N V T VN:CNG TY C PHN T VN U T THO NGUYN XANHTHUYT MINH D N

PHNG KHM LU NG CHO I TNG CNG NHN VINCH U T

N V T VN

CNG TY CP T VN U T

THO NGUYN XANH

(Tng Gim c)

NGUYN VN MAI

Tp.HCM - 4/2015MC LC

1CHNG I: TM TT D N

11.1. Gii thiu ch u t

11.2. M t s b thng tin d n

2CHNG II: CN C U T D N

22.1. Cn c php l

32.2. Cn c quy nh khm sc khe nh k cho ngi lao ng

32.2.1. Khm sc khe nh k cho ngi lao ng theo thng t s 14 ca B Y t

42.2.2. Yu cu ca ngi lao ng i vi ni khm bnh

42.3. Cn c tnh hnh Y t Vit Nam ni chung

42.3.1. Thc trng qu ti bnh vin

62.3.2. Thc trng hot ng ca cc c s y t t nhn

62.4. Kt lun s cn thit u t

7CHNG III: NI DUNG D N

73.1. a im u t d n

73.2. Quy m d n

73.3. Phng n u t

73.3.1. Ngun khch hng

73.3.2. Thit b y t

93.3.3. Nhn s

93.4. Tin u t

10CHNG IV: PHN TCH HIU QU TI CHNH

104.1. Ni dung tng mc u t

104.2. Tin u t

104.3. Cc thng s kinh t v c s tnh ton

114.4. Doanh thu ca d n

114.5. Chi ph ca d n

124.6. Hiu qu u t ca d n

134.7. nh gi hiu qu kinh t - x hi

13CHNG V: KT LUN

CHNG I: TM TT D N

CHNG I: Gii thiu ch u t

Tn cng ty

:

M s doanh nghip:

ng k ln u:

i din php lut:

Chc v:

a ch tr s

: Ngnh ngh KD: CHNG I: M t s b thng tin d n

Tn d n

: Phng khm lu ng cho i tng cng nhn vin a im u t: Ton quc Quy m d n

: 200 chic khm lu ng Mc tiu u t: Xy dng m hnh phng khm lu ng hin i u tin trn c nc. Hnh thc u t: u t mi

Hnh thc qun l : Ch u t trc tip qun l d n thng qua ban Qun l d n do ch u t thnh lp.

Tng mc u t: 1,000,000,000,000 ng

+ Vn u t phng khm lu ng : 340,000,000,000 ng+ Vn gp cho cc bnh vin : 660,000,000,000 ng Tin u t

: Qu II/2015: Hon thnh cc th tc php l

Qu III/2015: Trin khai u t my mc thit b

Qu IV/2015: Tuyn dng nhn s v chun b i vo hot ngCHNG II: CN C U T D N

CHNG II: Cn c php l

Bo co u t c lp da trn c s cc cn c php l sau:

Php lnh Hnh ngh y, dc t nhn s 07/2003/PL-UBTVQH11 ngy 25/2/2003;

B lut Dn s s 33/2005/QH11 ngy 14/6/2005 ca Quc Hi nc CHXHCN Vit Nam;

Lut u t s 59/2005/QH11 ngy 29/11/2005 ca Quc Hi nc CHXHCN Vit Nam;

Lut Bo v mi trng s 52/2005/QH11 ngy 29/11/2005 ca Quc Hi nc CHXHCN Vit Nam;

Lut Doanh nghip s 60/2005/QH11 ngy 29/11/2005 ca Quc Hi nc CHXHCN Vit Nam;

Lut Thu thu nhp doanh nghip s 14/2008/QH12 ngy 03/6/2008 ca Quc Hi nc CHXHCN Vit Nam;

Lut thu Gi tr gia tng s 13/2008/QH12 ngy 03/6/2008 ca Quc Hi nc CHXHCN Vit Nam; Lut Khm bnh cha bnh s 40/2009/QH12 nm 2009 ca Quc Hi nc CHXHCN Vit Nam ban hnh 23/11/2009;

