PROPOSAL PERMOHONAN
PENGADAAN ALAT VENTILATOR NEONATAL
Disusun Oleh :
1. Fajar Ahmad Fauzi
20133010032
2. Muhammad Nasrullah
20133010033
3. Ika Nurcahyani
20133010044
4. Dyan Nova Lesiska N
20133010056
PRODI TEKNIK ELEKTROMEDIK
PROGRAM VOKASI
UNIVERSITAS MUHAMMADIYAH YOGYAKARTA
2016
I. Latar Belakang
Rumah sakit merupakan tempat atau rumah bagi para mereka yang sedang mengalami
ketidakseimbangan atau kondisi tubuh yang sedang tidak stabil atau kondisi fisik yang tidak
baik. Penyebab ini dikarenakan banyak faktor di antaranya kecelakaan yang tidak disengaja,
virus bahkan faktor genetik. Rumah sakit sebagai tempat untuk mengatasi dan mencari
solusi permasalahan tersebut, dalam hal ini dituntut untuk mengedepankan fasilitas
kesehatan di rumah sakit yang baik dan sesuai standar pelayanan yang memadai.
Memberikan pelayanan fasilitas rumah sakit merupakan salah satu bentuk kepedulian
rumah sakit di bidang medis. Fasilitas rumah sakit tersebut dibedakan menjadi 3 bagian
yaitu; peralatan kesehatan (medis, non-medis, mebel air), sarana, dan prasarana. Salah satu
aspek yang penting adalah ketersediannya peralatan kesehatan yang lengkap, berfungsi
dengan baik dan sesuai standar badan kalibrasi.
Pemerintah atau badan khusus penanganan peralatan kesehatan nasional telah membuat
peraturan terkait dengan kelayakan dan standarisasi yang harus dipenuhi oleh public service
dalam hal ini adalah rumah sakit. Peran pemerintah tersebut bertujuan untuk mendorong
demi kemajuan dan perbaikan peralatan kesehatan. Ini merupakan kewajiban bagi
pemerintah untuk memenuhi tugasnya sebagai fungsi regulator, pelaksana dan pembiayaan.
Secara umum jika melihat peraturan pemerintah, alat kesehatan adalah alat yang
merupakan barang, aparat, atau instrumen dengan tiap komponen array bagiannya
diproduksi dan dijual untuk pemeliharaan, perawatan, diagnosa, pencegahan, peringanan,
dan penyembuhan untuk setiap gejala kelainan kesehatan yang terjadi pada tubuh manusia.
Namun dalam pelaksanaan di lapangan masih banyak terjadi kendala-kendala priciple
di antaranya keterbatasan alat-alat yang memadai, maintenance dan service yang tidak rutin,
kerusakan alat yang tidak bisa di repair ulang, bahkan pemeliharaan dan penggunaan
peralatan yang tidak sesuai prosedur sehingga hal-hal tersebut sangat mempengaruhi dan
memperlambat pelayanan mutu kinerja rumah sakit.
Dampak kurangnya penanganan peralatan kesehatan tersebut tentu akan memunculkan
banyak permasalahan. Di antaranya terganggunya penanganan pasien yang membutuhkan
peralatan cepat atau vital. Bahkan resiko yang paling merugikan adalah kematian.
Rumah sakit sebagai pelayan kesehatan harus bersedia bertanggung jawab atas hal-hal
tersebut jika demikian terjadi dan siap menerima segala sanksi serta tuntutan pihak
berwenang terutama pengaduan dari pasien yang tidak bisa menerima secara prosedural.
Karena alat-alat kesehatan semestinya harus dijadikan prioritas utama oleh rumah sakit
sebagai alat pembantu petugas medis untuk melayani pasien bahkan masyarakat umum
yang memang penanganannya tidak hanya tergantung pada pemberian obat.
Dengan menilai dan menimbang segala hal baik administrasi, teknik dan prosedur
peraturan pemerintah tentang peralatan kesehatan yang standar. Maka selaku petugas
lapangan dalam hal ini teknisi elektromedis rumah sakit, memiliki kewenangan untuk
melaporkan dan memberi masukan serta gambaran kepada bagian kepala gudang bagian
pengadaan barang alat kesehatan, untuk menerima proposal pengadaan alat kesehatan
berupa alat ventilator. Untuk segala perincian dan teknis alat serta perhitungan harga akan
dijelaskan pada bagian berikutnya.
Oleh karena itu, tim pimpinan staf elektromedik memutuskan untuk mengajukan
proposal “PERMINTAAN PENGADAAN ALAT VENTILATOR NEONATAL”.
II. Rencana Teknis
Dalam pengajuan proposal ini, kami memiliki dua alternatif alat yang akan diajukan
pengadaannya. Berikut beberapa pembanding yang kami jabarkan sebagai pertimbangan
pemilihan keputusan.
A. Spesifikasi (brochure) dan Gambar Alat
i. Terlampir
B. Rencana Anggaran Biaya
ii. Terlampir
C. Analisis Perhitungan
iii. Terlampir
D. Rencana Jaringan Proyek
iv. Terlampir
E. Rencana Cash Flow
v. Terlampir
III. Keputusan
vi. Terlampir
IV. Daftar Referensi
1.
(E-katalog lkpp 2016), Katalog alat-alat kesehatan, 2016 [online] tersedia :
<e-katalog.lkpp.go.id >. [8 januari 2016 14.47 WIB].
2.
(Scribd 2011) Proposal pengadaan alat kesehatan, 2011 [online] tersedia :
<https://www.scribd.com/doc/76121869/Proposal-Pengadaan-Alat-Kesehatan>.
[6
januari 2016].
3.
(Hamilton medical 2016), The universal ventilator solution, hamilton-C2, 2016
[online]
tersedia
:
<https://www.hamilton-medical.com/dam/jcr:5a76833f-4e77-4cc5-8a31efc7862e1f72/HAMILTON-C2-tech-specs-en-689277.08.pdf>. [6 Januari 2016].
4.
(Imtmedical 2016), Bellavista® 1000, imtmedical, 2016 [online] tersedia :
http://www.imtmedical.com/enus/products/bellavista/Documents/bellavista_Basis_Brochure_EN.pdf [8 januari 2016].
5.
(Detik News 2013), Berita terbaru, detik news, 2013 [online] tersedia :
<http://news.detik.com/berita/2180382/nicu-kurang-hikmah-bayi-gizi-buruk-meninggaldi-rscm> [14 desember 2015].
6.
(Lembaga Bank Indonesia 2016), Kurs transaksi bank ndonesia, bank indonesia,
2016 [online] tersedia :
<http://www.bi.go.id/id/moneter/informasi-kurs/transaksi-bi/Default.aspx>. [8 januari
2016 Pukul 15.20 WIB].
7.
(PT PLN (Persero), Distribusi Jakarta Raya dan Tangerang 2016) Penyesuaian tarif
tenaga listrik, PLN, 2015 [online] tersedia :
<http://www.pln.co.id/disjaya/?p=3645> [7 januari 2016].
8.
