Cost analysis of minimum standards; Still we crib about hospital bills
A simple calculation of per bed cost per day if the draft prepared by the committee constituted vide memo F. No 35 17 2012 Ministry Co ordination cell by AIIMS committee as minimum standards that are to be adopted for 10 bed ICUs throughout the country.
For a10 bedded ICU committee recommendations .
1).... Full Time Director.... 1 =1.5 lacs per month
2)... Full Time Senior accredited specialist ( PG with 5 - 7 years ) 2 1.5 lacs x 2= 3 lacs
3)..... Consultants 3 years post PG 4 1lac x 4 = 4 lacs
4)..... Resident doctors (minimum 2 24X7 ') , 9 total 60000 x 9 = 5.4 lacs
5).... Other specialty doctors on call 24h Day basis... 10 10 x 10000 = 100000
6)..... Head nurse full time 5 years experience 1 =60000
7).... One senior nurse 1 =40000
8).... In charge Nurse MSc 3 years experience 8 total 25000 x 8= 2,00,000
9).... Nurse staff 1 1 (ratio BSc 40 :60 ) 15000 x 30= 450000
10).... Physiotherapist 1 shift per five beds on 24 hours x 7 days 25000 x 2= 50000
11).... Technicians 1 5 beds per shift .,8 15000 x 8= 120000
12).... Additional technician in charge 4 20000x4= 80000
13).... Radiographer One each for 6 ( 12 bedded ICU) 24h day basis. 25000 x 6= 150000
14).... Dietician One each for 6 . 30000 x 2= 60000
15).... Psychologist I Counselor One each for 6 bed. 40000x2=80000
16)... Pharmacist One each for 6 bed. 20000x2 =40000
17)..... Computer operator One each for 6 bed. 15000 x 2=30000
18).... Two data entry operator medical secretary for 6 bed. 12000x4=48000
19).... Biomedical engineer ( Available 24hrs x 7 ) ...4 40000x4=160000
20)..... Biomedical waste sanitary attendant ...7 10000x7=70000
21)..... Security guard 24hrs x 7 days....4 10000x4=40000
Total Expenditure per month on human resource @ AIIMS Committee 31,68,000 per month
or 1,05,600 per day
or 10560 per bed per day whether or not the bed is occupied. If Infrastructure and equipment costs are added to this @ 10000/bed then total becomes 20560 per bed per day whether occupied or not. To break even the cost of unoccupied beds will be borne by the occupied beds plus cost of disposables and drugs and investigations and procedures etc.
Are the govt. Hospitals or even private hospitals capable of following these guidelines specially in view of judgments which mandate that any surgery should be done only in a nursing home / hospital which has ICU facilities. ?
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
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