750
Cost and Time Analysis: Life Cost
When conservative escalation rates were applied to the data for a forty
year period, it indicated that the total average annual cost of these three
items alone would amount to about 12.5% of the original construction cost.
If the 0.5% marginal first cost of the system building is to be paid for out of
an item costing 12.5% of the same base figure, then 1/25th, or 4%, of that
item must be saved each year.
752.2.4
To summarize, if a systems hospital cost 8% more than an equivalent
conventional hospital, then it must allow a 4% reduction in the annual total
cost of housekeeping, maintenance and alterations to break even after
forty years.
752.3
ANALYSIS OF EXISTING VA HOSPITALS
752.3.1
The field change orders, Central Office change orders and the station-
initiated completion items for each of the five hospitals studied for the cost
base (Section 530) were reviewed with the intent of relating them to the
integrated subsystems. The results of this attempt, however, were
inconclusive to the point that tabulations would be worthless.
752.3.2
It is apparent that since most of the hospitals are relatively new, there is a
conflict between the needs for changes resulting from "settling down" and
those dictated by new technology or other new requirements. The time
lapse of at least seven years from inception to occupancy increases this
conflict. At any rate, none of the subsystems provided for any form of
adaptability in spatial arrangements or performance characteristics. The
oldest hospital studied, Martinez, was constructed under a policy of only
partial air-conditioning. Expanding the cooled areas of this hospital has
been very costly. It is interesting to note that, in spite of the restricted
cooling in the initial design, the original cost of this installation is among
the highest. (See Section 532.4.7).
752.3.3
There have been very few additions to the hospitals studied, in terms of
adding space. There have been, however, numerous instances of
conversion of ward areas to other uses. This has resulted in the fact that
many of the hospitals do not contain the number of nursing beds required
by their original design program. An outstanding example of this is a
complete floor of the tower at Miami which now contains administrative
offices created by merely adding doors and partitions in the five-bed ward
areas. Such situations appear to be characteristic; their scope and costs
practically impossible to identify.
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