(Hamilton medical 2016), The universal ventilator solution, hamilton-C2,
2016[online] tersedia :
<https://www.hamilton-medical.com/Products/Mechanical-ventilators/HAMILTONC2.html> [4 januari 2016].
9.
(APBD DKI Jakarta 2015), Informasi Belanja Langsung, Informasi APBD, 2015
[online] tersedia :
<http://www.jakarta.go.id/v2/apbd/browse/2015#browse>.[13 Januari 2016].
LAMPIRAN I
Spesifikasi Alternatif Alat 1
HAMILTON-C2
Technical specifications
The HAMILTON-C2 mechanical ventilator is a uni-
•
Ventilation of adults, children, and neonates
versal ventilation solution for all patient groups.
•
Tidal volumes as low as 2 ml
The HAMILTON-C2’s compact design and indepen-
•
> 7 h of battery operating time
dence from external power and air supplies allow
•
Independent airsupply
for maximum mobility throughout the hospital. The
•
AdvancedventilationmodesincludingASV®
integrated high-performance turbine guarantees top
•
High-performance NIV ventilation
performance even with noninvasive ventilation.
For more information, visit our website: www.hamilton-medical.com/C2
Technical specifications
Ventilation Cockpit
Dynamic Lung
Real-time visualization of the lungs with representations of tidal volume, lung compliance, resistance, and patient activity
Vent Status
Visual representation of ventilator dependency, grouped into oxygenation, CO2 elimination, patient activity
ASV target graphics
Graphic display of target and actual parameters for tidal volume, frequency, pressure, patient activity, and minute ventilation
Monitoring
Display of 41 monitoring parameters
Real-time waveforms
1)
Paw, Flow, Volume, Ptrachea, CO
2
Others
1)
1)
1)
Loops: P-V, V-Flow, P-Flow, V-FCO
, V-PCO
, Trends: 1, 6, 12, 24, and 72 hours
2
2
Alarms
Operator adjustable
Low/high minute volume, low/high pressure, low/high tidal volume, low/high rate, apnea time,
low/high oxygen, low/high PetCO21)
Special alarms
O2 cell, disconnection, exhalation obstructed, loss of PEEP, pressure not released, flow sensor, pressure limitation, performance limited, battery, power supply, gas supply, oxygen concentration, ASV
Adjustable (1 – 10)
Loudness
Ventilation Modes
Type
Mode
Description
Closed-loop control
ASV
Adaptive Support Ventilation. Guaranteed minute volume based on user
Adult/Ped.
Neonatal 1)
ü
settings and application of lung-protective rules.
Pressure
Volume
Noninvasive
PCV+
Pressure-controlled ventilation. Biphasic breathing
ü
ü
PSIMV+
Pressure-controlled synchronized intermittent mandatory ventilation
ü
ü
SPONT
Pressure support ventilation
ü
ü
APRV
Airway pressure release ventilation
ü
ü
DuoPAP
Duo positive airway pressure
ü
ü
(S)CMV+/APVcmv
(Synchronized) controlled mandatory ventilation
ü
ü
SIMV+/APVsimv
Synchronized intermittent mandatory ventilation
ü
ü
NIV
Noninvasive ventilation
ü
ü
NIV-ST
Spontaneous / timed noninvasive ventilation
ü
ü
1)
nCPAP-PS
Nasal continuous positive airway pressure - pressure control
Maintenance
Blower lifetime
1)
Optional - not available in all markets
Dynamic lifetime surveillance; typically 8 years. 5 year warranty.
ü
Technical specifications
Standards
IEC 60601-1, IEC 60601-1-2, ISO 80601-2-12, CAN/CSA-C22.2 No. 601.1, UL 60601-1
Configurations
Options 1)
Neonatal ventilation, nasal CPAP, volumetric mainstream capnography, sidestream capnography
Electrical and gas supplies
Input voltage
10 0 to 240 VAC, 50 / 60 Hz or 12 to 24 V DC
Power consumption
50 W typical, 150 W maximum
Backup battery time
7 h typical with 2 Li-Ion batteries / hot swappable
Oxygen supply
28 0 to 600 kPa (41 to 87 psi), V´max 120 l/min
Low pressure oxygen
≤15 l/min, max. 600 kPa for low pressure
Air supply
Integrated ultra-quiet turbine
Degree of protection
IP21
Environment
Temperature
Operating: 5ºC to 40ºC (41ºF to 104ºF)
Storage: -20ºC to 60ºC (-4ºF to 140ºF)
Humidity
10% to 95%, noncondensing (operating and storage)
Altitude
Up to approx. 4,000 m (13‘120 ft), 1,100 to 600 hPa
Interface connectors
USB, RS-232, nurse call, CO
2
Event log
Storage and display of up to 1,000 events with date and time
IntelliTrig
Leak compensation
Automatic response to varying leaks and configurable trigger sensitivity in all modes
Inspiratory leakage up to 85 l/min, expiratory leakage up to 30 l/min
IntelliSync
1)
Optional - not available in all markets
Guaranteed rate ventilation
Technical specifications
Controls
Type
Adult / Pediatric
Neonatal
Special functions
Manual breath, O2 enrichment, standby, sigh, screen
Manual breath, O2 enrichment, standby, screen lock,
lock, apnea backup ventilation, inspiratory hold, print
apnea backup ventilation, inspiratory hold, print
1)
screen, suctioning tool, dimmable screen, configurable screen, dimmable screen, configurable quick-start setquick-start settings, start up settings based on patient
tings, start up settings based on patient weight and
height and gender, integrated pneumatic nebulizer,
gender, tube resistance compensation TRC, reference
tube resistance compensation TRC, reference loops
loops
Ventilation modes
See page 2, Ventilation modes
See page 2, Ventilation modes
Patient groups
adult / pediatric
neonatal
Patient height
30 to 250 cm
-
Patient gender
male / female
-
Patient weight
-
0. 2 to 30 kg
(S)CMV+/APVcmv
4 to 80 b/min
15 to 150 b/min
SIMV+/APVsimv+
1 to 80 b/min
1 to 150 b/min
PCV+
4 to 80 b/min
15 to 150 b/min
NIV-ST
5 to 80 b/min
15 to 150 b/min
PSIMV+
5 to 80 b/min
15 to 150 b/min (without IntelliSync 5 to 150 b/min)
DuoPAP
1 to 80 b/min
1 to 150 b/min
APRV
1 to 80 b/min
1 to 150 b/min
1)
nCPAP-PS
-
15 to 150 b/min
Tidal volume
20 to 2,000 ml
2 to 300 ml
PEEP/CPAP
0 to 35 cmH2O
0 to 25 cmH2O
Oxygen
21% to 100%
21% to 100%
I:E ratio
1:9 to 4:1 (DuoPAP 1:599 to 149:1)
1:9 to 4:1 (DuoPAP 1:599 to 149:1)
%MinVol (ASV)
25% to 350%
-
Inspiratory time (TI)
0.1 to 12 s
0.1 to 12 s
Flow trigger
off, 1 to 20 l/min
off, 0.1 to 5 l/min
Pressure control
5 to 60 cmH2O, added to PEEP/CPAP