Ngh nh s 103/2003/N - CP ngy 12/9/2003 ca Chnh ph qui nh chi tit thi hnh mt s iu ca Php lnh hnh ngh Y, Dc t nhn;

Ngh quyt s 05/2005/NQ - CP ngy 18/04/2005 ca Chnh ph v y mnh x hi ho cc hot ng gio dc, y t, vn ho v th dc th thao;

Ngh nh s 124/2008 N-CP ngy 11 thng 12 nm 2008 ca Chnh Ph v thu thu nhp doanh nghip;

Ngh nh s 123/2008/N-CP ngy 08/12/2008 ca Chnh ph Qui nh chi tit thi hnh Lut Thu gi tr gia tng;

Ngh nh s 112/2009/N-CP ngy 14/12/2009 ca Chnh ph v Qun l chi ph u t xy dng cng trnh;

Ngh nh s 29/2011/N-CP ngy 18/04/2011 ca Chnh Ph quy nh v nh gi mi trng chin lc, nh gi tc ng mi trng, cam kt bo v mi trng;

Ngh nh 87/2011/N-CP hng dn Lut Khm, cha bnh ban hnh 27/09/2011;

Thng t 41/2011/TT-BYT hng dn cp chng ch hnh ngh i vi ngi hnh ngh v cp giy php hot ng i vi c s khm, cha bnh do B Y t ban hnh ngy 14/11/2011; Thng t s 14/2013/TT-BYT ngy 6/5/2013 v hng dn khm sc khe; Quyt nh 153/2006/Q-TTg ngy 30/06/2006 ca Th tng Chnh ph ph duyt quy hoch tng th pht trin h thng y t Vit Nam giai on n nm 2010 v tm nhn n nm 2020;

Quyt nh s 4858 /Q-BYT ngy 3 thng 12 nm 2013 ca B Y t v/v ban hnh th im B Y t nh gi cht lng bnh vin;

nh mc chi ph qun l d n v t vn u t xy dng km theo Quyt nh s 957/Q-BXD ngy 29/9/2009 ca B Xy dng;

Cng vn s 1779/BXD-VP ngy 16/08/2007 ca B Xy dng v vic cng b nh mc d ton xy dng cng trnh - Phn Kho st xy dng;

Cc vn bn khc ca Nh nc lin quan n lp Tng mc u t, tng d ton v d ton cng trnh.CHNG II: Cn c quy nh khm sc khe nh k cho ngi lao ngCHNG II: Khm sc khe nh k cho ngi lao ng theo thng t s 14 ca B Y t Theo Thng t s14/2013/TT-BYT ngy 06 thng 5 nm 2013 ca B trng B Y t quy nh hng nm, ngi s dng lao ng phi t chc khm sc kho nh k cho ngi lao ng, k c ngi hc ngh, tp ngh; lao ng n phi c khm chuyn khoa ph sn; ngi lm cng vic nng nhc, c hi, ngi lao ng l ngi khuyt tt, ngi lao ng cha thnh nin, ngi lao ng cao tui phi c khm sc khe t nht 06 thng mt ln. Ni dung khm ti thiu theo thng t 14 quy nh bao gm:STTNi dung khm NghaGhi ch

Khm tng qut(o huyt p, chiu cao, cn nng, Khm TQ ni, ngoi, da liu, mt, RHM, TMH, phn loi sc khe)Khm nh hng bnhCn c Thng t s14/2013/TT-BYT ngy 06 thng 5 nm 2013 ca B trng B Y t

X quang phiPht hin bnh l ca tim phi thng qua hnh nh

Cc xt nghim

NGFL Cng thc muPht hin bnh l mu

Glucose (ng huyt)Chn on i tho ng

Urenh gi chc nng thn

Creatininnh gi chc nng thn

GOT - GPTnh gi chc nng gan

TPTNT (Tng phn tch nc tiu)Pht hin bnh l ng tit niu, bnh thn h, vim thn,...

