The Indian healthcare dates back to the Vedic system of healthcare (Ayurveda) in 5000 BC. The Ayurvedic principles of positive health and therapeutic measures relate to physical, mental, social and spiritual welfare of human beings. During the early Vedic period, Ayurveda was perhaps the only system of overall healthcare and medicine. It enjoyed the unquestioned patronage and support of the people and their rulers. Ayurveda proliferated the most during the Vedic period. The Vedic period is followed by a long medieval history marked by uncertain political conditions and several invasions from outside the country when Ayurveda faced utter neglect and its growth stunted. Unani medicine was brought into India during this time and gained momentum with the extensive support of Mughal emperors.  With the British invasion, Allopathy was also brought to India and soon got acceptance for swift results. Today, with continuous research and development, Aallopathy dominates the Indian health care market.Healthcare industry in India is divided into two segments - services and manufacturing. While the manufacturing segment consists of both medical equipment manufacturing industry and the pharma production, the services segment is basically split into direct services and indirect services. Hospitals, health insurance services and R&D services are considered as direct services, while third party insurance, claims settlement services and others, are considered as indirect services. The chart given below shows the structure of the industry. The estimated size of Indian Healthcare industry was USD 35 billion in 2008 and grew at 23 per cent per annum and touched USD 80 billion in 2012 and by 2017 will reach over USD 150 billion. There is an increasing number of private and public healthcare facilities and are expected to rise in demand for the industry accounting for USD 6.7 billion.A specialty hospital is dedicated to specific sub-specialty care (paediatriccentres, oncology centres, psychiatric hospitals). Patients will often be referred from smaller hospitals to a speciality hospital for major operations, consultations with sub-specialists and when sophisticated intensive care facilities are required. These hospitals have highly trained specialists, high-end technology and provide round the clock services. These hospitals are able to do specialised tests, undertake dialysis for acute renal failure, provide ventilation to patients with respiratory failure and render intensive care to critically ill patients. These hospitals undertake research and have adequate library facilities. These hospitals concentrate on a particular organ of the body and provide medical care e.g., cancer, dental, psychiatry, T.B. etc.

 

Table of Contents

 