3 to 60 cmH2O, added to PEEP/CPAP
Pressure support
0 to 60 cmH2O, added to PEEP/CPAP
0 to 60 cmH2O, added to PEEP/CPAP
Pressure ramp
0 to 2,000 ms
0 to 600 ms
P high (APRV/DuoPAP)
0 to 60 cmH2O
0 to 60 cmH2O
P low (APRV)
0 to 35 cmH2O
0 to 25 cmH2O
T high (APRV/DuoPAP)
0.1 to 40 s
0.1 to 40 s
T low (APRV)
0. 2 to 40 s
0. 2 to 40 s
Expiratory trigger sensitivity (ETS)
5% to 80% of peak inspiratory flow
5% to 80% of peak inspiratory flow
Peak flow
up to 240 l/min
up to 240 l/min
Respiratory rate
1)
Optional - not available in all markets
Technical specifications
Monitoring parameters
Type
Parameter
Unit
Description
Pressure
Paw
cmH2O;mbar;hPa Real-time airway pressure
Ppeak
cmH2O;mbar;hPa Peak airway pressure
ü
Pmean
cmH2O;mbar;hPa Mean airway pressure
ü
Pinsp
cmH2O;mbar;hPa Inspiratory pressure
PEEP/CPAP
cmH2O;mbar;hPa Positive end expiratory pressure/
Numeric
Wavemonitoring forms
Vent
Status
Dynamic
Lung
ü
ü
ü
ü
continuous positive airway pressure
Flow
Volume
Ptrachea
cmH2O;mbar;hPa Real-time tracheal pressure
Pplateau
cmH2O;mbar;hPa Plateau or end inspiratory pressure
Flow
l/min
Real-time inspiratory flow
Insp Flow
l/min
Peak inspiratory flow
ü
Exp Flow
l/min
Peak expiratory flow
ü
Volume
ml
Real-time tidal volume
VTE/VTE NIV
ml
Expiratory tidal volume
ü
VTI/VTI NIV
ml
Inspiratory tidal volume
ü
ExpMinVol/MinVol NIV
l/min
Expiratory minute volume
ü
Spontaneous expiratory minute volume
ü
MVSpont/MVSpont NIV l/min
ü
ü
ü
ü
ü
ü
ü
Leakage minute volume
Leak/MV Leak
Time
I:E
ü
Inspiratory-expiratory ratio
ü
ü
b/min
Total breathing frequency
ü
ü
fSpont
b/min
Spontaneous breathing frequency
ü
TI
s
Inspiratory time
ü
TE
s
Expiratory time
ü
%fSpont
%
Percentage of spontaneous breathing rate
ml/cmH2O
Static compliance
ü
ü
ü
ü
ü
AutoPEEP
cmH2O;mbar;hPa AutoPEEP or intrinsic PEEP
ü
RCexp
s
Expiratory time constant
ü
Rinsp
cmH2O*s/l
Inspiratory flow resistance
ü
RSB
1/l*min
Rapid shallow breathing index
PTP
cmH2O*s;mbar*s
Pressure-time product
P0.1
cmH2O;mbar;hPa Airway occlusion pressure
ü
O2
%
Airway oxygen concentration (FiO2 )
ü
mmHg%
Real-time CO2 measurement
FetO2
%
Fractional end-tidal CO2 concentration
ü
ü
PetCO2
mmHg;Torr;kPa
End-tidal CO2 partial pressure
ü
ü
SlopeCO2
%CO2/l
V/Q status of the lung
ü
VTalv
ml
Alveolar tidal ventilation
ü
VTaiv/min
ml
Alveolar minute ventilation
ü
V‘CO2 /min
ml/min
CO2 elimination
ü
VDaw
ml
Airway dead space
ü
VDaw/VTE
%
Dead space fraction measured at the airway opening
ü
VeCO2
ml
Exhaled volume of CO2
ü
ViCO2
ml
Inspired volume of CO2
ü
Carbon dioxide1) CO2
1)
Leakage percentage at the airway
fTotal
Lung mechanics Cstat
Oxygen
%;l/min
Optional - not available in all markets
ü
ü
ü
ü
ü
ü
Technical specifications
Accessories
Cylinder holder, humidifier support, tubing support arm, infusion poole
Compact transport solution
Bed mount and wall mount available
Adapter plate
Quick-lock adapter plate for various applications
es
er
ve
d.
Trolley accessories
Physical dimensions
See illustrations below
Weight
9.5 kg (21 lb) without trolley
Display
10.4 in, TFT color, backlit, touch screen
Main patient outlet
ISO 5356-1; 22M/15F
Oxygen inlet (high pressure)
DISS or NIST male
Oxygen inlet (low pressure)
CPC quick coupling, 3.2 min ID
rig e
ar tra
de
m
Size
14 0 cm
43 cm
(55.1 in)
e
su
bj
ec
(16.9 in)
25 cm
31 cm
(9.8 in)
S
pe
cif
ic
(12.2 in)
4 6 cm
6 6 cm
(26 in)
Hamilton Medical AG
Via Crusch 8, 7402 Bonaduz, Switzerland
( + 41 58 610 10 20
info@hamilton-medical.com
www.hamilton-medical.com
Your contact:
68
92
77
.0
(18.1 in)
Spesifikasi (brochure) Alternatif Alat 2
Design and performance
Good things can be improved. With this in mind, we have
developed a revolutionary new generation of ventilators.
bellavista ensures a step into the future for all of our clients.
Not only the attractive, elegant outward appearance and
outstanding technology, but also the new, groundbreaking
operating system, developed closely with leading physicians,
set bellavista apart from the competition. bellavista
refreshingly redefines ventilation technology with an attractive yet conspicuously discreet design, which stands
out from the typical clinical instrumentation and integrates
functionality, Swiss quality and high performance with
user-friendliness and innovative design.
Intelligent aesthetics
bellavista offers a new type of operating experience by
allowing individual adaptation of the applications to suit the
needs and habits of the user. Whether a patient, nurse,
or doctor, the relevant information is immediately visible and
available.
Revolutionary operation
Smart touch operation
UserView ™
Building user confidence
bellavista’s new touch screen simplifies
the set-up process and adjustment
of ventilator and monitoring values and
curves.
The screen displays only relevant information for the selected user. A status
indicator simplifies the screen by hiding
complicated graphs and figures that
could otherwise confuse the patient.
The physician, however, sees all values,
curves and loops, which enables
him/her to rapidly familiarise himself/
herself with the patient’s condition.
bellavista supports daily use of the
ventilator with multimedia capabilities.
Wizards and instructional videos displayed directly on the device support the
bellavista set-up and operating process.
These instruments assist in reducing user
anxiety while operating the device.
By using the direct menu, the user can
see the actions available in the selected
field, thereby guaranteeing intuitive
operation of the device. Various respiratory parameter setting methods
are additionally available to the user.
The user interface can be individually
customised directly on the screen according to the user’s wishes and requirements by positioning each operating
component where expected.
Videos and pictures detailing health
conditions and treatments can be loaded
and displayed directly on the ventilator.
