Full text of Labor Requirements for Hospital Construction : Bulletin of the United States Bureau of Labor Statistics, No. 1340

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Labor Requirements for Hospital Construction. Bulletin No. 1340

Errata Sheet

(1)

Page 15, second paragraph, last sentence, should read:

"However, a very rough adjustment for price change indicates
that on-site man-hours per $1,000 (in constant prices) for hospital con­
struction have declined by approximately one-third in the past 20 years.*1

(2)

Page 15, fourth paragraph, first sentence, should read:

"It is interesting to note that the decrease over the 20 years
in site man-hours appears to be about the same as that for schools and
about twice as large as that for Federal buildings.M







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Preface

This study of labor requirements for the construction of general hospi­
tals is the fourth in a series of such studies authorized by the 86th Congress
for various types of construction that might be affected by Government action.
Previous studies were made for schools, highways, and Federal office buildings.
Surveys currently in preparation cover the civil works activities of the Corps
of Engineers, such as the construction of dams and levees and dredging of
channels, and several segments of the housing industry (private single-family
dwellings, public housing, and housing for college students). Other surveys
are in the planning stages.
The studies are being made by the Bureau of Labor Statistics, Division of
Productivity and Technological Developments, under the supervision of James F.
Walker. This report was prepared by Herman J. Rothberg, who also directed the
collection of statistical data. Ronald E. Kutscher was in charge of the group
determining the employment created by the use of building materials.
The Bureau is grateful to the Public Health Service of the U.S. Department
of Health, Education, and Welfare and the Departments of Health of the various
States for their generous cooperation and for making available the data which
were tabulated to determine the direct labor requirements for federally aided
hospital projects. The Bureau also appreciates the cooperation of the con­
struction contractors who supplied the materials data on which the estimates
for indirect requirements were based, as well as the on-site man-hour data for
nonfederally aided projects.




i




CONTENTS
Page
Introduction..............................................
1
Nature of survey ........................................ . . . . . . .
2
General survey findings and characteristics ...........................
4
Building characteristics ..............................................
6
On-site man-hour r e q u i r e m e n t s ..............
11
Regional group comparisons..................
13
Labor requirements in earlier periods ..................... . . . . .
15
Requirements by occupation ....................... . . . . . . . . . .
16
General and special trade contractors* shares . .....................
18
The cost of direct w a g e s ......................................
21
Off-site e m p l o y m e n t ..............
2A
Builders* off-site employment ...................................... ..
25
Employment in transportation, trade, and service ................. ..
26
"Last manufacturing stage" employment ................................
26
Bnployment in secondary activities. . . . . . .........................
26
Construction time . . . . . ................. . . . . . . . . . . . . .
27
Employment by construction periods ....................................
27
Materials u s e d .................................
30
Changes in m a t e r i a l s ..........
36
Requirement comparisons with school, public building, and highway
construction .............................................................. 38
Appendix A. Scope and method of s u r v e y ......................... ..
41
Characteristics of the universe and selection of the s a m p l e ........ 41
Collection of on-site man-hour d a t a ........................... ..
43
Off-site m a n - h o u r s ............
44
Primary distribution industries employment . ............... . . . . .
44
Primary manufacturing employment .........................
44
Secondary employment in all industries ...............................
45
Total man-hour r e q u i r e m e n t s ............
45
Tables:
1.
2.
3.

4.

5.

Number and cost of 46 hospital construction projects, by
selected characteristics andregion, 1959-60 . . . . ............
On-site man-hour requirements for hospital construction projects,
by selected characteristics and region, 1959-60 ...............
On-site man-hour requirements per $1,000 of hospital construction
contract, by proportion of lower skilled labor employed and
region, 1959-60
Distribution of hospital construction projects, by number of on­
site man-hours required for each $1,000 of construction
contract, by region, 1959-60
..................................
On-site man-hour requirements per $1,000 of hospital construction
contract, by occupation and region, 1959-60 ........ . . . . .




iii

8
12

14

14
17

CONTENTS— Continued
Page
Tables— Continued
6.