1.       DISTRICT PROFILE & GEOTECHNICAL SITE CHARACTERIZATION

1.1.     General

1.2.     Climate & Rainfall

1.3.     Map

1.4.     Physical Characteristics

1.5.     Economy & Industries

1.6.     Transportation and Communications

2.       SYNOPSIS

3.       EXECUTIVE SUMMARY

4.       PROJECT CONCEPT

4.1.     Hospital Project at A Glance

5.       INDUSTRY ANALYSIS

5.1.     Overview of Indian Healthcare Industry in India

5.1.1.  Introduction

5.1.2.  Healthcare Industry Structure

5.2.     Structure & Segmentation of Hospital Industry

5.2.1.  Classification of Hospitals Based on Objective

5.2.2.  Classification of Hospital Based on Ownership

5.2.3.  Classification Based on System of Medicine

5.3.     Market Size and Growth

5.3.1.  Market Size

5.3.2.  Public Healthcare Expenditure

5.3.3.  Healthcare Infrastructure

5.4.     Growth

5.4.1.  Growth drivers

5.4.2.  Medical Tourism and improving health insurance penetration

5.4.3.  Medical Information & Telemedicine

5.4.4.  Diagnostic Services Outsourcing

5.4.5.  Enhancement in Public Expenditure

5.4.6.  Increasing Health Awareness

5.4.7.  Medical Insurance

5.5.     Major Healthcare markets in India

5.5.1.  Mumbai

5.5.2.  Delhi

5.5.3.  Chennai

5.5.4.  Bangalore

5.5.5.  Kolkata

5.5.6.  Hyderabad

6.       HOSPITAL MANAGEMENT ISSUES

6.1.     Management & Commercial Plans

6.1.1.  Brief Introduction about Hospital Management

6.1.2.  Outpatient Services

6.1.3.  Inpatient Services

6.1.4.  Material Management

6.2.     Steps Involved in Setting up a Hospital

7.       PLANNING THE HOSPITAL

7.1.     Brief Description of Major Disorders:

7.2.     Permissions & Clearances Required

7.3.     Advertising, Marketing & Promotional planning

7.4.     Mobilising Bank Loan

7.5.     Critical Success Factor

7.6.     Example of PPP in Health Care

7.7.     Hospital Accreditation

7.8.     Tentative Project Implementation Plan

8.       PLANNING OF HOSPITAL BUILDING

8.1.     Key Flow Chart of a Hospital

8.2.     Nursing Ward in a Hospital

8.3.     Flow Chart of Obsteric Department

8.4.     Flow Chart of Surgical Ward

8.5.     Flow Chart of Outpatient Department

8.6.     Flow Chart of Outpatient Department

8.7.     Suppliers of Building Furniture, Fittings & Accessories

8.7.1.  Furniture Fittings & Accessories

8.7.2.  Bathroom Fittings & Accessories

8.7.3.  Air Conditioning & Refrigeration Units

9.       FINANCIALS & COMPARISON OF MAJOR INDIAN PLAYERS/COMPANIES

9.1.     About Financial Statements of CMIE Database

9.2.     Profits & Appropriations

9.3.     Total Liabilities

9.4.     Total Assets

9.5.     Net Cash Flow from Operating Activities

9.6.     Section – I

9.6.1.  Name of Company with Contact Details

9.6.2.  Name of Director(S)

9.6.3.  Capacity

9.6.4.  Location

9.6.5.  Name of Raw Material(S) Consumed with Quantity & Cost

9.7.     Section – II

9.7.1.  Assets

9.7.2.  Cash Flow

9.7.3.  Cost as % Ge of Sales

9.7.4.  Forex Transaction

9.7.5.  Growth in Assets & Liabilities

9.7.6.  Growth in Income & Expenditure

9.7.7.  Income & Expenditure

9.7.8.  Liabilities

9.7.9.  Liquidity Ratios

9.7.10.   Profitability Ratio

9.7.11.   Profits

9.7.12.   Return Ratios

9.7.13.   Structure of Assets & Liabilities (%)

9.7.14.   Working Capital & Turnover Ratios

10.    LIST OF HOSPITAL EQUIPMENTS

10.1.Brief Description of Some Common Hospital Equipments

10.2.Brief Description of Major Machinery

10.2.1.   Magnetic Resonance Imaging (MRI)

10.2.2.   CT (computerised tomography) scanner

10.2.3.   Colour Doppler

10.2.4.   Mammography

10.2.5.   Bone Densitometer

10.2.6.   Haemodialysis

10.2.7.   Gamma Camera

10.2.8.   Linear Accelerator (LINAC)

10.2.9.   High-Dose Rate (HDR) Brachytherapy

11.    SUPPLIERS OF MEDICAL, SURGICAL & HOSPITAL INSTRUMENTS

11.1.X-Ray Machinery & Equipments

11.2.Laboratory Equipment

12.    SUPPLIERS OF MEDICAL MACHINERY & EQUIPMENT

12.1.Electromedical Equipment/Medical Technology

12.2.Blood Pressure Equipment

12.3.Electrocardiography (ECG) Equipment and Accessories

12.4.Patient Monitoring Systems/Measuring Stations

12.5.Electromagnetic Wave Equipment/Biofeedback Systems

12.6.Device and Systems for Glucose Determination Units

12.7.Podiatry/Podology

12.8.OT Tables and Attachments

13.    SUPPLIERS OF RAW MATERIAL

13.1.Medical Disposables

13.2.Bedsheets, Drapes

13.3.Catheters

13.4.Intravenous Cannulae

13.5.Needles, Syringes

14.    SUPPLIERS OF LABORATORY CHEMICAL

15.    CHALLENGES IN THE INDUSTRY

16.    HOSPITAL EQUIPMENT & FACILITIES PHOTOGRAPH

17.    LIST OF JCI APPROVED HOSPITALS IN INDIA

18.    LIST OF NABH ACCREDITED HOSPITALS

19.    APPLICANTS HOSPITALS FOR NABH ACCREDITATION

20.    CONCLUSION

 

PROJECT FINANCIALS

·         Project at a Glance

Annexure

·         Assumptions for Profitability workings ….…………………………………………....................... 1

·         Plant Economics…………………………………………………………………………….................... 2

·         Production Schedule……………………………………………………………………….................... 3

·         Land & Building…………………………………………………………………………….................... 4

§  Factory Land & Building

§  Site Development Expenses

·         Plant & Machinery………………………………………………………………………….................... 5

§  Indigenous Machineries

§  Other Machineries (Miscellaneous, Laboratory etc.)