These informational spots support
the patient as well as physician with video
and audio functions and ensure comfortable assistance for example during mask
fitting. These capabilities enable ventilator acceptance by the patient and increase the chances of successful therapy.
VentilationAssist™
VentilationAssist supports the medical
specialist in parameter adjustment
when a patient is initially connected to
bellavista ventilator. After entering
the relevant patient information (includ
patient history, age, lung volume, etc)
VentilationAssist suggests a suitable ve
lation configuration. This suggestion
can then be evaluated and adjusted by
medical specialist.
Innovative features
MaskFit™
WeanVent™
ChameleonLook™
Experts agree that initial ventilator contact is critical in determining future
therapy success. If the patient accepts the
ventilator and mask during this first
phase, it is very likely that non-invasive ventilation can be used throughout the
therapy. If non-invasive therapy is not
an option, the consequence is often intubation causing long-term therapy with
increased complications.
During ventilator weaning, bellavista
supports the patient with WeanVent.
During this phase, the patient is prepared
with targeted measures and training
programs that are individually customised
by the medical specialist. The entire
weaning process is supported by multimedia functions. Real-time patient
information and measuring results are
continuously available for review and
diagnosis during therapy.
The multitude of ventilators with varying
user-interfaces presents significant
challenges for medical specialists.
The consequences encountered by this
variety are increased costs for device
familiarisation and training.
MaskFit assists the patient and medical
specialist during initial contact with the
device and mask. With assisted guidance
and multimedia support, the patient
easily adjusts to ventilation step by step.
bellavista’s ChameleonLook offers
revolutionary support for anyone working
with a broad range of ventilators. At the
click of a button, the ChameleonLook
adapts bellavista’s operating surface to
an interface that the operator is more
familiar with.
ModeAssist™
While the ventilation is running, a new
mode or form of therapy can be selecte
and pre-configured using ModeAssist.
Selections of varying ventilation pattern
based upon empirical values are available. Changes are only applied when t
configuration is complete and the user
initiates the new settings.
10
Innovative features
FlexiView™
ActiveHelp™
ConnectionAssist™
The bellavista user interface can be
individually customised using FlexiView.
This feature allows users to continuously adjust the user interface to their
needs and wishes. While the device is
in operation, monitoring values and curves
can be adjusted and loops can easily
be configured.
ActiveHelp is easily accessible directly
on bellavista’s user interface. In every
phase of operation, assistance pertaining
to the current topic is available by the
push of a button. The bellavista ventilator
details responses with informative text
including pictures, instructional videos or
relevant sections from the electronic
user manual.
Correctly connecting and operating
bellavista is detailed step-by-step with
ConnectionAssist. All interfaces have
a ConnectionAssist button next to them.
When this button is pushed, information appears on the screen describing the
function of the selected connection.
An adequate pneumological examination requires a substantial diagnosis. During this process, parameters from
various machines must be correlatively analysed. bellavista
is the world’s first ventilator where all the sensors
necessary for a reliable pneumological diagnosis are either
integrated in the device or attachable.
All relevant parameters are displayed and recorded polygraphically and simultaneously. This allows the specialist to
make a reliable diagnosis quickly and simply and evaluate
critical changes in the patient’s condition.
With a complete record of all patient parameters, a detailed
post-analysis can be determined. The ArtefactFinder
supports the physician in evaluating the data displayed and
reliably highlights irregularities.
Cardio Pleth
SpO2
CO2
FiO2
Lung mechanics
Flow & volume
Pressure
12
World premier in diagnostics and monitoring
Standard parameters
Lung mechanics
Blood gas monitoring
The flow, volume and pressure parameters give insight into respiratory tract
obstructions, compliance dysfunctions
and leakages. Alarm parameters can
be comfortably adjusted directly on the
touch screen.
The quantitative analysis of the respiratory
system must be accompanied by an
understanding of the complex reciprocal
effect between patient and ventilator.
This analysis delivers important clinical
information about lung function and
the course of a disease and allows the
medical specialist to customise ventilator
settings for the individual patient.
Pulse oximetry, the transcutaneous measurement of SpO2, is crucial in recognizing
the quality of ventilation. Blood gas
monitoring simplifies long-term monitoring
and avoids invasive arterial blood gas
analysis.
Capnography
The integrated capnograph enables simple
monitoring of the tubus and indicates
potential pulmonary embolism.
Ventilators providing high-performance for every type of
therapy are rare. For years the devices used at home
were dramatically different from those used in hospitals.
bellavista combines the advantages of the proven,
classic proportional valve technology of ICU ventilators,
with the high-performance blower technology primarily used in non-invasive ventilation. Thus, bellavista offers
a ventilation platform for all applications; for noninvasive and invasive ventilation, for children and adults,
at home and in the hospital.
14
Top ventilation performance
Ventilation and synchronisation
Various types of therapy
Oxygen
The proportional valve technology
patented for bellavista enables optimal
synchronisation between the ventilator and patient and regulates an exact
air dosage for each breathing phase.
bellavista’s superior exhalation
performance also increases patient
comfort.
Pressure and volume controlled ventilation
modes give the user the greatest flexibility in selecting the appropriate therapy.
For anxiety-free and assisted mask
adjustment, bellavista offers the MaskFit
mode which provides multimedia assistance to doctors and patients.
Depending on the clinical diagnosis
and therapy, the air provided can be mixed
with a precise dose of oxygen. bellavista
supports all O2 supply systems available
in the market.
The DayNight mode enables patients to
switch independently between two
different types of prescribed therapies.
This accommodates the physiological differences of the lung functions and
optimises the patient’s comfort.
The DayNight mode also takes into account
differing therapies at the relevant time
of day and adjusts the ventilation
appropriately.
Medication therapy support
An integrated medication nebuliser
permits exact dosages of medication in
accordance with the chosen therapy.
The intelligent control system can adapt
the dosage patterns. Customised modes
such as pressure and volume controlled sighs or targeted administration
of manual breath can further promote
patient weaning off the ventilator.
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The appropriate device for every application. The bellavista
model 1000 is available in two separate basic versions
in order to accommodate varying ventilator applications –
bellavista 1000 and bellavista 1000e. Each version
distinguishes itself through unique attributes and advantages. Several features are available separately or
after an initial purchase.