CHNG II: Yu cu ca ngi lao ng i vi ni khm bnh

Ai cng bit, ngi lao ng v cc n v cung cp dch v y t u hot ng trong gi hnh chnh. Nu n v cung cp dch v y t khng m bo v cht lng khm s nh hng n thi gian lm vic ca ngi lao ng, t nh hng n hiu qu kinh doanh ca doanh nghip. V vy, ngi lao ng v doanh nghip ni chung lun mong mun cc n v cung cp dch v y t phi m bo nhng yu cu sau ngoi yu t tin li:1. Gi: Vic so snh chi ph gia mt s n v cung cp dch v l cn thit. Cn ch l mi ni khm c th cu hnh gi khm khc nhau. Do , vic so snh gi gia hai gi khc nhau l khng hp l v khng thc t. Cch tt nht l yu cu bo gi theo mt gi c chn sn.

2. Thi gian: thi gian rt quan trng i vi doanh nghip, v vy mt s lng ln cng nhn vin n bnh vin khm cng mt thi im s nh hng n nng sut hot ng v hiu qu kinh doanh ca doanh nghip, nht l khi bnh vin qu ti, ngi i khm phi ch i lu.3. Quy trnh: Mt c s khm c quy trnh hp l v r rng chng t tnh chuyn nghip cao v hn ch c nhng sai st, nhm ln. Cn ch l vic khm nh k c thc hin hng lot, s lng ln nn vic ln ln mu, nhm s l rt d xy ra nu khng c c ch lm vic khoa hc v phn cng trch nhim r rng.

4. C s vt cht.5. Tnh thn thin ca dch v: Bao gm phong cch phc v cng nh cch t chc cuc thm khm. Tnh tin li, s nhanh chng v n ci ca nhn vin l nhng im cng chn la.CHNG II: Cn c tnh hnh Y t Vit Nam ni chungCHNG II: Thc trng qu ti bnh vin

Sc khe l vn qu nht ca con ngi, do vy nhng nm qua ng v Nh nc lun quan tm chm lo sc khe nhn dn. Nh , ngnh y t t c mt s thnh tu ng ghi nhn, c bn b quc t nh gi cao. Tuy nhin, trong tnh hnh thc t cng nh nhu cu ngy cng cao ca nhn dn th nn y t nc nh cn c bc thay i t ph t c s vt cht, trang thit b, i ng nhn lc n c ch hot ng.Nh cp trn, mc d hin nay mng li khm-cha bnh c bn t c nhng mc tiu ra, nhng cng vi s bt cp chung trong qu trnh i mi th h thng khm cha bnh cn cha thch ng kp thi vi s pht trin ca nn kinh t x hi; s thay i v c cu bnh tt; nhu cu ngy cng cao v a dng ca nhn dn;... Chnh v vy m trong nhng nm gn y hin tng qu ti bnh vin tr nn ngy cng ln, gy kh khn, bc xc cho ngi bnh v c cn b y t cc bnh vin, c bit l cc bnh vin tuyn trn, v mt s nhm chuyn khoa cc thnh ph ln.

Theo thng k ca B Y t, cng sut s dng ging bnh trung bnh ca bnh vin cng ln ti 110%, nhiu bnh vin tuyn Trung ng nh ti bnh vin K trung ng 170%, BV Bch Mai 168%, Ch Ry 139%... Khoa phu thut tng hp, bnh vin K trung ng cng sut s dng ging ln ti 340%, Khoa phu thut v l 326%, Khoa x (282%). Ti cc BV a khoa ln nh Ch Ry, Vit c, Bch Mai, Nhi Trung ng cc khoa nh tim mch, h hp, ung bu, ni tit cng lun trong tnh trng qu ti khong 200%.T thc t cng nh nghin cu cho thy, tnh trng qu ti bnh vin l nguyn nhn dn ti:

1. Gim cht lng dch v khm, cha bnh, chm sc ngi bnh:

a) i vi khm bnh, iu tr theo n hoc iu tr ngoi tr: ngi bnh phi ch i lu khi khm bnh, lm xt nghim, th thut; thi gian khm bnh, t vn hn ch.

b) i vi iu tr ni tr: ngi bnh phi ch i lu khi cn c cung cp dch v th thut, phu thut...; vic chm sc theo nhu cu ngi bnh b hn ch nh phi nm chung gng bnh; vic hng dn, thc hin v kim tra v chm sc ngi bnh nh t vn bnh tt, chia s tnh cm, sn sc n ung, ng ngh, ting n, cc iu kin v sinh c nhn, ung thuc, tim thuc theo gi, theo di ngi bnh theo phn cp h l b hn ch.

