates: (Hadhramout, Al-Mahrah,Taiz,Shabwah, Abian, Lahj and Dhala, in addition to Aden Governorate).- Obtaining land area of ten thousand km 2 with the building ready, and rehabilitation for him to the hospital,which gave us of the free zone in Aden.- Lack of medical services and the aforementioned finally found them did not meet the minimum medicalstandards.

Geography and climate:

Aden economic and commercial capital of the Republic of Yemen and the Yemen and the gaps in the gatelocated on the southern coast of the Arabian Sea (Gulf of Aden) near the Strait of Bab AlMandab- the mainentrance to the Red Sea - at the intersection of Asia with the continent of Africa and the capital city of Aden atthe site of a compromise between the East and West.

the city of Aden, lying directly above the sun twice a year within the virtual movement of the sun between thetropics because of its astronomical ,We note that the temperature rises in summer and winter to be warm inJulythe average temperature between( 24.5 ) minimum and (40.5) at the most, while the up averagetemperatures in January between (18.6) and minimum (31,6), Rate and pressure of the city of Aden in thesummer at least, where in July, up to (1002.1) millibars, while increasing the proportion of rates in the winter,up in January (1015.4) millibars.

Pricing policy for the hospital services and to identify revenue :

Have been adopted in the level of income of the Yemeni people and when the adoption of pricing policy for thehospital, As well as experience generated operating result medical units and the level of service provided and

the summarize following are the most important element in determining the prices of medical servicesprovided:

- Open the operating room and anesthesia around (355) $ for a time.- Emergency around ( 13 ) $ per patient.- The cost of the detection of a single patient (13 $)- Revenue of medicines (pharmacy) per day ( 148 $)- Accommodation per room about ( 45 $) per day- Revenue Laboratory (1,181$) per day.

Second: The technical study

- Components and basic elements of the hospital:

Can be divided into elements hospital functionally into four main sections:

1 - Nursing Services: are those services provided by nurses to patients living in the dormitories, and doctorslocated in this section on an ongoing basis for diagnosis and treatment procedure, And the Department ofNursing is the section devoted to the establishment of inpatients in the hospital and is the provision of health

services as well as some recreational activities which also provides treatment to patients, which includes drugscreening and follow-up and treatment., so this section is the most important sections of the hospital and itneeds the best guidance and to link appropriately with the main entrance .

2- Sections, detection and treatment:

The section includes patient rooms in addition to rooms nurses & bathrooms and divided into wardsdepending on the type of disease, associated with this section reception and outpatient clinics andOperations Division is a major and is also associated with the administration, stores and kitchen.

3-Administrative Services: includes the services of remedial management - management services andnon-therapeutic.

4- General Services: Pharmacy - the morgue - the kitchen - laundry - sterilization - General Stores - PersonnelServices - Green areas - parking lots.

considerations in the design :

Have been adopted, the basic considerations in the redesign of the building to serve as rehabilitation hospital,including:

-The human dimension in the design :With the development of treatment methods had to be a similardevelopment in the planning and design of hospitals Something that has been taken into account whenpreparing designs for the hospital design is given to the patient a sense of safety and comfort, both ininternal been achieved by a lot of way architectural and natural colors and measure masses and sizes.- Flexibility: The design allows the hospital with enough flexibility to change and switch the use of empty


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space as needed this was done using the flexible Module clips allow a change of internal spaces toaccommodate a variety of activities were also choose the method suitable for electrical and mechanicalinstallations to fit the space when you use it.- Susceptibility to stretch: the taking into account that some sections in the hospital need to be extended andexpanded to the design has been prepared and are aware of the process of expansion in the spaces in thefuture and designed to rehabilitate the building So as to allow for this Extensions be horizontal, with theformation projections Walt allows horizontal extension.- Stages of implementation and construction: Due to the high costs of construction of hospitals and thedifficulties of funding to the hospitals have become established in a phased manner is necessary in order toadvantage from the first stage to be done to provide the necessary support to the remaining stages.

It is also taken care to some of the considerations in the design of portlets.

*There is a ramp for the disabled and the elderly in a way to enter

* There is a main entrance for pedestrians and cars.

*Ambulance entrance has a room to check arrivals and a waiting room

*Connected to the service entrance of the yard to unload the servicing needs of the kitchen and laundry andadmitted.

Motion Paths of horizontal and vertical:

Design paths of horizontal and vertical movement so as to serve the various regions in addition to all of: thesick, the guest - Doctors, nurses and technicians - materials and sterile medical instruments - contaminatedmaterial and non-clean - files and medical reports

These tracks have been designed so that items are not link to any cross-section of another department toavoid transmission of infection and obstruction of work in other sections and paths of movement designed toallow an extension of the hospital operations without hindering.