Apprentices as percent of on-site employment on hospital con­
struction projects, by occupation and region, 1959-60 . . . . .
Percent of total on-site man-hour requirements for hospital con­
struction, by type of contractor and region, 1959-60 ........
Average number of contractors per hospital construction project,
by cost group and region, 1959-60 ..............................
Average on-site hourly earnings on hospital construction pro­
jects, by selected characteristics and region, 1959-60 . . . .
Average number of weeks required for construction of hospitals,
by cost group and region, 1959-60 ..............................
Total cost of material components for each $1,000 of hospital
construction contract, 1959-60 ........... • .................

7.
8.
9.
10.
11.

19
20
20
22
28
31

Charts:
1.
2.
3.

Distribution of man-hours for each $1,000 of hospital construc­
tion contract, 1959-60 . . ......................................
Percent distribution of on-site wages and materials used for each
$1,000 of hospital construction contract, 1959-60 .............
On-site man-hours of construction labor for each $1,000 of hos­
pital construction contract, by decile of construction time . .




iv

5
7
29

LABOR REQUIREMENTS FOR HOSPITAL CONSTRUCTION

Introduction
New construction is a major component of the Nation’s output of goods and
services and an important source of employment.
It creates jobs not only at
project sites but also in the many manufacturing, trade, and transportation
industries which furnish materials required in the construction process.
Because of their far-reaching employment impact, construction projects are
often regarded as a means of counteracting cyclical unemployment.
To measure the labor requirements for various types of construction, the
Bureau of Labor Statistics has undertaken a series of studies. Hospital
construction— public and private, profit and nonprof it— was selected for early
study because it represents a relatively substantial part of all nonresidential
building construction expenditures and because of the widespread expression
of need for additional hospital facilities of all types. Expenditures for the
construction of hospital and related medical facilities (including Federal
facilities and those federally assisted) were at an annual rate of $1.16
billion in 1961 and accounted for about 7.5 percent of the total nonresidential
building construction that year. Federal funds accounted for $220 million or
almost one-fifth of all hospital construction expenditures, with $165 million
of this sum devoted to assisting various State and local public and private
nonprofit groups to meet demonstrated need for hospital and related facilities
under the Hill-Burton program.
(See appendix A.) This programsinitiated in
1946, was influential in helping to bring hospital facilities to areas that
never before had hospitals, or in some cases, had inadequate facilities. The
extent to which the program aided in generating the construction of hospital
facilities is indicated by the fact that from its inception through December 31,
1961, $4.67 billion in total costs were approved under the program; and for
every $1.45 of the Federal share, $3.22 was spent by the assisted States or
local public and private nonprofit groups.
It is estimated that almost $4 billion will be spent in the 3-year period
1962 through 1964 for the construction of hospital and related medical facili­
ties. 1 I A few thousand projects will probably be involved. The Public
Health Service anticipates that to meet future needs for hospital facilities,
increasingly higher expenditures of Federal, State, and local public funds as
well as private moneys, will be required for hospital construction through the
latter sixties and early seventies.
Etnphasis is expected on construction
devoted to expansion and renovation of "big city" hospitals, chronic disease
hospitals, and skilled nursing homes. Although general hospitals 2/f both
1/ Unpublished preliminary estimates of the Division of Hospital and
Medical Facilities, Public Health Service, U.S. Department of Health,
Education, and Welfare.
2/ For definition of "general hospitals," as used in this study, see
appendix A.




