Construction and operation of multidisciplinary in-hospital under the State Enterprise ÂŤKaraganda State Medical UniversityÂť in Karaganda city
March, 2016
Karaganda State Medical University University’s Key Facts
1950
The University was founded
2005
The University has successfully gained QMS certification to ISO 9001 NQA-UK (Great Britain).
2009
It received the University status
2015
QMS Recertification
TODAY
There are 35,848 graduates
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Karaganda State Medical University Strategically Facts MISSION Karaganda State Medical University is the leader in the field of medical education training health specialists meeting the best global practice and supporting national health VISION
Research University, implementing educational activity through research, practice and innovation VALUES Conformism Innovations Medical education market leadership
Corporate patriotism Integration and cooperation STRATEGIC DIRECTIONS OF THE UNIVERSITY DEVELOPMENT Corporate University management Human resources Innovations in education Research
and innovations
Developing integrated health systems
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Karaganda State Medical University University Partners and Memberships
University of Barcelona, Spain St. George’s University of London, UK
Graduate school of Management Barcelona, Spain University of Milano, Italy University of Poitiers, France University of Porto, Portugal Medical University of Plovdiv, Bulgaria National University of Vilnius, Lithuania University of Albany, USA State Medical University of Medicine and Pharmacy, Moldova Ataturk University, Turkey National Taiwan University, Taiwan (R.O.C.) International
Medical University, Malaysia;
Adiyaman University , Turkey Siberian State Medical University
Novosibirsk State Medical University Altay State Medical University, Russia 4
Karaganda State Medical University University Structure
4 faculties 51 departments
Center for Monitoring of Antibiotic Resistance
Diagnostic center
Center of practical skills
13 educational and research laboratories
Center for Clinical Immunology and Pharmacology
Research Center for environmental influences
Dental clinic
IT-campus 5
Karaganda State Medical University Students and staffing
7789 students 7660 Undergraduate, including 763 international students
48 Master students 81 PhD students
934 staff members 1 academician of the National Academy of Science of the RK 2 academicians of the Academy of Natural Sciences of the RK 63 Full Professors 194 Associate Professors and PhDs 97 Masters
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Karaganda State Medical University Educational programs implemented in KSMU
8 − − − − − − − −
Undergraduate Programs
General medicine Stomatology Public Health Pharmacy Nursing care Medical-preventive care Biology Pharmaceutical Production Technology
7 − − − − − − −
Postgraduate Masters Programs
Medicine Public Health Nursing care Pharmacy Medical-preventive care Biology Pharmaceutical Production Technology
4 − − − −
PhD Programs
Medicine Public health Pharmacy Pharmaceutical Production Technology
34 Residency Programs 52 CPD Programs 7
Karaganda State Medical University Erasmus + projects participation
Erasmus + project TAME Training Education against medical errors KSMU is the official coordinator of program First medical education project aimed at targeting avoidance of error without damage or injury to patients.
International Credit Mobility programs with Universities: For 2015 – 2016 and 2016 – 2017 years Lund University, Sweden University of Poitiers, France Medical University of Plovdiv, Bulgaria University Porto, Portugal
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Karaganda State Medical University Areas of research and innovations
Ecology Environment Immunopathology Cancer Cardiovascular disease and diabetes Research in medical education
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University Clinic in Karaganda Project’s Goals
To create a modern material base for Karaganda State Medical University for the purpose of: the development of practical skills in a university clinic in the framework of student learning, professional development and retraining of doctors. sustainable improvement of quality of medical care on the basis of access to advanced technologies and scientific developments; carrying out the actual clinical and laboratory research with immediate results in a transfer of practical health care.
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University Clinic in Karaganda Preliminary CAPEX Estimation
14 599,56 mln. KZT Basic objects of construction 266,88 mln. KZT Energy Sector Facilities 158,76 mln. KZT Temporary buildings Total CAPEX*: 17 320,13 mln. KZT (48,21 mln. USD) including Fixed Assets 5 857,09 mln. KZT (16,30 mln. USD)
* calculated in prices of 2001 year as of 2014 -2017
38,43 mln. KZT Objects Auxiliary and Service Facilities 8,48 mln. KZT Transport and Communication Facilities 362,75 mln. KZT Additional construction costs 30,11 mln. KZT Others 1 855,72 mln. KZT VAT
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University Clinic in Karaganda Project Preparation Timeline
Due Diligence
In process: • Technical feasibility
Preparatory actions: • Tender Documents • Draft Concession Agreement • Examination of concession documents by authorized organizations
I stage Prequalification process
Expected completion time: July, 2017
Preparatory actions: • Financial feasibility • Social and Economic Research • Risk research • Examination of concession proposal by authorized organizations Expected completion time: July, 2016
Tender
II stage Evaluating of technical proposals and priced bids
Expected completion time: December, 2016
May 2018
Commercial Close
Completed: • Legal Due Diligence • Market research
Tender’s Preparation
Expected completion time: March, 2018
Result of Stage: Concession Proposal
Tender Documents and Draft Concession Agreement
Concession Agreement
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University Clinic in Karaganda In-Patient Units
Multidisciplinary surgical unit
110
abdominal surgery, chest surgery, urology, emergency gynecology, vascular surgery, neurosurgery, casualty, contaminated surgery, colorectal, ophthalmologic, oral surgery
