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DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:

A FEASIBILITY STUDY

A Feasibility Study
Presented to the
Faculty of the Graduate School
St. Jude College, Manila

In Partial Fulfillment of
The Requirements for the Degree
Master in Hospital Administration

WILSON J. RIVERA, M.D.

June 2015

DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:

A FEASIBILITY STUDY
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APPROVAL SHEET

This project study entitled “DIALYSIS CENTER AT MAGSAYSAY MEMORIAL

DISTRICT HOSPITAL: A FEASIBILITY STUDY”, submitted by Wilson J. Rivera,
M.D in partial fulfillment of the degree of Masters in Hospital Administration, has
been examined and recommended for oral examination.

____________________________________
FORTUNATO C. GABON JR, RRT, MHA, Ph.D
Adviser

Approved in partial fulfillment of the requirements of the degree for oral

Examination Committee.

____________________________________
TERESITA CALIP-CORPUS, M.D., MHA, Ed.D.
Chairman

_____________________ ____________________________
BU. CASTRO, M.D., LLB MARIA MARTHA FAROLAN, LLB
Member Member

Accepted in partial fulfillment of the requirements for the degree of Master

in Hospital Administration.

Comprehensive Examination:
Oral Defense Grade:

_____________________________________

TERESITA CALIP-CORPUS, M.D., MHA, Ed. D.

Dean, Graduate School

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EXECUTIVE SUMMARY

NAME OF INSTITUTION/HEALTH UNIT

Magsaysay Memorial District Hospital is the name of the institution wherein this

feasibility study primarily proposes to have a dialysis center.

LEVEL OF THE HEALTH CARE UNIT/INSTITUTION

Magsaysay Memorial District Hospital is a level one government hospital of 75-bed

capacity. People regardless of their economic status prefer to come to this hospital for

consultation and for their medical and emergency care. Patients are not only from Lopez,

Quezon and neighboring towns but also even to those as far as Camarines provinces of

the Bicol region. It also attends and responds to referrals fro other health care facilities

such as barangay health stations, rural health units, private practitioners, private

hospitals/clinics and other government hospitals being a Center of Wellness and “CORE”

referral hospital of unified local health development zone 8 composed of five (5) rural

health units of Guinayangan, Lopez, Buenavista, Calauag, and Tagkawayan

(GLoBuCaT), Calauag Municipal Hospital (Infirmary), Guinayangan Medicare Community

Hospital and two (2) other district hospitals: Ma. Eleazar Memorial District Hospital and

Magsaysay Memorial District Hospital itself.

Current services offered and remarkable accomplishments of the hospital are as

follows:

a. Medical, surgical including Traumatology, Obstetrics and Gynecology, and

Pediatric Care

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A FEASIBILITY STUDY
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b. Ophthalmology services such as cataract extraction and ocular lens

replacement to patients

c. Neurological services

d. Serves as a referral center – accepts and attends to referrals from barangay

health stations, rural health units, private practitioners and private

hospital/clinics and other government hospitals

e. Provides public health services as control of diarrheal diseases, control of

communicable and non-communicable diseases, maternal and child health,

voluntary blood donation, rabies prevention and control program for the elderly

f. Provides animal bite treatment

g. Provides easily accessible health services such as pharmacy, laboratory, x-ray

and others

h. Authorized Blood Collecting Unit and blood station

i. Coordinating center and at times provides technical support to catchment

Rural Health Units and municipalities

j. Qualified partner as a training hospital for student affiliates of allied health

sciences courses around schools and universities over the Quezon province

k. Designated as “CORE” Referral Hospital of Unified Local Health Development

Zone 8 composing of two (2) district hospitals, two (2) community hospitals

and five (5) rural health units

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OWNERSHIP

The proposed project will be owned by the Magsaysay Memorial District Hospital

as part of its holistic operation. However, a private-public partnership will be used to aid

in setting up the dialysis center wherein the private partner shall be receiving credits for its

partnership with the aforementioned government hospital.

