Based on the general argument of applying a principle of caution to dimensioning and a focus on flexible building design, the expert panel has made reductions to all parameters in relation to the dimension foundation specified by the regions. Based on general principles, the panel has therefore fixed an adjusted financial framework for the investment projects that have received preliminary approval.
Dimensioning the new hospitals
The dimensioning (net floor space) in the future hospitals is a function of three parameters:
Treatment need expresses how many operations, admissions, outpatient treatments, etc., need to be handled by the hospitals in the future.
Capacity utilisation covers the number of hours of operation per day, for example for operating theatres and outpatient clinics, as well as bed occupancy rates. The required number of rooms and the way these need to be distributed can be calculated based on the capacity utilisation and treatment need.
Space standards determine how many square metres of floor space need to be built, given that the hospital needs to contain the necessary number of operating theatres, wards, etc.
The calculated net area is multiplied by a gross/net factor to allow for corridors, equipment rooms, technical functions, etc. and derive a gross area. This in turn is multiplied by a price per square metre to give the total acquisition cost.
The expert panels' dimensioning criteria for the new hospitals
The Kvalitetsfonden construction projects are subject to the following framework conditions and dimensioning criteria, defined by the Government's expert panel.
The regions must adjust the dimensioning of the construction projects based on an expected 50 per cent increase in the number of outpatient treatments and an expected 20 per cent reduction in beds between 2007 and 2020.
An occupancy rate of 85 per cent is assumed for a hospital/wards with a large proportion of acute patients. The panel assumes better bed utilisation in projects involving a large proportion of elective patients.
Degrees of utilisation
The expert panel assumes a capacity utilisation for the treatment areas of around 7 hours a day, 245 days a year.
The regions should adjust the dimensioning based on an average standard area of 33-35 m2 for single occupancy rooms.
The regions should base the construction of new somatic buildings on a gross/net factor of 2.0. For psychiatry, which has significantly less need for equipment etc., a general level of 1.8 should be adequate.
The expert panel has decided that new construction projects should have a maximum price level of DKK 29,000/m2, including DKK 5,800/m2 for equipment, IT and furnishings. This corresponds to 25 per cent of the construction cost of DKK 23,200/m² justifiable for university hospital buildings being constructed on a vacant site or under similar conditions.
For other new construction and auxiliary buildings, a maximum level of DKK 27,000/m², including 4,500/m² for equipment, IT and furnishings (corresponding to 20 per cent of the construction cost of 22,500/m²) is deemed to be adequate.
For psychiatry, a price level of up to DKK 22,000/m² (total price incl. equipment, etc.) may be justified.
Costs of renovation will vary depending on the specific mix of construction and renovation, and the costs have therefore simply been reduced by 20 per cent.
IT and equipment
For new construction on a vacant site the expert panel has decided that 25 per cent of the construction cost/total budget is a good indicator.
The expert panel has assumed the cost of equipment will be lower in the case of extensions to existing hospitals, where one can expect a higher degree of gradual operational transition and where the hospital typically already performs a number or the majority of the functions and special services the new structure is expected to provide. A base rate of 20 per cent of the new construction cost has therefore been used for such extension projects.
For psychiatry, a level of approximately 3 per cent is considered appropriate, for both renovation and new construction.
The aim of the fixed financial frameworks is not to manage the regions' construction projects at the detailed level. The assumptions about need projection and capacity utilisation, etc. used as a basis for adjustment by the expert panel are not binding in their own right on the implementation of the project. For each specific construction project the region may decide, within the investment framework for a given planning phase, which solutions are appropriate in the local situation – taking into account the general principles for better capacity utilisation, etc., as long as this happens within the specified budget framework.