Table 1.

Key assumptions in estimation of hospital expenditure and revenue

Assumption	Details	Source/justification
Land area required for hospital construction	330 ft2 per bed	Data from 27 district hospitals surveyed under CHSI study [11, 24, 31]
Allocation of open space	20% of the land is allocated for open space	Guidelines for clinical establishments in India [32]
Land purchase cost	₹5000 (US $60.24) per square foot	Prevailing market rates in tier-2 and tier-3 cities of India [33]
Basic building construction cost	₹1800 (US $21.69) per square foot	Market survey data and interviews with construction stakeholders [34–36]
Specialized medical infrastructure cost	₹600 (US $7.23) per square foot for oxygen supply, fire safety systems, and air conditioning	Market survey data and interviews with construction stakeholders [34–36]
Financing strategy for land and construction	20% as down-payment, remaining amount amortized via equated monthly instalments over 40 years at 9% annual interest	Monetary policy of Reserve Bank of India and standard banking regulations [37]
Maintenance cost for equipment and furniture	10% of initial cost annually	Data from 27 district hospitals surveyed under CHSI study [11, 24, 31]
Building maintenance cost	5% of construction costs annually	Data from 27 district hospitals surveyed under CHSI study [11, 24, 31]
Future cost adjustment	7% annual inflation rate	Inflation trend in India over the past decade [38]
Human resource salary increment	8% annual increase	Consumer price inflation-linked norms in India [39]
Expenditure on drugs and consumables	Calculated using patient volume, types of drugs used, and drug prices	Data from 27 district hospitals surveyed under CHSI study [11, 24, 31]
Revenue from OPD services	15% of the IPD services	Annual reports of private hospitals [40, 41]
Bed-to-doctor ratio	8.13	Data from 27 district hospitals surveyed under CHSI study [11, 24, 31]