LOCATION

The fourth legislative district where the hospital primarily caters is composed of ten

(10) municipalities: Alabat, Atimonan, Calauag, Guinayangan, Gumaca, Lopez, Perez,

Plaridel, Quezon and Tagkawayan composing of four hundred fifty two (452) barangays

having the total land area of 2,079.4 sq. km. Specifically, the dialysis center’s office shall

be housed at Magsaysay Memorial District Hospital which is particularly located at the

Municipality of Lopez.

The building that will be constructed or renovated or expanded should have space

for the following areas: patient waiting area, administrative area, doctor and examination

room, dialysis area, dialsate preparation room, nurse cabin, water treatment room, and

janitorial room.

BRIEF DESCRIPTION OF THE PROJECT

The primary objective of this feasibility study is to propose for the establishment of

dialysis center at Magsaysay Memorial District Hospital. The proposal recognizes the

growing necessity for provision of medical and health services to the people in the most

affordable and accessible means possible.

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The project design shall be communicated and collaborated with various sectors

of the government and assistance with non-government firms in order to foster the

maximization of varied skills and resources in innovative ways and allow sharing of

benefits, risks, and responsibilities.

The aforementioned project upon operations shall be assessed and success

points shall be measured. Thence, the same proposal shall be proposed to other districts

of the province in attainment of the objectives and in hopes of propelling the advocacy to

foster the affordability and accessibility of public health.

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PROJECT SUMMARY

MARKET FEASIBILITY

With the growing population comes the increase in number of aging individuals

and those who suffer from hypertension and diabetes that are resulting to renal failures.

These patients are in need of constant medication, kidney transplant, and dialysis

treatment. Nonetheless, renal treatments are of high costs and not nearly available to the

growing demand for renal care. Consequent to this, there is an acute shortage of dialysis

treatment facilities in the locality.

With this, comes the rationale behind the inception of Magsaysay Memorial District

Hospital. In Quezon Province, dialysis centers can only be availed in the capital city,

Lucena City. Consequently, that would take long hours of travel and extended agony of

dialysis patients just to be treated. They had to wait for long lines to avail medical

treatment and cost of medication is progressively increasing. To handle the medical

concerns of the elderly especially in remote areas in the third and fourth legislative

districts of Quezon Province in a more affordable and accessible way, MMDH Dialysis

Center is proposed.

TECHNICAL FEASIBILITY

The medical facility housing the dialysis center is situated attached to the main

facility of Magsaysay Memorial District Hospital. The facility shall be operating 5-dialysis

machine operations.

Laboratory, diagnostic and ambulatory services shall be provided by the main

facility of Magsaysay Memorial District Hospital.

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MANAGEMENT FEASIBILITY

The project shall be run and managed by the same management as the

Magsaysay Memorial District Hospital. Expenses and profits shall be solely be

shouldered and reaped by the MMDH management. Partnerships with other entities shall

be limited to the development of marketability of the dialysis center.

FINANCIAL FEASIBILITY

The project shall entail high costs of initial capital due to the acquisition of capital

and biomedical equipments and the construction of the dialysis center facility,

Nonetheless, upon continuous operation, capital investments shall be returned upon the

first year of operation.

Upon further years, the geriatric care center aims to also contribute cash inflows to

the operation of the district hospital helping in shouldering other hospital costs and

provide it with more benefits.

SOCIO-ECONOMIC IMPACT

The project would offer a better support to the social fabric by providing accessible

and affordable dialysis services to the locality in Quezon province particularly to the fourth

legislative district, and nearby third legislative district and Bicol Region.

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INTRODUCTION

BRIEF BACKGROUND WHY YOU ARE DOING THIS FEASIBILITY PROBLEM

Dialysis is essential for patients suffering from End Stage Renal Disease (ESRD)

and it is observed from preliminary studies that the major contributing diseases are

diabetes and high blood pressure. Hypertension was estimated to be 118.2 million and

expected to hike at 213.5 million in 2025 and experienced of 20-40% of adults in urban

areas and 12-17% of adults in rural areas. Meanwhile, Philippine cases of diabetes are

recorded at 34.7 million in 2004 and are to rise to about 57.2 million in 2025.