1000
Area of application
Intensive care unit (ICU)
Subacute / Intermediate care unit (IMC)
Emergency Room (ER)
Intrahospital transfers
Ventilation
Non-invasive (High Performance NIV)
Invasive
Neonatal
Pediatric
Adult
Single limb breathing circuit
Dual limb breathing circuit
Ventilation modes
Pressure controlled
CPAP, PCV, P-A/C, PC-SIMV, PSV, beLevel, APRV
CPAP, S, S/T, T, P-A/C
Volume controlled
VCV, V-A/C, VC-SIMV
PLV (Pressure Limited Ventilation)
on all volume controlled modes
Oxygen
Basic Oxygen Therapy
Advanced Oxygen Therapy
Oxygen flush
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indelivery
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available
optionally 
available, included in the ClinicSuite
1000 e
TM package
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1000
ExpertVentilation TM package
Single & multiple sighs
Manual breath
Inspiratory hold
Expiratory hold
AutoPEEP
NIF (Negative Inspiratory Force)
Vtrapped (trapped volume)
P0.1 (occlusion pressure)
ATC (fully configurable)
bellavistaModes (beModes)
SingleVent™
Backup Ventilation
TargetVent™
DualVent™
DayNight™
MaskFit™
WeanVent™
Special features
UserView™
FlexiView™
UserAssist™
VentilationAssist™
Various monitoring and trending views
ConnectionAssist™
ActiveHelp™
ChameleonClassic™
ChameleonGreen™
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1
16
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Overview
1000
Monitoring
Standard parameters
Pressure
Ppeak, Pplateau, Pmean, PEEP
Volume
Vti, MVi (MinVol), Vti/kg, MVi/kg,
Vte, MVe (MinVol), Vte/kg, MVe/kg
Timing
Rate, Ti, Te, I:E, Ti/Tot
Oxygen
FiO2
Curves
Pressure, Flow, Volume
incl. Ptrach curve if ATC is enabled
Up to three curves
Up to eight curves & loops
Curve freeze
Curve cursor
Leak
Leak flow, Auto-Leak TM
Pulse oximetry Pulse rate, SpO2 saturation,
Cardio pleth curve
Capnography inCO2, etCO2, CO2-curve
SBE
% Spont
ExpertMonitoring TM
Volume
MVi spont
MVe spont
Timing
Rate spont, Ti support,
SBE
%Spont 1h, %Spont 8h
WOBimp
Work of Breathing imposed
PTP
Pressure Time Product
P0.1
breath-by-breath occlusion pressure
Tobin Index
RSBI (Rapid Shallow Breathing Index)
Leak
% Leak
Curves
Up to eight real time curves
1000 e
1000
Patient info
Patient info sheet
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Diagnostics
Correlated diagnostic data
Oxygen fraction FiO2
Diagnostic Package Pulse Oximetry
Diagnostic Packages Capnography
Diagnostic lung mechanics
Curves
Proximal flow & volume
Loops
P/V (pressure/volume)
P/F (pressure/flow)
F/V (flow/volume)
Loop freeze
Loop cursor (inflection points, ...)
Reference loop
Loop overlay
Parameters
Rinsp, Rexp, Cstat, Cdyn,
C20/Cdyn, CDyn/kg, CStat/kg
Trending
Standard trending (all monitoring parameters)
Real time trending (all curves)
Alarms
Alarm log
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Ventilation alarms
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System alarms
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Auto self-test
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1000
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1000
Data transfer / Central Monitoring (PDMS)
USB-stick
Screenshot (on USB-stick)
bellavista ConfigurationSuite™
Philips VueLink™ and IntelliBridge
Operation and signals
Giant screen (13,3")
Touch screen operation
360° multicolor signals
Stereo loudspeakers
Ergonomics
Compact design
Innovative bellavista operating concept
Ergonomic colour design
Integrated carrying handle
Integrated mounting possibilities
Low noise design
Technology
Multiprocessor architecture
Redundant safety components
Low power design
Proportional valve technology
High performance turbine
Oxygen
External medication nebulizer
1000 e
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1000
1000 e
Extension modules
beBay™
Humidifier
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Software upgrades
Software upgrade via USB interface
iVista software download
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Maintenance
Minimal maintenance
Easy air filter exchange
ServiceAssist™
Easy to clean surface
Support
Test and diagnostic tools
Training
Integrated multimedia applications
Tutorial videos
Integrated electronic user manual
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18
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Overview
1000
Technical data
Ventilation settings
Pinsp (IPAP)
0 .. 60 mbar
0 .. 80 mbar
Psupport
0 .. 60 mbar
0 .. 80 mbar
PEEP (EPAP)
0 .. 40 mbar
CPAP
4 .. 30 mbar
Rise time
0 .. 2000 ms
Ramp
Off, 5 .. 45 min
Tidal volume
40 .. 2500 mL
10 .. 2500 mL
2 .. 2500 mL
Body Weight
6 .. 250 kg
1.5 .. 250 kg
0.4 .. 250 kg
Peak flow
260 L/min
Flow pattern
Square, Dec., Dec. 50 %
Breathing frequency
1 .. 100 bpm
1 .. 150bpm
Inspiration time
0.1 .. 10 s
I:E ratio
1:599 .. 49:1
Inspiration trigger (flow)
0.1 .. 20 L/min
Inspiration trigger (pressure) 0.1 .. 15 mbar
Expiration trigger
5 .. 90 % of insp. peak flow
Auto-Synch TM
Apnea backup
off, 2 .. 100 s
Oxygen
5 levels
Advanced Oxygen Therapy
21 .. 100 % FiO2
1000 e
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1000
Technical data
Technical specifications
Weight
Dimensions (w x h x d)
Ambient temperature
Ambient humidity
Ambient pressure
Energy supply
Wide range power input
Low voltage input
Battery operation
Intelligent battery
management
Green power mode
Oxygen connector
Wide range oxygen inlet
9.1 kg
35 x 22 x 33 cm
5 .. 40 °C
10 ..90 % r.H.
600 .. 1100 hPa
100- 240 VAC / 50-60 Hz / 80 W
24 VDC / 3.5 A (Typ.)
4-6 h (internal)
0 .. 7 bar/0 .. 100 psi
Interfaces
Coded plug connections
100 MBit ethernet
beBus™
USB 2.0 interfaces
Serial ports
Nurse call
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 included
indelivery
 optionally 
available
optionally 
available, included in the ClinicSuite
TM package
1000
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2 0 0 8 Good Design Award of The Chicago Athenaeum, USA
Design Award of the Federal Republic of Germany 2010

imtmedical ag Gewerbestrasse 8 9470 Buchs Switzerland
T +41 81 750 66 99 www.bellavista-ventilator.com
MADE IN
SWITZERLAND
LAMPIRAN II
RENCANA ANGGARAN BIAYA
Tabel 1. Perkiraan biaya Ventilator Neonatus Hamilton C2
Harga alat
Per unit
CHF
39.085,83
Kurs beli CHF - IDR
17 Desember 2015
Rp
13.842,37
Harga alat dalam IDR
Per unit
Rp 541.040.520,62
Perkiraan tarif dokter NICU (dari ventilator)
Per tindakan
Rp
40.000,00
Perkiraan ganti Oxygen Cell
Per tahun
Rp
3.000.000,00
Perkiraan maintenance kit
Per tahun
Rp
14.000.000,00
Tarif Listrik
Rp/Kwh
Rp
1.509,38
Daya alat
Watt
100
Perkiraan kebutuhan
jam/hari
13
Perkiraan penggunaan listrik
kWH/hari
1,3
Perkiraan bayar listrik
Per hari
Rp
1.962,19
Asumsi 1 bulan=30 hari
Per bulan
Rp
58.865,82
Per tahun
Rp
706.389,84
Total biaya perawatan
Per tahun
Rp
17.000.000,00
Perkiraan tarif ventilator
Per tindakan
Rp
230.000,00
Tabel 2. Perkiraan biaya Ventilator Neonatus Bellavista 1000
Harga alat
Per unit
Rp 666.270.000,00
Ongkos kirim
Rp
2.730.650,00
Total biaya awal
Rp 669.000.650,00
Perkiraan tarif dokter NICU (dari ventilator)
Per tindakan
Rp
40.000,00
Perkiraan ganti Oxygen Cell
Per tahun
Rp
3.500.000,00
Perkiraan maintenance kit
Per tahun
Rp 15.000.000,00
Tarif listrik
Rp/kWH
Rp
Daya alat
Watt
80
Perkiraan kebutuhan
jam/hari
15
Perkiraan penggunaan listrik
kWH/hari
1,2
Perkiraan bayar listrik
Per hari
Rp
1.811,26
Asumsi 1 bulan=30 hari
Per bulan
Rp
54.337,68
Per tahun
Rp
652.052,16
Total biaya perawatan
Per tahun
Rp 18.500.000,00
Perkiraan tarif ventilator
Per tindakan
Rp
1.509,38
240.000,00
LAMPIRAN III
ANALISIS PERHITUNGAN
Asumsi (untuk kedua alternatif):