2. Thi gian iu tr b ko di do ch i cc k thut chn on, can thip hoc do bin chng trong qu trnh iu tr;

3. Gim s hi lng v mc hp tc ca ngi bnh v gia nh ngi bnh vi bnh vin. S bc bi, chn nn ca ngi bnh v gia nh ngi bnh dn n tnh trng hung d, th l v thm ch lng m nhn vin y t, gia tng cc n th khiu ni, cc hnh vi gy hu qu nghim trng i vi bnh vin v nhn vin y t;

4. Tng t l tai bin, bin chng, in hnh l nhim khun bnh vin, t l sai xt trong chuyn mn tng nh sai xt trong k n, cho sai thuc, sai liu dng, nhm ln v tn sut, khong cch gia cc ln dng thuc;

5. Gia tng chi ph iu tr i vi ngi bnh, bnh vin v x hi;

6. Gy nhng tn hi v sc khe tm thn ca bc s v nhn vin y t, do phi lm vic trong iu kin qu ti v cng vic, thi gian v hn ch khng gian gy nn mt mi, tm trng bc xc, dn n tng nguy c mc bnh trm cm hoc gy cu gt, lm gim kh nng chnh xc trong thc hin k thut, gim s tn tnh trch nhim i vi ngi bnh.

CHNG II: Thc trng hot ng ca cc c s y t t nhn

Cc c s khm cha bnh t nhn cn cha to c lng tin v thu ht c lng bnh nhn nht nh v l do:

+ C s vt cht, trang thit b cn hn ch

+ i ng nhn lc cho vn hnh thit b v chn on, khm cha bnh cn hn ch

+ T chc hot ng phng khm thiu chuyn nghip

+ Khm cha bnh bo him y t

+ S lng cc bnh vin, phng khm uy tn v c cht lng tht s tt thng khng nhiu, v ch yu tp trung ti hai thnh ph ln l H Ni v Tp. H Ch Minh

Trong khi cc bnh vin cng ang qu ti th cc bnh vin t li cha hot ng ht cng sut.CHNG II: Kt lun s cn thit u t

Nhn thy nhu cu khm bnh nh k ca ngi lao ng; ng thi hiu r tnh hnh y t nc ta, ch u t chng ti quyt nh u t d n Phng khm lu ng cho i tng cng nhn vin trn phm vi c nc vi quy m ban u l 200 chic xe lu ng c trang b nhng thit b y t hin i nh mt phng khm.Tm li, vic u t d n l hon ton cn thit, l mt nh hng u t ng n khng ch gii quyt cc hiu qu x hi, gii quyt nhu cu m cn gp phn thc y s pht trin y t c nc ni chung.CHNG III: NI DUNG D N

CHNG III: a im u t d n

D n s c trin khai ti cc tnh thnh trong c nc.CHNG III: Quy m d nD n s u t 200 xe lu ng c trang b cc thit b y t hin i nh mt phng khm nhm kim tra sc khe nh k cho ngi lao ng theo Thng t 14 ca B Y t.CHNG III: Phng n u tCHNG III: Ngun khch hng

Khch hng s dng th bo him y t.

