The Task

You are establishing a hospital for heart Ailments including Open Heart Surgery (money)

Current scenario of the world with regards

to medical care
In 2001, about US$3.059 trillion—approximately 9 percent of global gross domestic product (GDP)—was
spent on health care worldwide (WHO 2004b; World Bank 2004e); however, only 12 percent of this
amount was spent in LMICs, which account for 84 percent of the global population and 92 percent of the
global disease burden (Mathers and others 2002).

Ongoing epidemiological, demographic, and nutrition transitions will pose significant challenges for
health financing systems in LMICs in the near future as the communicable disease burden lessens and
the noncommunicable disease and injury burdens expand.

At the same time, the current communicable disease burden in low-income countries (LICs) and in many
middle-income countries (MICs), especially that caused by malaria, tuberculosis, and HIV/AIDS, poses a
serious threat to public health, health systems, and economic growth.

The various types of Heart surgeries

 Coronary artery bypass grafting (CABG).
o In CABG — the most common type of heart surgery — the surgeon takes a healthy
artery or vein from elsewhere in your body and connects it to supply blood past the
blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the
coronary artery, creating a new path for blood to flow to the heart muscle. Often, this is
done for more than one coronary artery during the same surgery. CABG is sometimes
referred to as heart bypass or coronary artery bypass surgery.
 Heart valve repair or replacement
o Surgeons either repair the valve or replace it with an artificial valve or with a biological
valve made from pig, cow, or human heart tissue. One repair option is to insert a
catheter through a large blood vessel, guide it to the heart, and inflate and deflate a
small balloon at the tip of the catheter to widen a narrow valve.
 Insertion of a pacemaker or an implantable cardioverter defibrillator (ICD).
o Medicine is usually the first treatment option for arrhythmia, a condition in which the
heart beats too fast, too slow or with an irregular rhythm. If medication does not work,
a surgeon may implant a pacemaker under the skin of the chest or abdomen, with wires
that connect it to the heart chambers. The device uses electrical pulses to control the
heart rhythm when a sensor detects that it is abnormal. An ICD works similarly, but it
 sends an electric shock to restore a normal rhythm when it detects a dangerous
arrhythmia.
 Maze surgery.
o The surgeon creates a pattern of scar tissue within the upper chambers of the heart to
redirect electrical signals along a controlled path to the lower heart chambers. The
surgery blocks the stray electrical signals that cause atrial fibrillation — the most
common type of serious arrhythmia.
 Aneurysm repair.
o A weak section of the artery or heart wall is replaced with a patch or graft to repair a
balloon-like bulge in the artery or wall of the heart muscle.

 Heart transplant.
o The diseased heart is removed and replaced with a healthy heart from a deceased
donor.
 Insertion of a ventricular assist device (VAD) or total artificial heart (TAH).
o A VAD is a mechanical pump that supports heart function and blood flow. A TAH
replaces the two lower chambers of the heart.

An approximate cost of a heart surgery in india

 In private hospitals, open heart surgery costs Rs.1.5 lakh to Rs.2.25 lakh
 for children, open heart surgery costs Rs.1.25 lakh to Rs.2 lakh
 valve surgeries cost between Rs.2.5 lakh and Rs.2.75 lakh.
 The treatment is even cheaper in government hospitals
 with the difference being usually between Rs.75,000 and Rs. 1 lakh.
 Listed below are the cost of heart surgeries across india

City Lowest Cost Average Cost Highest Cost

New Delhi 1,90,000 2,65,000 3,40,000

Mumbai 2,00,000 2,75,000 3,50,000

Chennai 2,25,000 3,00,000 3,75,000

Bangalore 2,10,000 2,90,000 3,60,000

Hyderabad 2,50,000 3,25,000 4,00,000

Ahmedabad 2,75,000 3,50,000 4,25,000

Nagpur 1,75,000 2,50,000 3,25,000

Kolkata 2,75,000 3,50,000 4,25,000

Pune 2,00,000 2,75,000 3,50,000

Gurgoan / Gurugram 1,90,000 2,65,000 3,40,000

Chandigarh 2,00,000 2,75,000 3,50,000

Jaipur 2,50,000 3,25,000 4,00,000

Noida 1,90,000 2,65,000 3,40,000

Kerala 2,75,000 3,50,000 4,25,000

Goa 2,50,000 3,25,000 4,00,000

 A Basic Budget and Department wise allocation for a hospital

Sl.
Departments Facilities & Items Qty Cost (INR)
No

Outpatient check-up rooms with proper

preliminary diagnostic devices
Multispecialty Dental Chair 2-3 50,000
ENT check-up workstation with audiometer and 1 2,50,000
1. OPD tympanometry 1 3,00,000

General (beds) 20 5,50,000

ICU/ICCU(beds) ≤1 19,90,000
2. In-patient Ward Nursery with Intensive Care 0 9,00,000

20,40,000
Basic operation room (+)
3. OR Setup With optional laparoscopic facility 2 18,00,000

Emergency
4. Block 1 6,43,000

38,50,000
Radiology, pathology, and imaging rooms 8,00,000
Diagnostic separately (+)
5. Framework With optional MRI machine (each dept.) 1 1,00,00,000

6. CSSD Sterilization equipment and storage 2,75,000

Ambulatory
7. Service Medical vehicle with life support 1 5,00,000

Refrigerated and regulatory guidelines complied

storage facility for blood bank and blood
8. Special Storage products 1 5,00,000

9. Mortuary 1 4,00,000

Plan for financing the hospital

1. Estimating costs and profitability, planning, and budgeting

- First and foremost, healthcare finance involves evaluating the financial effectiveness of current
operations and planning for the future.

2. Managing financial operations.

Healthcare organizations spend a lot of time managing cash and supply inventories as well as
collecting money owed for services rendered. Proper management of these functions is
necessary to ensure operational effectiveness and to reduce costs. Typically, managers at all
levels are involved, to a greater or lesser extent

3. Financing decisions.
All organizations must raise funds to buy the assets necessary to support operations. Such
decisions involve many issues, such as the choice between long-term and short-term debt and
the use of leases versus conventional financing. Senior managers and the financial staff typically
make the financing decisions, but these decisions have ramifications for managers at all levels.

4. Capital investment decisions.

One of the most critical decisions managers make is the selection of new facilities (including land,
buildings, and equipment). Such decisions are the primary means by which businesses implement
strategic plans; hence, they play a key role in a business’s financial future

5. Financial reporting.

For a variety of reasons, businesses must record and report to outsiders the results of
operations and current financial status. This task is typically accomplished with a set of financial
statements

6. Financial and operational analysis.

To achieve and maintain a high level of organizational performance, businesses must constantly
monitor both financial and operational conditions and take actions as needed to ensure that
goals are met

7. Contract management.
 In today’s healthcare environment, health services organizations must negotiate, sign, and
monitor contracts with managed care organizations and health insurers. The finance staff
typically has primary responsibility for these tasks, though operational managers clearly are
affected by external contracts and must be involved in their negotiation and management.

8. Financial risk management.

Many financial transactions that take place to support the operations of a business can, in
themselves, increase a business’s risk. Thus, an important finance staff activity is to manage
financial risk.