But with this data having the need for a dialysis treatment center, constraints such

as unavailability in the locality, distance and travel constrictions, and financial

predicaments are present.

In summation, the need for dialysis centers in rural and district health units is very

much present. With this, patients can avail their needed treatment at a more accessible

and affordable means.

MAIN OBJECTIVE OF THE FEASIBILITY STUDY

The project feasibility study directly aims to cater the following objectives:

1. To enhance the scope, as well as service capabilities of public hospitals

2. To establish a medical facility that shall provide patients the highest quality of care

and excellence in health service

3. To bring dialysis services at an affordable and accessible vicinity to the population

needing it

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SIGNIFANCE OF THE STUDY

Dialysis centers provide the patient with needed services that are easily

accessible with minimal travel time. Preferably a family member drives a dialysis patient

to and from the treatment facility but it is not uncommon that patient transport

himself/herself. For the patient who needs dialysis yet does not live within easy

commuting distance of a dialysis center, the only option is to move to the community

where the center is situated incurring more costs in relocation and absence of social

support system. The nearest dialysis center available to the province is situated in its

capital, Lucena City, which can take at least four to five hours of drive. Putting a dialysis

machine on rural and district hospitals would be of immense help since those patients

needing dialysis in the area would not be hindered by distance and travel time just to avail

their needed treatment.

BACKGROUND OF THE STUDY

The human kidney performs the following essential functions:

1. Removes the waste and water from the blood stream

2. Balances the chemical composition of the body

3. Assists in producing red blood cells (RBC)

4. Assists in maintain the normal blood pressure

5. Assists bone development

Renal failure or failure of kidney’s normal function can be broadly classified into

acute kidney failure (kidney suddenly stops working, may be temporary and can be

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caused of injury, accident or poisoning) and chronic kidney failure (gradual loss of kidney

functions and may be permanent).

Patients who suffer from the acute kidney failure are given drug relief and

temporary dialysis until normal operation of the kidneys commence while option for

treatment for chronic kidney failure is to replace the kidney with a suitable donor but with

unavailability, other option for treatment is to continue dialysis up until replacement is

available.

Hemodialysis and Peritoneal Dialysis are the two ways by which dialysis is

provided to patients. Hemodialysis is more popularly used because it involved lesser

capital costs while the other can be self-administered though it entails more costs.

Patients prescribed with dialysis need to undergo the process until they go for

renal replacement. The frequency of dialysis varies from once a week to once a day

depending on the renal failure’s severity. Patients spend at a range of ten thousand to

twenty thousand pesos (P10, 000- 20,000) a month to avail treatment. They also have to

take special food and additional medicines to sustain the medication.

Government provides alternative through established hemodialysis centers,

capacity of them are limited as only a maximum of 4 cycles are possible per machine

operating round the clock. Hence, there are points where these centers are overloaded

and patients have to wait for long lines just to get treated.

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MARKET STUDY

THE MARKET: GEOGRAPHICAL CONSIDERATIONS

The dialysis center must be strategically incepted at Magsaysay Memorial District

Hospital, at the heart of Quezon’s fourth legislative district and which is particularly

situated in Lopez, Quezon. The rationale was due to the fact that kidney problems in the

locality were enormously putting the life of people in danger because of its cure’s

unavailability beyond this area of Quezon province.