System with the availability of fire insurance as well as escape route in case of fire.

Investment cost of the project

First: The equipment and medical equipment:

estimated total cost of this item

AMOUNTUNIT PRICEQTYITEM

4000040000)1(LAPROSCOPE

2000020000)1(ERCP

800000800000)1(MRI

400000400000)1(CT- SCAN

500000500000)1(ANGIOGRAPHY

6000060000)1(MAMOGRAPHY

16000040000)4(VENTILATOR FOR ADULT

16000040000)4(VENTILATOR FOR INFAT

6000030000)2(MECROSCOPE(ARTHROSCOP(

70000700001((C- ARM

750005000)15(ICU MONITER

3600018000)2(GASTROSCOPE

1000010000)1(COLONOSCOPE

600060001((AUDIOMETRY FOR CHILDREN

180000180000)1(X-RAY (500 MA) DIGITAL

60000300002((X- RAY (100 MA(

22000220001((ENDOSCOPICSCLEROTHEAPY ANDBAND LIGATION


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56000280002((GASOMETRY

3600018000)2(BRONCOSCOPY FLAXBAL

75000150005((OPERATION TABLE (HYDROLIC(

1200012000)1(OPERATION TABLE FORORTHOPEDIC OP.

1600080002((DELIVERY CHAIR

160000320005((ANASTHETIC MACHIN

50000100005((CUOTARY

160004000)4(PORTABLE LIGHT SOURCE

320008000)4(LIGHT SOURCE (FIXED(

180003000)6(STERELIZED LAMP

10000100010((DRUG TABLE

60001000)6(TABLE( STEEL ) FOROPERATION INSTRUMENT

180003000)6(ECG

60000600001((ULTRASOUND +ECHOCARDIOGRAPHY

80008000)1(INSTRUMET FORTONSILECTOMY OPERATION

40004000)1(INSTRUMET FORSEPTOPLASTY OPERATION

2000020000)1(CBC

1000010000)1()SCREEN ARTER3000)BIOCHEITY

20002000)1(WATER BATH

40001000)4(MICROSCOPE

80008000)1(REFRIGRATE FOR SOLUTIOS

1200012000)1(REFRIGRATE FOR BLOODBANK

90003000)3(INCUBATORS FOR CULTURES

20001000)2(DIGITAL CENTER FUGE

2000020000)1(ELIZA

20002000)1(ROTATRY

20002000)1(SHWKER FOR B.BAGS

3900039000)1(COPAS

1800018000)1(ELCTROLIT 9180


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60006000)1(GLYCATED HB (HB A,C(

2800028000)1(A25 BIOSYSTEM

1000010000)1(COAT RON (COAGULATIONFACTORS(

160008000)2(DENTAL CHAIR WITH HISINSTRUMENTS

100005000)2(BABY SECTION

200002000)10(LAPRATOMY MINOR SET

400005000)8(INSTRUMENT FORORTHOPEDIC OPERATION

4000010000)4(Ped.warmar

3000010000)3(Ped. Warmer with ventilator

300.000300.000)1(Device Cardiac Catheterization

&care

100002500)4(Sterilization units

3894000Total

Second: furniture and medical equipment: The cost of this item about (10 388) million dollars, according to thefollowing items:


1000005000)20(VOLVE MOUNTED PANLEFOR ICU

300.0002000)150(VOLVE MOUNTED PANLEFOR PATIENT ROOM

75000500)150(DREIP STAND

7500005000)150(PATIENT BEDS

100001000)10(OFFICE FOR DOCTORS

100001000)10(CHECK BEDS

2250001500)150(COMEDINO

120.000120.000)1(Pharmacy

13875000TOTAL

Third: Cars: The cost of this item about 20380 million dollars, according to the following items:


150.0000300000)5(AMBULANCE

880.000440000)2(AMBULANCE SPECAILY FORCARDIAC CASSES

2380000Total

Fourth: The cost of rehabilitating the building and construction: estimated cost of the item 20100 milliondollars, according to the following items


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27000Total area of the2.100.000300building in two phases

2.100.000Total

V / other equipment: The cost of this item about 918 thousand dollars in accordance with the following items


1000010000)1(Telephone network

300.000150.000)2(Energy system, centralair-conditioning

300.000150.000)2(GENERAL MOTORS500KW

160008000)2(WASHER MASHINE

120006000)2(IRON

18000060000)3(Hospital left (15persons(

1000010000)1(Cafeteria & restaurant

4000040000)1(Computer network

50.00050.000)1(section morgue

918000Total

VI: furniture and office equipment: The cost of this item about 100 thousand dollars:


100.000100.000Furniture & officeequipment

100.000Total

Administrative structure of the hospital: Takes into account the administrative structure of the hospital coversthe activities of the hospital in order to achieve full performance with a message suited to the hospital:


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Third: the study of financial

Investment Costs: As a conclusion of a technical study of the project, the expected investment costs of theproject is about (10780)million dollars

AMOUNTITEMNO

2100the cost of rehabilitation of the building and new

construction

1

3894Equipment and medical equipment2

1388Furniture and medical equipment3

2380Cars4

100Furniture and office equipment5

918Other equipment6

10780Total7

Operating costs :According to data available as a result of past experience in hospital management, it isexpected that the annual operating cost of approximately (1.010) million dollar and distributed on thefollowing:

Operating costs :


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AMOUNTITEM

24000Annual rental

44500Maintenance expenses

107000Water and electricity

648000Wages and salaries of medical staff

15000Marketing costs

838500Total

Administrative costs:

AMOUNTITEM

20000Office supplies and stationery

22000Public relations and hospitality

9000Cleaning expenses

120000Salaries of administrators

171000Total

Annual depreciation:

is calculated according to the annual depreciation rates shown in the table following:

Annual depreciationRate ofdepreciation

Investment costITEM

1055%2100the cost of rehabilitation of thebuilding and new construction

77920%3894Equipment and medicalequipment

13910%1388Furniture and medical equipment

47620%2380Cars

1010%100Furniture and office equipment

13815%918Other equipment

164710780Total

:Revenue

In accordance with the conclusion of marketing studies income is expected to run at about 30 705 milliondollar

Revenue per thousandITEM

1280Operations (open the operating room and anesthesia(

240Emergency

640accommodation

480Clinics


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640Pharmacy

425Laboratory

3705Total

List of annual income:

Will prepare a list of the annual income of the project during the first five years and in accordance with thefollowing assumptions :

Increase the annual expenditure rate of 10% Increase revenue by 5%

Revenue per thousand

Total54321ITEM

2047245034289408538903705Revenue

5123122911171015923839expenses

1534932743172307029672866Net operating profit

1045251228207188171Administrative expenses

823516471647164716471647depreciation

606913761297121611321048Net Profit

Statement of Cash Flows:

Will prepare a list of project cash flows project during the first five years and in accordance with the followingassumptions:

Increase the annual expenditure rate of 10%

Increase revenue by 5%

54321Construction

-Cash inflows

10780Finance

45034289408538903705-Operating income

4503428940853890370510780-Cash inflows

Cash outflows

10780-Investment costs

122911171015923839Operating expenses

251228207188171Administrative expenses

1480134512221111101010780Cash outflows

302329442863277926950Net cash flows

14304112818337547426950Cumulative net cash flows

-Indicators of feasibility of the project

1 - Period of recovery of investments : Estimated payback period of recovery of the head of the amount

invested about 3 years and 10 months and this period is relatively short periods to cover.

2-The present value of net cash flows :Reliance on a discount rate of 7.5%, the highest rate of returncalculated on the U.S. dollar currency loans currently in banks The net present value estimated at 747 000dollars were calculated in accordance with the following schedule is clear from this that the project is toachieve net cash flow plus investment costs Using the present value of cash flow using a discount factor of7,5%, and this was positive indicators for the project.


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the current valueof net cash flow

the discount rateNet cash flowYear

10780110780Construction

25070.93022695First

24050.86532779Second

23050.80502863Third

22040.74882944Fourth

21060.69663023Fifth

+747Net present value

Internal rate of return of the project:

Internal rate of return for the project is about 10% was calculated according to the following schedule:

the current value of net

cash flow

the discount rateNet cash flowYear

10780110780Construction

24490.90892695First

22960.82612779Second

21500.75092863Third

20090.68252944Fourth

18760.62043023Fifth

0Net present value

This is the rate of the high rates if what has to take into account the interest rate on dollar deposits, which isabout 0.5% to 9.5%

The results of the feasibility study:

Clear that the chances of success of the project is positive and for the following reasons:

1-Last demand for the product subject of the study due to the low level of medical services in Yemen ingeneral and the project site Aden city particular.

2 - Last representatives of government support to facilitate the procedures and for the awareness ofgovernment for Project Services.

3- the availability of medical expertise to the hospital.

4-Provide medical services unique to the project in question.

5 - level of equipment and medical equipment next to the professional level has been carefully plannedproject.

6-Positive financial results of the project, including :

*Short payback period of investments planned the project, estimated at about 3 years and 10 months.

* project achieved a positive result of the current value of the net cash flows generated from the operation ofthe project.

*The project achieved the internal rate of return of 10%, higher than the rates of return on deposits in foreigncurrency by about 9.5%.

All of this, the project is successful, God willing,


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Feasibility Study for the Project Hospital Emergency in Aden Free Zone