1. Analisis periode 10 tahun.
2. Suku bunga 7,5% (17 Desember 2015)
3. Rata-rata inflasi tahun 2015 = 6,38%.
4. Kenaikan pasien mulai tahun ke 3 sebesar 0,1% per tahun.
5. Kenaikan tarif dokter dan tarif ventilator mulai tahun ke-3 sesuai besar rata-rata inflasi
tahun 2015.
6. Kenaikan biaya perawatan mulai tahun ke-2 sesuai rata-rata inflasi tahun 2015.
Tabel 3. Perkiraan Jumlah Pasien
Tahun
(1+0,1%)n
Jumlah Pasien Tahun 1 & 2
Jumlah Pasien
F/P
P
F=Px(F/P)
1
-
-
1800
2
-
-
1800
3
1,001
1800
1802
4
1,002001
1800
1804
5
1,003003001
1800
1805
6
1,004006004
1800
1807
7
1,00501001
1800
1809
8
1,00601502
1800
1811
9
1,007021035
1800
1813
10
1,008028056
1800
1814
PERKIRAAN ALTERNATIF 1
Tabel 4. Perkiraan Biaya Dokter
Tahun
Jumlah Biaya
(1+6,38%)n
Jumlah Biaya Dokter (P)
F/P
Tarif Dokter x jumlah pasien tahun ke n
Dokter
F=Px(F/P)
1
-
- Rp 72.072.000,00
2
-
- Rp 72.072.000,00
3
1,0638 Rp 72.072.000,00
Rp 76.670.193,60
4
1,13167044 Rp 72.144.072,00
Rp 81.643.313,70
5
1,203871014 Rp 72.216.216,07
Rp 86.939.009,28
6
1,280677985 Rp 72.288.432,29
Rp 92.578.203,78
7
1,36238524 Rp 72.360.720,72
Rp 98.583.177,88
8
1,449305419 Rp 72.433.081,44
Rp 104.977.657,41
9
1,541771104 Rp 72.505.514,52
Rp 111.786.907,19
10
1,640136101 Rp 72.578.020,04
Rp 119.037.830,78
Tabel 5. Perkiraan Pendapatan dari Ventilator
Tahun
(1+6,38%)n
F/P
Jumlah Pendapatan (P)
Jumlah
Tarif ventilator x jumlah pasien tahun ke
Pendapatan
n
F=Px(F/P)
1
-
- Rp 414.414.000,00
2
-
- Rp 414.414.000,00
3
1,0638 Rp 414.414.000,00
Rp 440.853.613,20
4
1,13167044 Rp 414.828.414,00
Rp 469.449.053,80
5
1,203871014 Rp 415.243.242,41
Rp 499.899.303,33
6
1,280677985 Rp 415.658.485,66
Rp 532.324.671,76
7
1,36238524 Rp 416.074.144,14
Rp 566.853.272,81
8
1,449305419 Rp 416.490.218,29
Rp 603.621.530,12
9
1,541771104 Rp 416.906.708,50
Rp 642.774.716,33
10
1,640136101 Rp 417.323.615,21
Rp 684.467.526,97
Tabel 6. Perkiraan Biaya Perawatan
Tahun
Jumlah
(1+6,38%)n
Jumlah Biaya Perawatan (P)
F/P
1
Pendapatan
F=Px(F/P)
-
- Rp 17.000.000,00
2
1,0638 Rp 17.000.000,00
Rp 18.084.600,00
3
1,13167044 Rp 17.000.000,00
Rp 19.238.397,48
4
1,203871014 Rp 17.000.000,00
Rp 20.465.807,24
5
1,280677985 Rp 17.000.000,00
Rp 21.771.525,74
6
1,36238524 Rp 17.000.000,00
Rp 23.160.549,08
7
1,449305419 Rp 17.000.000,00
Rp 24.638.192,11
8
1,541771104 Rp 17.000.000,00
Rp 26.210.108,77
9
1,640136101 Rp 17.000.000,00
Rp 27.882.313,71
10
1,744776784 Rp 17.000.000,00
Rp 29.661.205,33
PERKIRAAN ALTERNATIF 2
Tabel 7. Perkiraan Biaya Dokter
Tahun
Jumlah Biaya
(1+6,38%)n
Jumlah Biaya Dokter (P)
F/P
Tarif Dokter x jumlah pasien tahun ke n
Dokter
F=Px(F/P)
1
-
- Rp 72.072.000,00
2
-
- Rp 72.072.000,00
3
1,0638 Rp 72.072.000,00
Rp 76.670.193,60
4
1,13167044 Rp 72.144.072,00
Rp 81.643.313,70
5
1,203871014 Rp 72.216.216,07
Rp 86.939.009,28
6
1,280677985 Rp 72.288.432,29
Rp 92.578.203,78
7
1,36238524 Rp 72.360.720,72
Rp 98.583.177,88
8
1,449305419 Rp 72.433.081,44
Rp 104.977.657,41
9
1,541771104 Rp 72.505.514,52
Rp 111.786.907,19
10
1,640136101 Rp 72.578.020,04
Rp 119.037.830,78
Tabel 8. Pendapatan Dari Ventilator
Tahun
Jumlah Pendapatan (P)
(1+6,38%)n
Tarif ventilator x jumlah pasien tahun ke
F/P
Jumlah Pendapatan
F=Px(F/P)
n
1
-
- Rp 414.414.000,00
2
-
- Rp 414.414.000,00
3
1,0638 Rp 432.432.000,00
Rp 460.021.161,60
4
1,13167044 Rp 432.864.432,00
Rp 489.859.882,22
5
1,203871014 Rp 433.297.296,43
Rp 521.634.055,65
6
1,280677985 Rp 433.730.593,73
Rp 555.469.222,71
7
1,36238524 Rp 434.164.324,32
Rp 591.499.067,28
8
1,449305419 Rp 434.598.488,65
Rp 629.865.944,48
9
1,541771104 Rp 435.033.087,14
Rp 670.721.443,13
10
1,640136101 Rp 435.468.120,22
Rp 714.226.984,67