DEMOGRAPHICS OF THE PLACE

The following are the number of barangays in the third legislative district of

Quezon Province and their recent population count according to the Total Population by

Province, City, Municipality and Barangay survey of the National Statistics Office (2010):

MUNICIPALITY NO. OF LAND TOTAL

BARANGAYS AREA POPULATION OWN
(km2)
Alabat 19 57.6 16,120
Atimonan 42 239.7 61,587
Calauag 90 324.7 69,223
Guinayangan 55 214.1 41,669
Gumaca 59 189.7 69,618
Lopez 95 355.4 91,074
Perez 14 57.5 12,039
Plaridel 9 35.1 10,238
Quezon 24 71.2 15,142
Tagkawayan 45 534.4 50,833
TOTAL FOR THE 4TH
LEGISLATIVE DISTRICT, 2,079.4 437,543
QUEZON

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RESEARCH DATA

The key data determined is as follows:

 CRF prevalence rate is 0.3% of the population

 75% of the population needing dialysis is dependent for government provision of

these medical treatments

 Mostly one per week is the prescribed dialysis treatment

 Average annual growth rate in the past 10 years is 1.87%

 95% is the common operating efficiency of dialysis machines

TARGET MARKET OF THIS STUDY

The exact number of people requiring dialysis in the country is still not identified

authoritatively. The Philippines Society of Nephrology has established a Chronic Kidney

Disease (CKD) registry and this is expected to provide useful epidemiological data in the

future.

In the prevention study done in Quezon, the prevalence at the community level is

8600 per million population in the study group and 13900 per million populations in the

control group. Data also revealed a prevalence of CKD that incidence of 151 per million

populations suffering from end stage renal disease (ESRD).

Kidney diseases rank seventh (7th) as the country’s leading cause of death. This

can be due to a “lethargic” lifestyle, and wrong food choices resulting to diabetes and

hypertension which in effect may cause kidney complications.

The Department of Health (DOH) said close to 23,000 Filipinos underwent dialysis

due to kidney failure in 2013, which is four times higher than the recorded cases in 2004,

summing up to a 10-15% hike per year. To quote Dr. Antonio Paraiso, manager of
DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:
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Philippine Network for Organ Sharing, at least 12,000 Filipinos developed kidney failure,

requiring crucial transplants or expensive dialysis. Escalated cases of hypertension and

diabetes are likewise reported, which are both contributors of kidney failure and

glomerulonephritis (an inflammation of either glomeruli or small blood vessels in the

kidney).

One Filipino develops chronic renal failure every hour or about 120 Filipinos per

million people per year. Before 2010, the National Kidney and Transplant Institute (NKTI)

said over 5,000 Filipinos were undergoing dialysis and about 1.1 million worldwide were

on renal replacement therapy. Those figures doubled beginning in 2010.

Consequent to this comes the need for regular medical check ups and a shift to

healthier lifestyle. However, the cost of treating a kidney disease is very expensive and

beyond the financial reach of the masses. Renal transplant is limited due to the monetary

constraints and shortage of donors. Best can be done through the prevention of

progression of renal diseases. Strongly, there’s a growing necessity for the demand for

dialysis centers.

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SWOT ANALYSIS
ENVIRONMENTAL ANALYSIS
STRENGTHS
 There’s a prevalence rate of 3 per 64,000
people in the Quezon locality and the
number of cases has a tendency to progress.
This may entails actual and potential market
demand for the establishment of a dialysis
center in the locality.
 The establishment of a dialysis center in
MMDH answers the problem for travel
distance and transportation for dialysis
rd th
patients in the 3 & 4 districts of Quezon,
as well as nearby Bicol areas since there
would be accessible treatment center instead
of them going for Lucena or Manila just to
avail it. Moreover, services are less costly as
compared to private health institution since it
is provided by the government.
OPPORTUNITIES
 The local government of Quezon is highly
supportive with regards to the concerns of
improving health and well-being of its
populace.
 No other dialysis unit operating in this area
had been noted; thus, increasing the demand
for a dialysis center.
 Outsourcing and partnership were the
DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:
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WEAKNESSES
 High cost of capital equipments and
associated employee/s may entail escalated
financial constraints.
 Power supply and procurement of supplies &
consumables add cost.
 There’s a need for development on physical
infrastructures and facilities in the existing
public healthcare system delimiting the
services available for the dialysis center.
 There is a necessity for proper training and
human resource development to propel
continual operations of such dialysis center
THREAT
 There’s a limited availability of trained
clinical and para clinical manpower.
Nephrologists are in short across the
country and huge shortage for dialysis
technicians is present.
 Requirement for rigorous infrastructure set
up and uptime performance of dialysis
machine may be hinder optimal service
provision of the dialysis center.
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MARKETING STRATEGIES

POSITIONING

Magsaysay Memorial District Hospital’s dialysis center aims to establish a holistic

institution for affordable and accessible dialysis services. Likewise, it also positions itself

as an avenue of the government in doing its responsibility to provide quality and complete

services to the people.