Khch hng lm vic lao ng trong cc khu cng nghip k hp ng vi ch u t. D n lin kt vi cc bnh vin ln nh bnh vin Ch Ry, bnh vin Bch Mai nu bnh nng cn lu tr.CHNG III: Thit b y t Hng mc thit b

Xe bus (GDW6117HK/Daewoo Bus,Viet Nam)

Thit b h tr in p P.S.U

H thng X-Quang KTS (My X quang thng quy cao tn: Radnext 32, H thng thu nhn nh X quang KTS: Aero DR)

My o huyt p t ng

T lnh bo qun mu (BPR-160/ Hanshin Medical/ Hn Quc)

My siu m 4D mu

Hnh nh thit b

M hnh xe bus lu ng

Trang thit b khm cha bnh bn trong xe(Hnh nh my mc c nh km theo Ph lc)CHNG III: Nhn s Mi xe c trang b 4 nhn s:+ Bc s a khoa1

+ Chuyn vin xt nghim1

+ Chuyn vin chn on hnh nh1

+ Tr l h s th tc v BHYT1

CHNG III: Tin u t

Qu II/2015: Hon thnh cc th tc php l

Qu III/2015: Trin khai u t my mc thit b Qu IV/2015: Tuyn dng nhn s v chun b i vo hot ngCHNG IV: PHN TCH HIU QU TI CHNH

4.1. Ni dung tng mc u t

Mc ch ca tng mc u t l tnh ton ton b chi ph u t xy dng D an Phng khm lu ng cho i tng cng nhn vin lm c s lp k hoch v qun l vn u t, xc nh hiu qu u t ca d n.

Tng mc u t ca d n: 1,000,000,000 ng (Mt ngn t ng), bao gm: Chi ph u t xe khm cha bnh lu ng: xe bus, my mc thit b trang b cho 200 xe v vn u t gp ti cc bnh vin.TT Chi ph u t S lng Gi

1 Chi ph u t 1 xe khm cha bnh lu ng 200 1,700,000

Xe bus (GDW6117HK/Daewoo Bus,Viet Nam)

Thit b h tr in p P.S.U

H thng X-Quang KTS (My X quang thng quy cao tn: Radnext 32, H thng thu nhn nh X quang KTS: Aero DR)

My o huyt p t ng

T lnh bo qun mu (BPR-160/ Hanshin Medical/ Hn Quc)

My siu m 4D mu

2Tng mc u t 200 340,000,000

Vn mua c phiu bnh vin 660,000,000

Tng 1,000,000,000

4.2. Tin u t

K hoch trin khai d n nh sau:

Qu II/2015: Hon thnh cc th tc php l

Qu III/2015: Trin khai u t my mc thit b Qu IV/2015: Tuyn dng nhn s v chun b i vo hot ng4.3. Cc thng s kinh t v c s tnh ton

Cc thng s gi nh dng tnh ton hiu qu kinh t ca d n trn c s tnh ton cc d n trin khai, cc vn bn lin quan n gi bn, cc ti liu cung cp t Ch u t, c th nh sau:

Theo d kin tng u t l 1,000,000,000 ng (Mt ngn t ng), trong bao gm vn ch s hu v vn huy ng t cc c ng.

Doanh thu ca d n c t+ Khm cha bnh lu ng v chia c tc t ngun vn Chi ph hot ng ca d n+ Chi ph lng

+ Chi ph nhin liu

+ Chi ph xng du, vn phng phm+ Chi ph qun l doanh nghip.

Thu thu nhp doanh nghip p dng 20% t nm 2016.

4.4. Doanh thu ca d n

Dch v khm cha bnh lu ng s c lin kt vi cc khu cng nghip, nh my, x nghip tp trung nhiu cng nhn nhm to s thun li h c th kim tra sc kho u n m khng lm nh hng n thi gian lm vic.

Gi s c khong 500 lt khm cho mi xe vi ph khm cha bnh thu c sau khi thanh ton li vi BHYT l 150,000 ng/ngi/khm cha bnh. Tuy nhin cc nm u th hiu sut hot ng cha cao.

Gi khm cha bnh iu chnh theo gi ca nh nc, tuy nhin d n gi nh tng 3% sau 5 nm.

