ISA 520 · ISA 570 · Healthcare

Financial Ratio Calculator
for Healthcare

Pre-configured for healthcare entities with conservative benchmarks reflecting public interest nature, regulatory scrutiny, and mixed funding models.

Financial Data

Enter the essential financial figures below. Expand the additional sections for a comprehensive analysis.

Financial Ratio Analysis Guide for European Auditors — free PDF

ISA 520 & ISA 570 practical workbook: all formulas with visual explanations, industry benchmark reference tables from BACH for 15 industries, ratio interpretation guide, and template narrative paragraphs for audit working papers.

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ISA 520.5 — Design and perform analytical procedures near the end of the audit that assist in forming an overall conclusion.

ISA 520.A1 — Analytical procedures may include ratios such as gross margin percentages and ratio of sales to accounts receivable.

ISA 570.A3 — Negative working capital, adverse key financial ratios, operating losses, and other indicators may cast doubt on going concern.

Financial Ratio Analysis for Healthcare

Healthcare financial ratio analysis must account for the sector's mixed funding models (public subsidies, insurance reimbursements, patient payments), regulatory compliance costs, and public interest sensitivity. Healthcare entities range from publicly funded hospitals to private pharmaceutical companies, each requiring different ratio interpretation. For publicly funded healthcare, total expenditure-based ratios are more meaningful than profitability ratios, while private healthcare groups benefit from standard profitability analysis.

The program expense ratio (programme costs / total expenditure) is a critical metric for non-profit healthcare entities — it measures how effectively the entity deploys resources toward its healthcare mission versus administrative overhead. Regulators and funding bodies typically expect programme expense ratios exceeding 75%. For private healthcare, gross margin analysis reveals the balance between service revenue and clinical delivery costs, while DSO reflects the complexity of the reimbursement cycle (insurance claims, government payments, patient billing).

European healthcare benchmarks from BACH show higher DSO than most sectors (median 60 days) due to insurance and government reimbursement processing times. Working capital management is complicated by the need to maintain critical medical supply inventories while managing cash flow cycles that can extend 60–120 days for government-funded services. Research-active healthcare organisations face additional complexity from grant-funded activities with restricted fund accounting requirements.

Regulatory Context

CQC regulatory compliance. Medical malpractice provisions. Grant income conditions (IAS 20). Research grant restricted funds. CSRD sustainability reporting obligations for healthcare groups.

Industry-Specific Going Concern Indicators (ISA 570)

Government funding cuts or commissioning contract losses

Regulatory quality ratings downgrades

Medical malpractice claims exceeding insurance coverage

Staff vacancy rates affecting ability to deliver services

Operating deficits exceeding 3% of total expenditure

Loss of accreditation or regulatory enforcement action

Worked Example: European Private Healthcare Group

MedCenter Groep NV — private hospital group with €65M revenue

Key results: Current Ratio: 1.33, Quick Ratio: 1.10, Gross Margin: 40.0%, Net Margin: 5.0%, ROE: 14.1%, ROA: 6.8%, D/E: 1.09, Interest Coverage: 4.3x, DSO: 48 days, Altman Z'-Score: 3.15 (Safe Zone)

Frequently Asked Questions — Healthcare

How should I analyse financial ratios for publicly funded healthcare?
For publicly funded hospitals and healthcare entities, traditional profitability ratios (ROE, net margin) have limited meaning because the objective is not profit maximisation but service delivery. Focus on: program expense ratio (>75% target), operating efficiency ratios (revenue per bed, cost per patient day), working capital adequacy, and debt service coverage. Compare against government funding levels and contractual obligations.
What DSO is typical for healthcare organisations?
European BACH data shows median healthcare DSO of 60 days, significantly higher than most sectors. This reflects insurance claim processing times (30–45 days), government reimbursement cycles (45–90 days), and patient billing collection. DSO exceeding 90 days warrants investigation into claim denial rates, billing accuracy, and revenue cycle management effectiveness.
How does grant income affect ratio analysis?
Grant income recognition under IAS 20 or IFRS depends on whether conditions are met. Unconditional grants are recognised immediately, while conditional grants are deferred. For ratio analysis, ensure that revenue includes appropriately recognised grants, and that deferred grant income is classified correctly between current and non-current liabilities. Clawback risk on conditional grants creates a qualitative materiality consideration.
What are healthcare-specific going concern indicators?
ISA 570 indicators specific to healthcare include: government funding cuts or contract losses, CQC/regulatory ratings downgrades, medical malpractice claim provisions exceeding insurance coverage, loss of accreditation, staff vacancy rates affecting service delivery, and NHS Trust deficit positions (UK). For private healthcare, loss of key insurance contracts or consultant relationships can trigger rapid revenue decline.
Should I adjust ratios for research-active healthcare entities?
Yes. Healthcare entities with significant research operations (university hospitals, pharmaceutical companies) should separate research grant income and expenditure from clinical operations for meaningful ratio analysis. R&D expenditure may distort net margin, while capitalised development costs (IAS 38) affect asset ratios. Restricted research fund balances should be excluded from available working capital assessments.