·         Other Fixed Assets………………………………………………………………………….................... 6

§  Furniture & Fixtures

§  Pre-operative and Preliminary Expenses

§  Technical Knowhow

§  Provision of Contingencies

·         Working Capital Requirement Per Month………………………………………………................. 7

§  Raw Material

§  Packing Material

§  Lab & ETP Chemical Cost

§  Consumable Store

·         Overheads Required Per Month and Per Annum ……………………………………................. .8

§  Utilities & Overheads (Power, Water and Fuel Expenses etc.)

§  Royalty and Other Charges

§  Selling and Distribution Expenses

·         Salary and Wages ……………………………………………………………………………................. 9

·         Turnover Per Annum ………………………………………………………………………................ 10

·         Share Capital…………………………………………………………………………………................ 11

§  Equity Capital

§  Preference Share Capital

•        Annexure 1            ::        Cost of Project and Means of Finance

•        Annexure 2            ::        Profitability and Net Cash Accruals

§  Revenue/Income/Realisation

§  Expenses/Cost of Products/Services/Items

§  Gross Profit

§  Financial Charges    

§  Total Cost of Sales

§  Net Profit After Taxes

§  Net Cash Accruals

 

•        Annexure 3            ::        Assessment of Working Capital requirements

§  Current Assets

§  Gross Working Capital

§  Current Liabilities

§  Net Working Capital

§  Working Note for Calculation of Work-in-process

 

•        Annexure 4            ::        Sources and Disposition of Funds

•        Annexure 5            ::        Projected Balance Sheets

§  ROI (Average of Fixed Assets)

§  RONW (Average of Share Capital)

§  ROI (Average of Total Assets)

 

•        Annexure 6            ::        Profitability ratios

§  D.S.C.R

§  Earnings Per Share (EPS)

§  Debt Equity Ratio

 

•        Annexure 7            ::        Break-Even Analysis

§  Variable Cost & Expenses

§  Semi-Variable/Semi-Fixed Expenses

§  Profit Volume Ratio (PVR)

§  Fixed Expenses / Cost 

§  B.E.P

 

•        Annexure 8 to 11   ::        Sensitivity Analysis-Price/Volume

§  Resultant N.P.B.T

§  Resultant D.S.C.R

§  Resultant PV Ratio

§  Resultant DER

§  Resultant ROI

§  Resultant BEP

 

•        Annexure 12          ::        Shareholding Pattern and Stake Status

§  Equity Capital

§  Preference Share Capital

 

•        Annexure 13          ::        Quantitative Details-Output/Sales/Stocks

§  Determined Capacity P.A of Products/Services

§  Achievable Efficiency/Yield % of Products/Services/Items 

§  Net Usable Load/Capacity of Products/Services/Items   

§  Expected Sales/ Revenue/ Income of Products/ Services/ Items   

 

•        Annexure 14          ::        Product wise domestic Sales Realisation

•        Annexure 15          ::        Total Raw Material Cost

•        Annexure 16          ::        Raw Material Cost per unit

•        Annexure 17          ::        Total Lab & ETP Chemical Cost

•        Annexure 18          ::        Consumables, Store etc.

•        Annexure 19          ::        Packing Material Cost

•        Annexure 20          ::        Packing Material Cost Per Unit

•        Annexure 21          ::        Employees Expenses

•        Annexure 22          ::        Fuel Expenses

•        Annexure 23          ::        Power/Electricity Expenses

•        Annexure 24          ::        Royalty & Other Charges

•        Annexure 25          ::        Repairs & Maintenance Expenses

•        Annexure 26          ::        Other Manufacturing Expenses

•        Annexure 27          ::        Administration Expenses

•        Annexure 28          ::        Selling Expenses

•        Annexure 29          ::        Depreciation Charges – as per Books (Total)

•        Annexure 30          ::        Depreciation Charges – as per Books (P & M)

•        Annexure 31          ::        Depreciation Charges - as per IT Act WDV (Total)

•        Annexure 32          ::        Depreciation Charges - as per IT Act WDV (P & M)

•        Annexure 33          ::        Interest and Repayment - Term Loans

•        Annexure 34          ::        Tax on Profits

•        Annexure 35          ::        Projected Pay-Back Period And IRR