Tabel 9. Perkiraan Biaya Perawatan
Tahun
1
(1+6,38%)n
Jumlah Biaya Perawatan (P)
F/P
-
Jumlah Pendapatan
F=Px(F/P)
- Rp 17.706.389,84
2
1,0638 Rp 17.706.389,84
Rp 18.836.057,51
2
1,0638 Rp 18.500.000,00
Rp 19.680.300,00
3
1,13167044 Rp 18.500.000,00
Rp 20.935.903,14
4
1,203871014 Rp 18.500.000,00
Rp 22.271.613,76
5
1,280677985 Rp 18.500.000,00
Rp 23.692.542,72
6
1,36238524 Rp 18.500.000,00
Rp 25.204.126,94
7
1,449305419 Rp 18.500.000,00
Rp 26.812.150,24
8
1,541771104 Rp 18.500.000,00
Rp 28.522.765,43
9
1,640136101 Rp 18.500.000,00
Rp 30.342.517,86
10
1,744776784 Rp 18.500.000,00
Rp 32.278.370,50
Tabel 10. Pembiayaan Setiap Alternatif
Biaya Awal
Ventilator Neonates
Ventilator Neonatal
Hamilton C2
Bellavista 1000
Rp 541.040.520,62
Rp 669.000.650,00
1 Rp 89.706.389,84
Rp 91.152.052,16
2 Rp 90.790.989,84
Rp 92.332.352,16
3 Rp 96.614.980,92
Rp 98.258.148,90
4 Rp 102.815.510,78
Rp 104.566.979,62
Biaya Operasional
5 Rp 109.416.924,86
Rp 111.283.604,15
(C)
6 Rp 116.445.142,71
Rp 118.434.382,89
7 Rp 123.927.759,83
Rp 126.047.380,28
8 Rp 131.894.156,02
Rp 134.152.475,00
9 Rp 140.375.610,74
Rp 142.781.477,21
10 Rp 149.405.425,94
Rp 151.968.253,44
1 Rp 414.000.000,00
Rp 432.000.000,00
2 Rp 414.000.000,00
Rp 432.000.000,00
3 Rp 440.853.613,20
Rp 460.021.161,60
4 Rp 469.449.053,80
Rp 489.859.882,22
Pendapatan
5 Rp 499.899.303,33
Rp 521.634.055,65
(B)
6 Rp 532.324.671,76
Rp 555.469.222,71
7 Rp 566.853.272,81
Rp 591.499.067,28
8 Rp 603.621.530,12
Rp 629.865.944,48
9 Rp 642.774.716,33
Rp 670.721.443,13
10 Rp 684.467.526,97
Rp 714.226.984,67
Useful life
10 tahun
10 tahun
Rp -
Rp
Salvage value (Asumsi:
digudangkan)
-
Tabel 11. Analisis Perhitungan
n
(1+i)n
Biaya
Pendapatan
F/P
PC x (F/P)
PB x (F/P)
P
1
1,075 Rp 83.447.804,50
Rp 385.116.279,07
2
1,155625 Rp 78.564.404,40
Rp 358.247.701,46
3 1,242296875 Rp 77.771.250,06
Rp 354.869.775,55
PW
4 1,335469141 Rp 76.988.308,94
Rp 351.523.700,19
(PWB – PWC)
Hamilton
5 1,435629326 Rp 76.215.303,53
Rp 348.209.175,04
Rp 2.186.539.039,25
C2
6 1,543301526 Rp 75.451.971,49
Rp 344.925.902,63
7
1,65904914 Rp 74.698.064,60
Rp 341.673.588,27
FW
8 1,783477826 Rp 73.953.347,85
Rp 338.451.940,06
(PW x (F/P)10)
9 1,917238662 Rp 73.217.598,56
Rp 335.260.668,85
Rp 4.506.525.971,79
10 2,061031562 Rp 72.490.605,52
Rp 332.099.488,21
PWC
Total
n
Rp 762.798.659,47
PWB
Rp 3.490.378.219,34
(1+i)n
Biaya
Pendapatan
F/P
PC x (F/P)
PB x (F/P)
1
1,075 Rp 84.792.606,66
Rp 401.860.465,12
2
1,155625 Rp 79.898.195,49
Rp 373.823.688,48
3 1,242296875 Rp 79.093.935,50
Rp 370.298.896,23
4 1,335469141 Rp 78.299.809,74
Rp 366.807.339,32
Bellavista
5 1,435629326 Rp 77.515.555,11
Rp 363.348.704,39
1000
6 1,543301526 Rp 76.740.922,57
Rp 359.922.681,01
7
1,65904914 Rp 75.975.676,21
Rp 356.528.961,68
8 1,783477826 Rp 75.219.592,35
Rp 353.167.241,81
9 1,917238662 Rp 74.472.458,75
Rp 349.837.219,67
10 2,061031562 Rp 73.734.073,86
Rp 346.538.596,39
Total
Rp 3.642.133.794,09
Rp 775.742.826,25
Rp 541.040.520,62
PW dan FW alternatif 2 LEBIH MENGUNTUNGKAN.
P
Rp 669.000.650,00
PW
(PWB – PWC – P)
Rp 2.197.390.317,85
FW
(PW x (F/P)10)
Rp 4.528.890.799,47
Tabel 12. Payback Period
Nama Alat
Formula
– P + (Benefit – Cost) th 1
Tahun 1
Hamilton C2
Tahun 2
Payback Period
Rp (216.746.910,46)
Saldo balik modal 1 + (Benefit – Cost) th 2 Rp 106.462.099,70
1 - (saldo balik modal 1/ (benefit-cost) tahun 2) = 1,67 tahun
– P + (Benefit – Cost) th 1
Tahun 1
Bellavista 1000
Saldo balik modal
Tahun 2
Payback Period
Rp (328.152.702,16)
Saldo balik modal 1 + (Benefit – Cost) th 2 Rp 11.514.945,68
1 - (saldo balik modal 1/ (benefit-cost) tahun 2) = 1,97 tahun
Payback period alternatif 1 LEBIH CEPAT dari alternatif 2.
