Improving Chile’s healthcare infrastructure

Antofagasta’s new hospital facilities are being constructed through a concession mechanism that forms part of the health system reform process put forward by the Chilean government. The purpose of that reform is to improve the country’s healthcare infrastructure. The need to increase efficiency in the healthcare sector and to meet the infrastructure requirements of 21st […]

 
Sacyr’s Hospital Puerta de Hierro Majadahonda in Madrid. With 794 beds, it is one of the biggest hospitals in Spain 
Author: Ignacio Aguirre, Project Manager, Sacyr
November 6, 2013

Antofagasta’s new hospital facilities are being constructed through a concession mechanism that forms part of the health system reform process put forward by the Chilean government. The purpose of that reform is to improve the country’s healthcare infrastructure.

The need to increase efficiency in the healthcare sector and to meet the infrastructure requirements of 21st century healthcare led to the creation of a new hospital concessions programme. As the demands of public health users change, along with epidemiological changes, ageing of the population and a noticeable increase in chronic diseases and other illnesses of greater complexity, new and better infrastructure is required to keep up.

The tender for the new hospital at the city of Antofagasta was launched as part of the first phase of this programme. This city, capital of the ‘second region’ of Chile (the Antofagasta region), is located about 1,100km north of the capital of the country, Santiago.

[The Antofagasta project] represents an investment of over $300m and will benefit over 260,000 people

The bidding began with an international prequalification process, with the aim of attracting companies with proven experience in the development of hospital infrastructures under the concession model. Finally, in October 2012, six consortia representing 15 national and international companies submitted their bids. In June 2013, the Government of Chile officially awarded the contract to a consortium led by Sacyr, who had the highest technical and economical score.

Building a reputation
The Sacyr Group is a world leader in the construction and operation of infrastructures, with vast experience in the hospital sector. Sacyr ranks ninth globally by number of concessions in which it participates, according to the ranking prepared by Public Works Financing (PWF) in 2012. Sacyr has 34 concessions spread through five countries (Spain, Portugal, Chile, Italy and Ireland), 21 highways totalling 1,700km, seven hospitals with more than 3,000 beds, two transportation hubs, an airport, two metro lines and a services areas company.

Between 2006 and 2012, Sacyr built 18 hospitals, representing an average of 2.3 hospitals per year or 324 hospital beds per year (5,842 total beds in six years), and helped hundreds of thousands of citizens gain access to operating rooms of different specialties, childbirth rooms, dialysis units, boxes for ambulatory care and emergency room, etc. These projects also involved providing the ancillary services the hospitals required, including: plumbing, special facilities (medicinal gases, fuels, protection against intrusion, etc.), electricity, air conditioning, communications, elevators, parking and heliports.

It is important to note that six of the 18 hospitals delivered by Sacyr during this period were set to be managed by Sacyr as concessions for a period of at least 30 years, which emphasises the level of technical and human capacity experience the company possesses.

The Antofagasta hospital is the 12th concession that Sacyr has been awarded by the Ministry of Public Works in Chile (all of which were successfully funded, either in construction or in operation, well within the timelines outlined in the contracts). In Chile, the Sacyr Group has executed over $3.2bn-worth of civil works and infrastructure projects since it first entered the country in 1996.

Antofagasta hospital project
The hospital model developed by the Government of Chile for this project is divided into two distinct phases. The first phase will last approximately four years and includes the development of the final design, the construction of the infrastructure, the provision and assembly of industrial equipment, as well as the purchase and installation of furniture and medical equipment. The second phase will commence once these works are completed. In this phase, the concessionaire will manage and maintain the infrastructure, facilities, industrial equipment maintenance services, as well as the provision of non-clinical support services, including the replacement and maintenance of furniture and medical equipment for 15 years.

The Sacyr-led consortium will also be responsible for the services associated with medical equipment and furniture. These services are very important within the concession because they are vital to the smooth running of the hospital. Thus, Sacyr will conduct the initial acquisition, maintenance and replacement of more than 4,700 pieces of equipment, some of which are technically very complex, such as magnetic resonance and X-ray machines, other imaging equipment, laboratory equipment, surgery equipment, etc.

This project represents an investment of over $300m and will benefit over 260,000 people within the Antofagasta region, plus the additional demand from the cities of Arica and Copiapó.

The new facility will be a state-of-the-art hospital, and Sacyr will provide 18 different support services to it, such as cleaning, maintenance, catering, supply, replacement and maintenance of medical equipment and furniture, etc.). The hospital will have 45 consultation rooms, 24 urgency rooms, 16 dental units, 30 dialysis units, a helipad, auditorium, chapel, library, 730 parking spaces, integrated labour and delivery rooms, 18 operating rooms and 671 beds. The Antofagasta Hospital will become the largest hospital in Chile.

This project has several peculiarities and comes with a special level of technical complexity. The hospital will be located in the Antofagasta region, which is an area of high seismic activity. This is very important when designing the buildings. In addition, the location for the hospital is 30m above sea level and therefore there is a high risk of floods and even tsunamis, so the buildings need to be designed to cater for efficient evacuation procedures in case one of these events occurs.

The consortium led by Sacyr is developing the final design in order to provide the best architectural, structural and functional design, to build a safe hospital that can remain working during a catastrophe. It is envisaged that this hospital will be a referral point in case of emergency. The design will also include easy access for emergency vehicles, such as fire engines and ambulances.

Geographical breakdown of backing
Geographical breakdown of backing