Guide to COST-BENEFIT ANALYSIS of investment projects - Ramiri

3.4.3.2 Project identificationDue to the complexity of a health care infrastructure, there is a need to clearly describe the objectives andcharacteristics of the project proposed. The main typologies of features to be considered are thefollowing:MAIN FEATURES TO BE CHECKED AND ANALYSEDFunctional features (for example):- the group of pathologies involved,- the scope of the target population,- the diagnostic functions,- the short or long term treatment.Basic data (for example):- the average and maximum numbers of users per day, month, year,- a list of the departments for assistance and prevention, treatment and diagnosis.Physical data (for example):- the surface area and covered area,- number of treatment rooms, wards, prevention and/or diagnostic consulting rooms,- existence and size of outpatients department.Technical and engineering features (for example):- arrangement of internal/external areas (lay-out),- description of the principal equipment and machinery for diagnosis and/or treatment (e.g. X-ray, scans, nuclear medicine,endoscopes etc.),- construction, and layout of buildings or parts,- viability and access systems (plus possible car parks) and links with the local communication routes.3.4.3.3 Feasibility and option analysisThe feasibility of the projects should be verified according to patient flows and trends and by taking intoconsideration the epidemiological data available.For the alternative options, the critical issues to establish are:- different medical-technological solutions;- the construction of a new infrastructure, or the enlargement of an old one;- different treatment systems.3.4.3.4 Financial analysisThe financial inflows and outflows are:Financial inflowsFinancial outflows• Fees for hospital admission • Investment costs• Fees for diagnosis - works• Fees for treatment - general expenses• Additional services - expenses for special equipment- single rooms • Operating costs• Transfer from government budget - raw materials for operation- maintenance- medicines- medical and administrative personnel costs- out-sourced medical servicesThe time horizon is usually around 20 years3.4.3.5 Economic analysisThe benefits of the investments in health infrastructures relate to people is welfare and can be derivedprimarily from morbidity and mortality changes, added quality of services or efficiency gains. Assigning amonetary value to health benefits is complex. The most prominent techniques are to refer to the marketprices of the service (willingness-to-pay) or to use standard methods, such as the indices for increased life122