Building hospitals involves addressing many complexities, and clarifying hospital construction costs from the outset is crucial. I am Major Paresh Singhal (ex), a Healthcare Infrastructure specialist, here to assist you. With over a decade of experience in the hospital industry, I have built 15+ hospitals and designed 25+ additional facilities. In this discussion, I will examine the various expenses related to constructing a hospital, focusing on major components such as land, building, and equipment. For improved comprehension, I will categorize these components accordingly. Kindly refer to my prior post on Infrastructure and Space Requirements in a hospital, where I delve into the specific requirements for various departments, including IPD, OPD, Diagnostics, and Administrative (Office, Kitchen) spaces. In this article, our attention will be centered on infrastructure costs, excluding operational expenses.

Various heads in which you can divide hospital Infrastructure and its costs are:

1. Land: I can’t comment on the land cost in your area but can give a general idea of how much you will need. You will need 50% of the total built-up area. So you need 30000 sqft of land for a 100-bed hospital.  Please read my post on the Land requirement for the hospital to read more.
2. Building:  It takes approximately 600 sqft of Build-up area per bed. For a 100-bed hospital total, the build-up area will be 60,000 Sqft. For smaller hospitals (50 beds) area per bed will increase as some common services like Diagnostics do not change much. This area requirement is for a standard hospital. If you are looking to build as per JCI standards or a very expensive boutique hospital area requirement will go to 1200 sqft per bed.  For a hospital catering to Ayushman Bharat patient or very low paying customers (eg if you can’t charge more than 15000 Rs for a C Section) then you should squeeze the size to 350 sq ft per bed. Squeezing should not mean, not to follow basic bed to bed distance or norms of NABH, Fire, AERB. For understanding norms kindly read my post on Hospital planning norms. 

• Cost of basic building: 1800 Rs per sq ft. Basic building means, like flats you get from a builder + lighting fixtures. 
• Subcomponents of a building are RCC frame, Walls, doors, windows, Flooring, Plumbing, Electrical, Painting.

1. Fire fighting: Fire arrangements a per NBC 2016, should be provided. There are 2 components of fire fighting arrangements 

• Cost: 100 rs per sqft of the total built-up area. 
• Fire Detection system: Smoke detector and fire alarm 
• Fire fighting system: Hydrant system, Sprinkler system, fire extinguishers and include an underground water tank, fire pumps, etc.

1. False ceiling: False ceiling is required to run a lot of services above it. We should try to avoid it as it is a source of potential infection.

• Cost: 75 rs per sqft of the total built-up area. Try to put a metal ceiling in place of gypsum as metal is more resistant to microbial growth. 

1. HVAC: Heating ventilation air conditioning. A term from the western world. I have not worked on any heating system as generally in India it is a cooling system only. You can opt for central air conditioning with ducts etc. Or can opt of multi-split System. Plan for fresh air. Avoid central ducting as it is very difficult to disinfect microorganisms. 

• Cost: 300 rs per sqft of the total build-up area

1. Building Façade:  Building has to look good and some minimal amount of Glass and ACP façade can be provided. There are many creative ways to do it other than glass and ACP. India is a hot country so avoid direct sunlight falling on glass or provide thermal insulation. We will further talk about it in my further posts. 

• Cost: 100 rs per sqft of the total built-up area. Assuming only 25 % is the façade area to building floor area.

1. Area work: this includes Boundary wall, Internal road, Security cabin, Roof waterproofing, etc. 

• Cost 100 rs per sqft of the total built-up area, assuming you have land to Build up area ratio of 1 to 2.5.

1. Medical / other Items: You have to cater to central Medical Oxygen supply, central Vacuum. LAN, Telephone, TV, CCTV, etc;

• Cost: 100 rs per sqft of the total build-up area

1. Interiors: the interior is an unending line and here I am limiting it to, Fixed furniture like ward robs, file cabinets on the wall, etc. Mobile non-medical furniture like Table, chair, waiting-seater. Soft Furnishing like, Curtains, blinds, paintings.

• Cost: 100 rs per sqft of the total build-up area

1. Building Equipment:  Larger equipment required are Lift ( at least 1 per 50 beds), Diesel Generator set, UPS, Transformer, Auto voltage regulator. 

• Cost: 150 rs per sqft of the total built-up area. I am mentioning cost apportioned to per sqft of building area so that we do not have too many units while totaling our costs. Please don’t confuse the unit with items in various heads.

1. Medical Furniture:  Beds, bedside storage, trolley carts used by nursing, OT Table, OT light, etc. the list has around 100 + items and I have mentioned major ones and to give an idea of the grouping. 

• Cost: 175 Rs per sqft of the total build-up area

Head	Rs/Sqft	Rs crore  (100 bed)
Basic Building	1800	10.8
Fire	100	0.6
False Ceiling	75	0.45
HVAC	300	1.8
Façade	100	0.6
Area work	100	0.6
Medical	100	0.6
Interior	100	0.6
Building eqpt	150	0.9
Medical Furniture	175	1.05
Total Cost of Infra	3000	18
Medical Equipment		9
Total Capital cost (land Extra)		27

1. Medial Equipment: Major ones are CT scan, ventilators, Colour Doppler, Laparoscope, Endoscope. The list has many items and these will also depend on specialties and services you want to provide. No Cost can be approximated for this head but as per my experience you should spend at least 50 % of the total cost you incur on all the other items mentioned above.  
2. I know experts can debate on all the points I have mentioned, the same as I can dig 100 X on each of the points. But the idea here was to look at a larger picture and plan for a setup. We are an expert Hospital planner and builder, Kindly contact me at 9874637777; 9348954200 or write to me at paresh.Lt@gmail.com and visit my web site www.eywa.pro. If you are looking to build a hospital I and my team of experts are there, we guarantee a saving of 5 % on your project. 

  Read more on How to start Hospital in India?