Tabel 13. Benefits Costs Ratio
PWB Hamilton C2
= Rp 3.490.378.219,34
PWB Bellavista 1000
B
PWB Bellavista 1000
= Rp 3.642.133.794,09
– PWB Hamilton C2
Rp 151.755.574,75
PWC Hamilton C2
= Rp 762.798.659,47
PWC Bellavista 1000
C
PWC Bellavista 1000
= Rp 775.742.826,25
– PWC Hamilton C2
Rp 12.944.166,77
BCR (B/C)
11,724
Karena BCR>1 maka pilih alternative dengan biaya awal paling besar yaitu Alternatif 2
(Ventilator Neonates Bellavista 1000)
DEPRESIASI
Formula
1. Straight Line (SL)
dt 
BS
N
2. Sum of Years Digits
3. Unit of Production
Depreciati on per unit 
BS
Total number of unit
Tabel 14. Depresiasi Alternatif 1
n
Hamilton C2
Straight Line
SOYD
BV
BV
UP
Pasien
BV
0
Rp 541.040.520,62
Rp 541.040.520,62
Rp 541.040.520,62
1
Rp 486.936.468,56
Rp 442.669.516,87
1800 Rp 487.130.996,36
2
Rp 432.832.416,49
Rp 354.135.613,49
1800 Rp 433.221.472,11
3
Rp 378.728.364,43
Rp 275.438.810,50
1802 Rp 379.258.038,33
4
Rp 324.624.312,37
Rp 206.579.107,87
1804 Rp 325.240.641,12
5
Rp 270.520.260,31
Rp 147.556.505,62
1805 Rp 271.169.226,51
6
Rp 216.416.208,25
Rp 98.371.003,75
1807 Rp 217.043.740,48
7
Rp 162.312.156,19
Rp 59.022.602,25
1809 Rp 162.864.128,97
8
Rp 108.208.104,12
Rp 29.511.301,12
1811 Rp 108.630.337,85
9
Rp 54.104.052,06
Rp 9.837.100,37
1813 Rp 54.342.312,94
10
Rp
Rp (0,00)
1814 Rp (0,00)
-
Tabel 15. Depresiasi Alternatif 2
n
Bellavista 1000
Straight Line
SOYD
BV
BV
UP
Pasien
BV
0
Rp 666.270.000,00
Rp 666.270.000,00
Rp 666.270.000,00
1
Rp 599.643.000,00
Rp 545.130.000,00
1800 Rp 599.882.553,30
2
Rp 533.016.000,00
Rp 436.104.000,00
1800 Rp 533.495.106,60
3
Rp 466.389.000,00
Rp 339.192.000,00
1802 Rp 467.041.272,45
4
Rp 399.762.000,00
Rp 254.394.000,00
1804 Rp 400.520.984,47
5
Rp 333.135.000,00
Rp 181.710.000,00
1805 Rp 333.934.176,20
6
Rp 266.508.000,00
Rp 121.140.000,00
1807 Rp 267.280.781,13
7
Rp 199.881.000,00
Rp 72.684.000,00
1809 Rp 200.560.732,65
8
Rp 133.254.000,00
Rp 36.342.000,00
1811 Rp 133.773.964,13
9
Rp 66.627.000,00
Rp 12.114.000,00
1813 Rp 66.920.408,84
10
Rp -
Rp
1814 Rp (0,00)
-
LAMPIRAN IV
RENCANA JARINGAN PROYEK
Tabel 16. Rencana Jaringan Proyek Alternatif 1
No.
1.
Kegiatan
Mengumpulkan data spesifikasi, fungsi, dan
Jalur
Waktu
-
1 minggu
2. Mencari penyedia barang
1
2 minggu
3. Membuat matrik pembanding (proposal)
2
3 hari
4. Mengajukan proposal
3
2 hari
5. Proposal disetujui
4
1 minggu
6. Kirim surat permintaan barang via email
5
1 hari
7. Tunggu balasan
6
1 minggu
8. Membuat surat kemitraan dan kerja sama
7
3 jam
9. Minta surat penawaran harga (negosiasi)
7
7 jam
10. Menjalin kerja sama di atas materai
9, 8
1 jam
11. Mencapai kesepakatan
9, 10
1 hari
12. Order pembelian (menunggu)
11
1 bulan
13. Barang diterima
12
1 hari
14. Disimpan di gudang
13
4 jam
15. Uji kelayakan
13, 14
1 bulan
16. Laporan barang telah diterima
13
1 hari
17. Membuat SOP dan jadwal pemeliharaan
15
4 hari
18. Terima faktur dari penyedia alat
16
3 hari
19. Alat dioperasikan
15, 17, 18
10 tahun
kegunaan alat
Gambar 1. Rencana Jaringan Proyek Alternatif 1
Gambar 2. Jalur Kritis Alternatif 1
Tabel 17. Rencana Jaringan Proyek Alternatif 2
No.
1.
Kegiatan
Mengumpulkan data spesifikasi, fungsi, dan
Jalur
Waktu
-
1 minggu
2. Mencari penyedia barang
1
2 minggu
3. Membuat matrik pembanding (proposal)
2
3 hari
4. Mengajukan proposal
3
2 hari
5. Proposal disetujui
4
1 minggu
6. Menghubungi penyedia barang dan membuat janji
5
2 hari
7. Menemui penyedia barang
6
1 hari
8. Minta surat penawaran harga (negosiasi)
7
2 jam
9. Mencapai kesepakatan
8
10 menit
10. Menjalin kerja sama di atas materai
9
20 menit
11. Order pembelian (menunggu)
10
1 bulan
12. Barang diterima
11
1 hari
13. Disimpan di gudang
12
4 jam
14. Uji kelayakan
12, 13
1 bulan
15. Laporan barang telah diterima
14
1 hari
16. Membuat SOP dan jadwal pemeliharaan
15
4 hari
17. Terima faktur dari penyedia alat
16
3 hari
18. Alat dioperasikan
14, 16, 17
10 tahun
kegunaan alat
Gambar 3. Rencana Jaringan Proyek Alternatif 2
Gambar 4. Jalur Alternatif 2
Gambar 5. Cash flow Alternatif 1
9
149.931.528,70
8
140.827.796,38
7
132.276.85337,63
6
124.245.144,62
5
116.701.127,96
4
109.615.192,93
3
102.959.523,20
2
96.707.991,58
1
90.836.057,51
0
89.706.389,84
541.040.520,62
684.467.526,97
642.774.716,33
603.621.530,12
566.853.272,81
532.324.671,7676
499.899.303,33
469.449.053,80
440.853.613,20
414.000.000
414.000.000
LAMPIRAN V
RENCANA CASH FLOW
10
Gambar 6. Cash flow Alternatif 2
9
151.968.253,4
8
142.781.477,21
7
142.781.477,2
1
6
126.047.380,28
5
118.434.382,89
4
111.283.604,15
3
104.556.979,62
2
98.258.148,90
1
92.332.352,16
91.152.052,16
669.000.650,00
0
10
714.226.984,67
670.721.444,13
629.865.944,48
591.499.067,28
555.469.222,71
521.634.055,65
489.859.882,22
460.021.161,60
432.000.000
432.000.000
LAMPIRAN VI
PENGAMBILAN KEPUTUSAN
Berdasarkan analisis perhitungan dengan keempat metode ekonomi, menghasilkan:
1. Keuntungan di masa sekarang yang LEBIH UNTUNG adalah ALTERNATIF 2.
2. Keuntungan di masa depan yang LEBIH UNTUNG adalah ALTERNATIF 2.
3. Payback period yang LEBIH CEPAT adalah ALTERNATIF 1.
4. Benefits Costs Ratio LEBIH BESAR dari 1 maka pilih ALTERNATIF 2.
KEPUTUSAN
Sesuai dengan tujuan pengadaan barang ini yaitu meningkatkan pelayanan rumah sakit
dan mendapat keuntungan yang dapat dimanfaatkan. Alternatif yang dipilih yaitu:
VENTILATOR NEONATES BELLAVISTA 1000.