Bills

Now let's see how use of special instruments is charged in hospital bills.
I had no knowledge of cost anaysis until recently when i had an opportunity to interact with one expert whose kin was admitted in my hospital and he used to be in her room every evening.
Robotic knee surgery has become the talk of the town. I found out its price and was shocked to know it to be ₹ 8 crores. I started wondering how does the hospital charge the patient and recover its price. So I asked Mr. Expert about it. He explained it in very simple words which I convey to you to understand.

1. If you borrow 8 cr at 11 percent for a term of 10 years, your EMI is ₹ 11 lakh plus.

2. Life of medical equipment can never be more than 7 to 8 years but lets assume it to be 10 years. At the end of 10 years if you wish to buy a new unit you need at least 3 to 4 times todays investment. Assuming depreciated value of present robo to reduce to zero after 10 years, its monthly devaluation comes to ₹6.67 lakh. Amount so collected can be used as a margin money for the loan to replace this outdated machine then.

3. After warranty of 2 years is over, one needs to spend on AMC to the tune of 15 percent per year. Assuming it to be only 10 percent only monthly outgo becomes ₹ 5.3
lakhs when extrapolated to 10 years.

Not calculating space, skilled manpower needed to use this machine, power consumption and associated consummables for each surgical procedure monthly costing for a 8 crore bare machine is ₹23 lakh.
If one has to recover ₹ 23 lakhs in 25 working days of a month, ₹ 1 lakh of daily billing of the equipment is necessary for a break even alone…
₹ 1 lakh divided by number of surgeries in a day is the cost analysis for special instrument……

FEMTO Eye lasers, 3T MRI machines cost in this range…
Pricing of different hospitals for similar instruments can vary according to the make and version of the equipment.
Routine equipment in the operation theatre is not charged separately from OT charges but costly instruments not used in every case is only billed additionally. In Orthopaedics, we use very expensive equipment like pneumatic or battery operated power drills, power saw, imported reaming sets, C arm image intensifiers, underwater cauteries, fluid pumps , arthroscopic surgery equipment, helium lasers, harmonic scalpels which have a limited life. Hence they are charged separately but still not to the extent cost accountants advise!!!!
Thus, people must know that those who want state of the art surgery , have to pay for it and the amount spent doesn't go in the doctor's pockets……

DR. NITIN BHAGALI
Hospital Board Of India
Pune Chapter

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