Therapeutic unit pulmonology, cardiological, gastroenterology, nephrological, endocrinous, hematologic, hematologic, stroke, rehabilitation
Obstetric-gynecologic unit
125 rheumatologic,
allergology,
65
gynecology, IVF, pregnancy pathology, birth, postnatal, newborn pathology, nursing of premature
Additional Operating unit
15 13
University Clinic in Karaganda Legal Scheme’s Options
Facility (Infrastructure) Scheme
Integrated Scheme
DESIGN
Concessionaire
Concessionaire
CONSTRUCTION
Concessionaire
Concessionaire
FINANCING
Concessionaire
Concessionaire
MAINTENANCE
Concessionaire
Concessionaire
MEDICAL SERVICES
University
Concessionaire
EDUCATION SERVICES
University
University 14
University Clinic in Karaganda Facility (Infrastructure) Scheme
Concession agreement
CSPP*
Grantor
Concessioner Technical operator
KSMU Medical Services’ Operator
* The Committee of State Property and Privatization 15
University Clinic in Karaganda Facility (Infrastructure) Scheme
Concession agreement
CSPP*
Grantor
Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire CSPP transfers object of the concession to the economic management of KSMU KSMU Medical Services’ Operator
* The Committee of State Property and Privatization 16
University Clinic in Karaganda Facility (Infrastructure) Scheme
Concession agreement
CSPP*
Grantor
Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire
II*
CSPP transfers object of the concession to the economic management of KSMU KSMU Medical Services’ Operator
I*
I* - Operating Management II* - Facility Management
17
University Clinic in Karaganda Facility (Infrastructure) Scheme
Concession agreement
CSPP
Grantor
Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire Agreement on CSPP transfers object of the concession to the cooperation №1 economic management of KSMU KSMU Medical Services’ Operator
II*
I*
I* - Operating Management II* - Facility Management
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University Clinic in Karaganda Facility (Infrastructure) Scheme
Lender (Bank1) Direct Agreement
CSPP
Grantor
Concession agreement Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire Agreement on CSPP transfers object of the concession to the cooperation №1 economic management of KSMU KSMU Medical Services’ Operator
II*
I*
I* - Operating Management II* - Facility Management
19
University Clinic in Karaganda Facility (Infrastructure) Scheme Repayment of a body and interest on the senior debt
Lender (Bank1) Direct Agreement
CSPP
Grantor
Concession agreement Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire Agreement on CSPP transfers object of the concession to the cooperation №1 economic management of KSMU KSMU Medical Services’ Operator
Return on equity
Shareholders (sponsors)
II*
Other lenders Repayment of a body and interest on shareholders loan
I*
I* - Operating Management II* - Facility Management
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University Clinic in Karaganda Facility (Infrastructure) Scheme Repayment of a body and interest on the senior debt
Lender (Bank1) Direct Agreement
CSPP
Grantor
Concession agreement Concessioner Technical operator
CSPP transfers object of the concession rights of possession and use of the Concessionaire Agreement on CSPP transfers object of the concession to the cooperation №1 economic management of KSMU Agreement on cooperation №2
KSMU Medical Services’ Operator
Patients Partner University Clinic
Students
Return on equity
Shareholders (sponsors)
II*
Other lenders Repayment of a body and interest on shareholders loan
I*
I* - Operating Management II* - Facility Management
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University Clinic in Karaganda Integrated Scheme
Lender (Bank1) Direct Agreement
Repayment of a body and interest on the senior debt Concession agreement Concessioner
CSPP*
Return on equity
Grantor Shareholders (sponsors)
CSPP transfers object of the concession rights of possession and use of the Concessionaire
II* Agreement on cooperation â„–1
Agreement on cooperation â„–2
Partner University Clinic
Shareholders loan Repayment of a body and interest on shareholders loan
KSMU
Students
Patients
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University Clinic in Karaganda Concessioner’s Resource of Revenue
Facility (Infrastructure) Scheme MEDICAL SERVICES NON-MEDICAL SERVICES CAPEX COMPENSATION OPEX COMPENSATION MANAGEMENT FEE
× ˅ ˅ ˅ ˅
Integrated Scheme
˅ ˅ ˅
× × 23
University Clinic in Karaganda Market-Based Revenue
Medical Services Guaranteed volume of free medical care Medical care under of compulsory social health insurance Paid medical services
Non-Medical Services Renting commercial space Catering services Facility services to other organizations
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University Clinic in Karaganda Project Key Indicators
10 years
to
from
percent
16,0
WACC from
years
25
SHAREHOLDERS’ EQUITY
6,0 percent
to
from
10 percent
30
CONCESSION PERIOD
to
percent 25
Karaganda Region Location and Population
Population
Life expectancy
1 369,7
70,27
thsd. people
year
Birthrate
Mortality rate
18,17
9,8
per 1000
per 1000
Average monthly nominal wage 107,82
thsd. KZT
Working age population 62,8
%
or
865,1 thsd. people
Over working age population 13,6
%
or
188,2 thsd. people
According to the Republic of Kazakhstan Agency for Statistics for 2014 26
Karaganda City Healthcare Organizations in Karaganda city
The Primary Health Care (PHC) – 90 (in Karaganda – 8) In – patient hospitals – 49 The private clinics - 209 Quantity of beds on the population of the area – 8 024 Deficiency of bed fund in the area in the directions: Surgery (110 beds) Therapy (140 beds) Gynecology (20 beds) Perinatal medicine (20 beds)
Average Build Depreciation 73,5 66,7
65,9
71,3
72,1
67,7
FY2010 FY2011 FY2012 FY2013 FY2014 9M2015
Average Equipment Depreciation 46,9 40,61
42,54
44,06
40,64
24,52
FY2010 FY2011 FY2012 FY2013 FY2014 9M2015
The necessity in creation of the following centers: Rehabilitations Reproductive medicine 27
University Clinic in Karaganda Interest from Private Side
Potential Concessionaires Eurofinsa, InterHealthCanada, Medicer, ABENGOA INABENSA, VAMED Management und Service, Vinci Construction, BI Group Construction, General Electrics, Philips Kazakhstan, STFA Construction Group, Egis International, HealthCity
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