PRODUCT

The product to be marketed is the Magsaysay Memorial District Hospital (MMDH)

dialysis center. The management shall try to offer holistic renal health care to the

constituents of the locality.

PLACE

There shall be lesser marketing emphasis on the place since the vicinity of
Magsaysay Memorial District Hospital is already familiar and known to people in the
community and other neighboring places.

The stated geriatric clinic ward will be incorporated as part of the hospital which
will be managed by the hospital itself and will be supported by the government. Private
sectors shall also aid in the implementation of such projects.

By this way, the dialysis center is easily accessible since it is attached to the
hospital’s main facility. Patients from the dialysis center can easily access other
ambulatory and diagnostic services since the facility is attached to the main infrastructure.

Also, the place of MMDH is strategically located along the Maharlika Highway
leading to Bicol Region so promotions posted beside/outside the hospital can be easily
seen and known by passerby.

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PROMOTIONS

Magsaysay Memorial District Hospital, along with the partner organizations and

firms, may promote the dialysis center be done in the form of printing pamphlets,

releasing reading materials on renal health care, and coordination with other district and

municipal hospitals.

TECHNICAL STUDY

REQUIREMENTS NEEDED TO CATER THE MARKET

The dialysis center to be located at Magsaysay Memorial District Hospital shall

start with a capacity of five-dialysis machines.

The center shall separate one machine out of five for Zero positive cases, this is

an average and can be altered based on the locality’s profile.

Laboratory, diagnostic and ambulatory services shall be provided by the main

facility of Magsaysay Memorial District Hospital.

SPECIAL PHYSICAL REQUIREMENTS FOR THE UNIT

The facility that shall be constructed should have the following specifications:

1. Space for the dialysis center: 1700 sq.ft. to 3000 sq.ft. of built-up space for running

five (5) dialysis machines including supportive services

2. Hemodialysis machines

3. RO plant

4. Cot, mattresses, and dialysis chairs

5. Para monitors, ancillary equipments, and crash cart

6. Consumables

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MANAGEMENT STUDY

FORM OF BUSINESS OWNERSHIP TO BE ADOPTED AND THE RATIONALE

The opportunity presented by the study is an avenue where government can

provide medical needs and services of the people. Several national and local providers of

dialysis services are available to partner with local government, other hospitals, medical

professionals, and investors to develop and continually operate a dialysis center.

The Government of Quezon in its commitment to improve the health and well-

being of the people has provided extensive resources to the primary and secondary level

public health facilities.

Roles and Responsibilities of the Government Hospital:

1. Providing built-up space or vacant space for the construction and setting

up of the dialysis treatment facility

2. Providing utilities such as electricity, power back-up, maintenance, and

water supply for the center

3. Providing laboratory, diagnostic, and ambulatory support whenever needed

4. Recruiting, training, and retaining of manpower for the dialysis center

5. Supervising the supply chain of medicines and consumables

Roles and Responsibilities of the Private Partner:

1. Aiding in finances for the operation of the dialysis center

2. Coordinating with the district hospital for renal related cases

3. Aiding in marketing and promotions that shall increase people’s knowledge

about the dialysis center and renal health care

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The project once initiated and at the time the contract period between the private

organizations has elapsed, both parties (the government and private partner/s) shall

together decide for feasibility and design of future courses of action in continuity of the

project.