1

2

new and additions to existing ones, are the subject of this study, the findings
may be useful in estimating man-hour requirements for the other types of hospi­
tal projects indicated.
Equipment and facilities of general hospitals encom­
pass the needs of all types of hospitals and related facilities.
Nature of Survey
This report is based on a survey of selected public and private pnpfit
and nonprofit general hospitals constructed in various localities of the
United States.
Data were collected for 46 projects, chosen as a representative
sample of hospitals on which construction was begun sometime between mid-1958
and mid-1959. Construction of both new general hospitals and additions,
whether separate buildings or extensions to existing ones, were studied. 3/
Although the survey did not cover moveable, unattached furnishings and
equipment used in the hospitals studied, it did include built-in equipment
unique to a hospital, such as X-ray dark room equipment, sterilizing equipment,
pharmacy and laboratory equipment, cabinets at nurses stations, and other
items, such as elevators and communications systems, which are permanently
fixed in place so as to constitute integral parts of the buildings.
The survey was designed primarily to determine the number of man-hours
represented by a fixed dollar volume ($1,000) of general hospital construction.
Man-hours, as defined by the survey, include both on-site construction employ­
ment and the off-site employment required to produce and deliver materials
used in the construction.
Data for on-site labor include total man-hours for
the supervisory, engineering, clerical, and custodial employees at the site,
as well as those for workers in each construction trade. For almost fourfifths of the projects, additional data were obtained on wages and timing of
employment.
Data for off-site labor include employment in the off-site
(e.g., office and warehousing) activities of construction contractors; in
building materials and equipment manufacture and distribution; and finally,
employment in all the other industries which are affected directly or indi­
rectly by the production and distribution of building materials from raw
material to the final manufacturing stage.
Certain types of employment, however, are not covered by the survey.
Excluded are preparation of plans and specifications of the projects; produc­
tion of movable furniture and administrative office equipment; the labor time
involved in installations by public utility employees, as well as any site
preparation, landscaping, and highway work not covered by the construction
contract. No estimate was made of the labor generated by the money expended
for contractors* overhead, other than off-site administrative salaries. The
major part of such overhead consists of salaries and profit.
It is believed

3/ For a more detailed description of method and for a list of States
included in each region, see appendix A.



3

that the other overhead items such as rent, bonds, insurance, taxes (including
payroll taxes), welfare payments, and office supplies, generate relatively
little employment.
Employment created by the respending of wages and profits
of the workers and their employers--the multiplier effect— was not considered
within the scope of the study.




4

General Survey Findings and Characteristics
For every $1,000 of construction contract concerned in the building of
general hospital structures in 1959-60, 223 man-hours of employment were cre­
ated, Of these, 89 were for employment at the construction site and 134 were
required for various off-site activities.
(See chart 1.) The latter included
all labor needed to produce and deliver materials and equipment used by the
on-site workers, plus employment by the construction contractors in adminis­
trative, warehousing, and certain other off-site operations. Total man-hours
were all ated as follows:
Man-hours per
$1,000 of contract

£.<01 c -1. i 0 1 1— u Q U f.

•

Construction:
O n - s i t e .................. ...... .............
Off-site ................................... .
M a n u f acturing..................................
Transportation ........ ............. ............
Trade and s e r v i c e ........ .....................
Other industry employment ....•.••«•............

Number

Percent

223

100

89
11
79
9
22
13

40
5
35
4
10
6

As pointed out in later sections of this report, new hospitals and addi­
tions to existing hospitals (with their related alterations) form two rela­
tively homogeneous subgroups to make up the general hospital construction
category and are therefore occasionally nalyzed separately. Thus, on-site
construction man-hours for additions amounted to 94 per $1,000 of construction
contract amount or 9 percent more than 86 man-hours required for the new hos­
pitals. This appeared to be due mainly to alteration and repair work as part
of the additions.
Detailed compilations of the off-site man-hours for both
of these subgroups were not made. However, while average cost of materials
(including rental or depreciated cost of construction equipment) for all the
projects was $544 per $1,000 of contract amount, the average was $513 for
additions and $557 for new hospitals.
Since off-site hours (except those in
the construction industry) are developed from cost data on the value of mate­
rials used at the site, it would indicate that the increased on-site hours
for additions were virtually balanced by the lower off-site hours as repre­
sented by lesser materials cost per $1,000 of contract, so that total require­
ments for both of the subgroups are almost identical.
(Lower materials cost
per $1,000 of contract value for additions appears to result mainly from the
fact that on-site hours including those used for alteration and repair work
consume a larger part of each $1,000 of contract amount than do the hours for
new hospitals.)