Doanh thu hot ng

vt: 1,000 ngNm2016201720182019

Doanh thu cho thu

T l tng gi1.031.031.031.03

Doanh thu t khm lu ng

S ca khm trung bnh/xe3,6004,8005,1005,400

S xe200200200200

Gi dch v155155155155

Doanh thu111,240,000148,320,000157,590,000166,860,000

4.5. Chi ph ca d nChi ph hot ng bao gm chi ph lng v chi ph xng du, vn phng phm. Chi ph lng: mi xe khm cha bnh hot ng s bao gm 4 nhn si ng bc sS lng(ngi)Mc lng

(ngn ng)

Bc s a khoa18,000

Chuyn vin xt nghim14,500

Chuyn vin chn on hnh nh15,000

Tr l h s th tc v BHYT14,000

Chi ph xng du, vn phng phm

Ngoi ra, khi d n i vo hot ng cn c cc chi ph xng du, vn phng phm c tnh khong 20,000,000 ng/thng.

Chi ph marketing

Ngoi ra, thi gian u hot ng d n cn phi c thm cc chi ph qung co v truyn thng, chi ph ny chim khong 2% doanh thu hng nm.

Chi ph qun l

Chi ph qun l c tnh chim 3% doanh thu.

Bng tng hp chi ph d n

vt: 1,000 vn

Nm20162017201820192020

T l tng mc lng hng nm1.001.051.101.161.22

S thng hot ng1212121212

Hiu sut hot ng60%80%85%90%100%

Chi ph hot ng-----

Chi ph lng314,760330,498347,023364,374382,593

Chi ph xng du, vn phng phm247,200247,200247,200247,200247,200

Chi ph marketing2,224,8002,966,4003,151,8003,337,2003,708,000

Chi ph qun l3,337,2004,449,6004,727,7005,005,8005,562,000

Tng chi ph6,123,9607,993,6988,473,7238,954,5749,899,793

4.6. Hiu qu u t ca d n1Tng mc u t 340,000,000,000 VND

2Gi tr hin ti thun NPV (30 nm)328,463,239,000 VND

3T sut hon vn ni b IRR33.8%

4Thi gian hon vn4 nm

5nh giHiu qu

Qua qu trnh hoch nh, phn tch v tnh ton cc ch s ti chnh trn cho thy d n mang li li nhun cho ch u t, sut sinh li ni b cao hn s k vng ca nh u t v kh nng thu hi vn nhanh.4.7. nh gi hiu qu kinh t - x hi

Cng vi xu hng pht trin ca nc ta trong giai on hin nay, khi d n i vo hot ng s mang li hiu qu kinh t cng nh gp phn bo v sc kho cho ngi lao ng, to iu kin thun li mi ngi c th bo v sc kho v cha tr kp thi.D n mang tnh kh thi cao, st vi thc t, c nhiu tc ng tch cc n s pht trin kinh t x hi. y l m hnh khm cha bnh linh hot v thng minh, mang tnh kh thi cao. D n xy dng s ng gip cho Nh nc v a phng c ngun thu ngn sch t Thu GTGT, Thu Thu nhp doanh nghip, ng gp vo s pht trin th trng bt ng sn ca t nc, ng thi bo v sc kho cho lc lng lao ng trong c nc.CHNG V: KT LUN

Vic thc hin u t D n Phng khm lu ng cho i tng cng nhn vin c nh gi kh thi bi xut pht t nhng nhu cu thit thc cng vi mong mun kinh doanh thu li li nhun trong tng lai. D n khng ch p ng nhu cu khm bnh nh k cho ngi lao ng mt cch tin li nht m cn i ng ch trng ca B Y t v gp phn pht trin kinh t x hi nc ta. Ring v mt ti chnh, d n c nh gi rt kh thi thng qua k hoch vay vn, s dng vn, chi ph u t, chi ph hot ng v ngun doanh thu.

V vy, Cng ty mong mun cc c quan ban ngnh, cc n v ti tr vn u t xem xt, ph duyt d n sm c trin khai i vo hot ng. Tp.HCM, ngy thng nm 2015

PHNG KHM DI NG CHO I TNG CNG NHN VIN

Tp.HCM - 4/2015

THUYT MINH D N

CH U T

N V T VN:

CNG TY C PHN T VN U T THO NGUYN XANH