MANPOWER REQUIREMENTS & JOB DESCRIPTIONS

In order to meet the goals and the success of the dialysis center, there should be

adequate manpower as proposed below:

No. Position Job Description

1 Nephrologist
6 Dialysis Technician
6 Staff Nurse
3 Administrative Personnel
2 Utility Personnel
Addresses the issues of dialysis patients and
responds to the emergency medical needs of the
dialysis patients
Attends to the operation, including maintenance
of efficiency, of dialysis machines
Attends to the concerns of the patients and
assists the needs of the nephrologists
Attend to the administrative records, needs, and
concerns of the dialysis patients; Coordinates
with the MMDH main facility with other
ambulatory, and diagnostic services
Regulates cleaning and maintenance of the
dialysis center

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FINANCIAL STUDY

TOTAL PROJECT COST

The construction and initial operation of the dialysis center shall entail the

following major cost groups for procurement:

1. Construction of the dialysis center’s facility and/or renovation of the existing

build-up facility to accommodate the improvements on the district hospital

2. Installation and maintenance of bio-medical equipments, furniture, and fixtures

3. Manpower costs for the operation of the dialysis treatment unit

4. Consumables or supplies costs for the operation of the dialysis center

Each of the costs groups are comprised and explained as follows:

BUILDING COSTS ESTIMATES (Amount in Pesos)

No Space for Dimension Sq.Ft. Area Cost
1 Patient Waiting Area 10*15 150 225,000.00
2 Administrative Area 10*15 150 225,000.00
3 Doctor & Examination Room 10*15 150 225,000.00
4 Dialysis Area 7*3+7*4+7*2 540 810,000.00
5 Dialsate Preparation Room 10*15 150 225,000.00
6 Washroom 3*5*10 150 225,000.00
7 Nurse Cabin 10*10 100 150,000.00
8 Janitorial Room 5*10 50 75,000.00
TOTAL BUILDING COST ESTIMATES 2,160,000.00

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EQUIPMENT COST ESTIMATES (Amount in Pesos)

No Particulars Units Unit Cost Total Cost
1 Hemodialysis Machine 5 600,000.00 600,000.00
2 Dialysis Fluid Filter 5 30,000.00 60,000.00
3 RO Plant 1 20,000.00 60,000.00
4 Hemocleaner 1 350,000.00 1,400,000.00
TOTAL EQUIPMENT COST ESTIMATES 2,120,000.00

SUPPORT SYSTEM COST ESTIMATES (Amount in Pesos)

No Particulars Units Unit Cost Total Cost
1 Waiting Chairs 20 600.00 12,000.00
2 Doctors chair 1 5,000.00 5,000.00
3 Medical Table 1 5,000.00 5,000.00
4 Admin/Nurse Chairs 5 1,000.00 5,000.00
5 Admin/Nurse Tables 2 3,000.00 6,000.00
6 Rack for MRD 2 8,000.00 16,000.00
7 Liftable bed 1 15,000.00 15,000.00
8 Bed side table/cabinet 5 2,000.00 10,000.00
9 Fans 10 2,000.00 20,000.00
10 Cleaning area set up 1 10,000.00 10,000.00
11 Exhaust fan for ceiling 1 5,000.00 5,000.00
12 Storage Almairah 2 15,000.00 30,000.00
13 Refrigerator 1 15,000.00 15,000.00
14 Crash cart 1 20,000.00 20,000.00
15 Stretcher trolley 1 15,000.00 15,000.00
16 Wheelchair 3 5,000.00 15,000.00
17 Air conditioner 2 25,000.00 50,000.00
18 Generator 30kW 1 350,000.00 350,000.00
19 Inverter Backup set 1 200,000.00 200,000.00
20 Computer with Printer-Scanner 1 50,000.00 1,000,000.00
TOTAL SUPPORT SYSTEM COST ESTIMATES 1,730,000.00

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BIOMEDICAL EQUIPMENT COST ESTIMATES (Amount in Pesos)