5

Chart 1. Distribution of Man-Hours for Each $1,000 of
Hospital Construction Contract, 1959-60

On-site
Construction
Off-site
PRIMARY
> MAN-HOURS

Construction

Transportation
and Trade

Last Manufacturing
Stage

SECONDARY
MAN-HOURS

13
Other
Manufacturing




Transportation,
Trade and
Services

All Othe
Industrie

6

The average cost of the hospitals studied was about $1.5 million (exclu­
sive of site and planning cost) and it was the same for new projects and for
additions. Average hospital construction time was approximately a year and a
half. Therefore, the hospital projects provided on the average the equivalent
of continuous work for 49 workers for 18 months at the construction site. A
somewhat greater amount of employment was provided in off-site activities. 4/
During recent years, an average of about $1 billion a year has been spent
for the construction of all hospital and related medical facilities.
This
would indicate that such construction has been the source of about 117,000
jobs annually--67,000 of these off-site. Meeting the anticipated needs previ­
ously noted, however, suggests the creation of an even higher level of
employment.
The survey disclosed wide ranges of man-hour and materials requirements
among individual projects, reflecting differences in size of building, geo­
graphical location, and local practices. There were also marked variations
in such related measures as average hourly earnings and site wages as
percentages of construction cost. On the average, however, 54 cents of the
construction dollar was spent for materials purchases, and 29 cents for wages
to on-site workers (earnings averaged $3.18 per hour).
(See chart 2.)
Building Characteristics
The size and cost of the 46 hospital projects surveyed averaged as
follows:
Average
Floor space ..............
Cost per square foot ....
Number of beds ..........
Cost per bed .............
Hospital construction cost

56.5 thousand square feet
$25.93

86

$16,947
$1,463,723

The size and cost of individual hospitals, of course, varied considerably
and reflected differences in design and type of construction, and metropolitan
versus nonmetropolitan needs.
(See table 1.) For example, included in the
sample is a small, one-story, 18-bed wood frame, brick-veneered building,
costing less than $100,000.
It has a multi-purpose delivery-operating room,
a small laboratory, including a small X-ray unit, and a waiting room. Its
very low cost per square foot was $6.50, and per bed, $2,887.

4/ The annual employment estimate of construction workers is based on
50 times the 1959 average employment in contract construction work of 35.7
hours a week as reported in the Bureau's Earnings and Hours series. For other
types of employment, 2,000 hours were considered a year's employment.




7

Chart 2. Percent D istribution of On-Site W ages
and Materials Used for Each $1,000 of Hospital
Construction Contract, 1959-60




Table 1.

Number and Cost of 46 Hospital Construction Projects, by Selected Characteristics and Region, 1959-60 1 /

Cost per—
Characteristic

Bed
(thou­
sands)

8

$29.63

$19.9

17.7
12.4

5
3

30.49
27.70

20.8
18.1

22.48
26.19

17.3
16.0

5
3

30.32
25.79

21.1
14.6

7
4
2
3

22.17
23.44
24.05
23.88

12.9
12.0
13.1
20.2

3
—
3
2

27.93
25.70
31.84

12.5
—
21.6
20.8

15.3
26.9
15.1
—

4
5
6
1

30.22
22.93
21.74
(2/)

17.4
18.3
11.9
(2/)

3
4
—
1

30.85
28.10
—
(2/)

21.5
18.0

23.53
28.15
29.72

16.8
26.6
16.3

11
1
4

22.75
(2/)
23.82

12.5
(2/)
18.7

3
2
3

24.95
29.64
30.57

17.8
15.3
21.7

12
4

27.78
23.74

19.6
14.1

6
10

23.83
22.94

18.2
12.5

6
2

30.15
25.18

19.8
21.2

(2/)
10.8
—

10
4
2

28.75
23.63
16.24

20.2
16.6
8.6

15

23.67

1

(2/)

16.9
—
(2/)

