healthcare facilities and medical equipment whole-of-life
TRANSCRIPT
#IFHEcongress2018
Claudio Meirovich MontrullMeirovich Consulting SL, Madrid, Spain
Healthcare Facilities and Medical Equipment Whole-of-Life Cost Modelling Tool
supporting policy makers - a Swaziland experience
#IFHEcongress2018
The Kingdom of eSwatini
#IFHEcongress2018
In case you need to leave…
0
1,000
2,000
3,000
4,000
5,000
6,000
Year 0 Year 1 Year 2 Year 3 Year 4 Year 5TH
OU
SAN
DS
Option 2 (Inhouse) Option 3 (Mix)
Option 4 (Outsourced) Option 5 (PPP)
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Maintenance Cost Centers
BuildingsEquipment
Infrastructure MEP + ICT
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Maintenance Cost Centers
EquipmentInfrastructure MEP + ICT
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Maintenance Cost Main Questions
?
or ?
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Maintenance Cost Calculation Options
% of
++ + +
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What do we need to know?
Value of AssetsDetailed Inventory of Assets
Type of works
required
Skills required
Training needed
Materials
Spare Parts
Qty
Purchase price
Date of Purchase
Condition of Assets
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What to do if we don’t have the procurement cost?
Use of Ratios• $/m2
• $/bed
• Building Cost Comp
• Typical Eq PM frecs
• Avg Spare Parts Prices
• Avg Work Efficiency
• others
Use prev exp
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Options for Maintenance of Healthcare Infrastructure and Equipment in the Kingdom of eSwatini
(PPP)
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Static Financial Analysis vs. Cashflows Analysis
% ≃ σ1𝑛 𝑎𝑛 ≃
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Situation Analysis:Infrastructure and Equipment Challenges
No specialized staff for building maintenance
No Inventories for Facilities
No renovation in buildings
No clear budget facility maintenance
Budget Equipment Maintenance
2.3 million USD
1 biomedical engineer
20 biomedical technicians
8 artisans
>50% equipment condemned / bad
Equipment Value:20 million USD
No Policies
185.000 m2 117 facilities
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Variables and Parameters: Number and Type (level) of Healthcare facilities
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Variables and Parameters: Other Variables
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Results obtained with our toolComparison Table Between Options
Source: Meirovich Consulting
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0
1,000
2,000
3,000
4,000
5,000
6,000
Year 0 Year 1 Year 2 Year 3 Year 4 Year 5
THO
USA
ND
S
Option 2 (Inhouse) Option 3 (Mix)
Option 4 (Outsourced) Option 5 (PPP)
Five years total cost comparison for different maintenance options
Source: Author’s own Analysis
Total 5-years cost comparison (USD)
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Preliminary Conclusions
• The tool allowed to compare the cash flows required to do maintenance over a period of five years including infrastructure and equipment.
• While the static analysis would not allow a clear understanding of the differences between different implementation approached our tools makes it evident
• The cheapest option was in our case to do full in-house maintenance while the most expensive one is the PPP.
• Our results ONLY apply to the initial hypothesis considered for OUR case. Different results may be obtained with different starting conditions
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Final Conclusion• The use of simulation tools allow a better understanding on the real
costs underlying the maintenance of any healthcare facility
• Today, developing or implementing a simulation tool is at everybody’s hands, and therefore simulation tools like the one presented today should be considered mandatory before deciding any major investment plan.
#IFHEcongress2018
Claudio Meirovich MontrullMeirovich Consulting SL, Madrid, Spain
[email protected]+34 675973332
Healthcare Facilities and Medical Equipment Whole-of-Life Cost Modelling Tool supporting policy makers
- a Swaziland experienceYou may contact me for any comments or questions you may have
👇