No Particulars Units Unit Cost Total Cost
1 Stethoscope 2 1,000.00 2,000.00
2 Sphygmomanometer 1 1,000.00 1,000.00
3 Needle cutter 1 500.00 500.00
4 Heart monitor 1 25,000.00 25,000.00
5 Defibrillator 1 10,000.00 10,000.00
6 Oxygen cylinder 2 6,000.00 12,000.00
7 Glucometer 1 15,000.00 15,000.00
8 Weighing scale 1 2,000.00 2,000.00
9 Autoclave 1 20,000.00 20,000.00
TOTAL BIOMEDICAL EQUIPMENT COST ESTIMATES 87,500.00

MANPOWER COST ESTIMATES (Amount in Pesos)

Ordinance No. Particulars Authorized Annual Salary
1 Nephrologist 1,800,000.00
6 Dialysis Technician 720,000.00
6 Staff Nurse 648,000.00
3 Administrative Personnel 288,000.00
2 Housekeeping/Cleaning Staff 120,000.00
TOTAL MANPOWER COST ESTIMATES (Annual) 3,576,000.00

TOTAL COSTING ESTIMATION (Amount in Pesos)

Particulars Amount
CAPITAL COSTS
Contruction Costs 2,160,000.00
Purchase of Capital Equipments 1,730,000.00
Purchase of BioMedical Equipments 87,500.00
Setting up of Support System 1,730,000.00
OPERATIONAL COSTS
Manpower Costs (Annual Est.) 3,576,000.00
Allowance for Supplies and Consumables 300,000.00
TOTAL COSTS ESTIMATED 9,583,500.00

INITIAL CAPITAL REQUIREMENTS

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In reference to the above mentioned table for Total Costing Estimation, initial

capital requirements should be inclusive of the following:

INITIAL CAPITAL REQUIREMENTS ESTIMATION (Amount in Pesos)

Particulars Amount
Construction of Dialysis Center 2,160,000.00
Purchase of Capital Equipments 1,730,000.00
Purchase of Biomedical Equipments 87,500.00
Manpower Costs (first month) 298,000.00
Initial Allowance for Supplies and Consumables 300,000.00
Training Programme Costs 10,000.00
Marketing and Promotional Expenditures 5,000.00
TOTAL INITIAL CAPITAL REQUIREMENTS (Est.) 4,590,500.00

SOURCE OF FINANCING

Funding for initial capital requirements shall be coming mainly from the provincial

budget appropriation for Magsaysay Memorial District Hospital. Likewise, private

donations from medical sectors, NGOs, and feasibility study’s private partners shall be

complimentary to the source of financing.

PROJECTED CASH FLOWS (Amount in Pesos)

The tables for projected cash flows for years one and two are presented below.

We can deduce from the table that there would be lesser inflows from year one as to

return the investment for capital and biomedical equipments, and the construction of

dialysis center facility per year. For the following year, regular patient must hike into 5

more regular patients. Increase in costs for the second year is likewise expected. Along

with governmental subsidies received from provincial government budgetary allocation

and from Philippine Health Insurance Corporation with efficient and effective business and

marketing planning and being able to meet the revenue quota, the dialysis center shall be

a profitable addition to the district hospital’s income generation.

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MAGSAYSAY MEMORIAL DISTRICT HOSPITAL DIALYSIS CENTER

PROJECTED STATEMENT OF CASH FLOWS
YEAR ONE

PROJECTED INCOME
Dialysis Treatment (est.15,000/treatment @52wks. @10 patients) 7,800,000.00
Consumables 800,000.00
TOTAL PROJECTED INCOME (First Year) 8,600,000.00
Add: Government Budget Appropriated for Dialysis Center 2,000,000.00
Subsidy from PHIC 202,500.00
PROJECTED TOTAL CASH INFLOWS 10,802,500.00

LESS: PROJECTED EXPENSES

Initial Capital Requirements (Exclusive of Manpower Cost) 4,292,500.00
Estimated Manpower Costs 3,576,000.00
Communication, Light and Water Expenditures 350,000.00
Office Supplies 50,000.00
Purchases of Consumables 500,000.00
Miscellaneous Expenditures 300,000.00
PROJECTED TOTAL CASH OUTFLOWS 9,068,500.00
NET CASH FLOW INFLOWS, YEAR 1 1,734,000.00

MAGSAYSAY MEMORIAL DISTRICT HOSPITAL DIALYSIS CENTER

PROJECTED STATEMENT OF CASH FLOWS
YEAR TWO

PROJECTED INCOME
Dialysis Treatment (est.15,000/treatment @52wks. @15 patients) 11,700,000.00
Consumables 1,000,000.00
TOTAL PROJECTED INCOME (First Year) 12,700,000.00
Add: Government Budget Appropriated for Dialysis Center 2,000,000.00
Subsidy from PHIC 202,500.00
PROJECTED TOTAL CASH INFLOWS 14,902,500.00

LESS: PROJECTED EXPENSES

Estimated Manpower Costs 4,000,000.00
Communication, Light and Water Expenditures 500,000.00
Office Supplies 60,000.00
Purchases of Consumables 700,000.00
Miscellaneous Expenditures 400,000.00
PROJECTED TOTAL CASH OUTFLOWS 5,660,000.00
NET CASH FLOW INFLOWS, YEAR 1 9,242,500.00

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SOCIO-ECONOMIC STUDY

Medical care is not a privilege; it is a right that should be given to each and every

one. Nonetheless, constraints such as financial costs, distance and travel, availability of

medical facilities are present hindering citizens to avail quality and accessible medical

services at the affordable amount possible.

The accomplishment of this would offer better support to the society by providing

effective medical care to dialysis patients and at the same time, this could reinforce the

commitment of the government towards the welfare of its constituents.

The establishment of this feasibility study’s actualization can address the needs of

dialysis patients for a more accessible, more affordable dialysis treatment that could ease

up their pain and financial costs. Provision of such in the locality can better help the

society in fostering well-being and health.

SUMMARY, CONCLUSIONS AND

RECOMMENDATIONS
The need for dialysis treatment is expected to increase drastically over the next

few years as population ages and acquires diseases resulting to renal failure. With this

escalated need for such treatment, hospital administrators and management should

consider adding a kidney dialysis treatment center to their medical facilities. In the shorter

term, establishing such shall require significant investment but in the longer run, the

people as well as the medical institution shall reap the fruits of their investment through

development and achieved well-being.

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REFERENCES

Agar, J. (2009). International variations and trends in Home Haemodialysis. Advances in

Chronic Kidney Disease, Vol. 16, No. 3 (May), 2009: pp 205-214

Blagg, C.R. (2008). The Renaisance of home hemodialysis: Where we are, why we got
here, what is happening in the United States and elsewhere, Haemodialysis
International 2008; 12: S2-S5

Cass, A. et.al. (2011) Increasing home-based dialysis therapies to tackle dialysis burden
around the world. 2011. http://onlinelibrary.wiley.com/doi/10.1111/j.1440-
1797.2010.01418.x/full

Feidhlim-Woods, H. (2010). The influx of dialysis patients, what does the future hold?.
Fresenius Home Therapies Conference 2010 – Presentation

National Kidney Institute. (2010). An overview of chronic kidney disease in Philippines,

2012 2 . AIHW 2011.

Projections of the incidence of treated end-stage kidney disease in Philippines, 2010-

2020. Cat. No. PHE 150. Canberra: AIHW Viewed 14 May 2015.
http://www.aihw.gov.au/publication-detail/?id=10737419875

Quezon Government. (2012). Quezon Renal Health Services Plan 2008-17, Part one: The
Way Forward, Quezon Territory Government Renal Health Service Plan 2010-
2015.

"Total Population by Province, City, Municipality and Barangay: as of May 1,

2010" (PDF). 2010 Census of Population and Housing. National Statistics Office.
Retrieved 22 November 2013.

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APPENDICES

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A FEASIBILITY STUDY
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LOGO OF DIALYSIS CENTER

DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:

A FEASIBILITY STUDY
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CURRICULUM VITAE

DIALYSIS CENTER AT MAGSAYSAY MEMORIAL DISTRICT HOSPITAL:

A FEASIBILITY STUDY