2
4
2

27.14
31.34
24.76

18.7
20.2
20.2

23.48
24.51

9.3
16.2

12
4

27.85
25.00

19.4
17.0

7
9

23.75
23.33

17.6
14.3

5
3

30.22
27.73

21.1
16.7

23.90

11.4
—

14
2
—

27.27
27.88
—

22.3
14.0
—

14
2
—

23.75
21.97
—

17.3
10.3
—

5
1
2

26.74
(2/)
29.06

17.8
(2/)
18.3

16

$23.66

$16.8

15.7
28.2

13
3

23.53
24.64

30.01
23.37

20.2
17.1

5
11

6
4
3
3

20.53
23.57
24.77
31.64

12.3
16.6
22.0
21.0

4
6
6
—

27.54
29.12
23.36
—

(2/)
16.2
9.5

9
5
2

24.13
(2/)

11.5
(2/)

1
5
—

(2/)
24.32
—

4
2

6

Square
foot

16

$27.44

$19.1

16.1
9.4

11
5

25.89
30.17

23.39
24.73

9.4
17.1

6
10

1
1
2
2

(2/)
(2/)
21.69
26.60

(2/)
(2/)
15.9
9.5

15.3
19.7
13.2
11.0

3
2
1
—

25.57
21.69
(2/)
—

10.1
15.9
(2/)

23.25
26.07
26.75

14.6
20.0
16.8

1
3
2

(2/)
21.39
26.60

29
17

26.30
23.26

17.5
13.6

5
1

Air-conditioned:
Full .....................
Partial ..................
Not air-conditioned .....

28
13
5

25.58
27.29
22.30

18.2
15.0
15.2

Full or partial basement ...
No basement ................

28
18

26.23
24.85

17.3
15.8

Exterior:
M a s o n r y ..... ............
Curtain wall .............
Other ....................

39
5
2

25.01
29.46
29.06

17.0
16.7
18.3

Square
foot

6

$23.90

$n. A

17.5
15.7

3
3

24.13
23.73

26.39
24.91

17.2
16.4

4.
2

17
9
10
10

22.23
23.05
24.14
27.74

12.4
14.5
17.7
18.1

Reinforced concrete .....
Load-bearing masonry ....
Wood .................... .

14
17
13
2

28.47
25.08
22.37
24.37

1 s t o r y ......... ..........
2-4. stories ................
5 or more stories .........

24
11
11

Elevators ..................
No elevators ...............

Square
foot

4.6

$25.93

$16.9

N e w ........................
Additions ..................

32
14

25.4-9
27.00

In a metropolitan area ....
Not in a metropolitan area .

20
26

Construction cost group:
Under $500,000 ..........
$500,000-3999,999 .......
$1,000,000-11,999,999 ....
$2,000,000 and over .....

Number

All hospitals ..........

Number

Cost per—
Square
foot

Square
foot

Bed
(thousands)

Bed
(thou­
sands)

Bed
(thou­
sands)

Bed
(thou­
sands)

Cost per—

Cost per—

Cost ;
per—

West

South

North Central

Northeast

United States

Number

Number

Number

—

Type of structural framing:

1/
2/

—

—

—

—

—

—

—

Although construction of projects studied extended over a ^ - y e a r period, most of the construction took place in 1959-60.
Insufficient coverage to warrant presentation.




—

(2/)

9

Also Included in the projects studied is a new, multistoried, "big city"
hospital of reinforced concrete frame and masonry exterior, costing about
$5 million.
It is air conditioned throughout, has five elevators and more than
300 beds. It is supplied with operating rooms, delivery rooms, diagnostic and
deep-therapy rooms, X-ray rooms, completely equipped laboratories, a large
emergency department, and ample provisions for outpatients and physical ther­
apy. The most modern signaling and call systems for doctors, nurses, and
patients have been installed. Written communications and small packets are
transmitted between hospital areas through a pneumatic airtube system, thereby
reducing handling costs of paperwork, records, supplies, and medications.
Kitchen and laundry facilities are in keeping with the overall demands of the
hospital. There are separate nurses quarters and an individual heating plant.
For this hospital, cost per square foot was $32.30 and $16,190 per bed.
Hospitals constructed in metropolitan areas— about 43 percent of the pro­
jects studied— were generally larger and more expensive in terms of total cost,
cost per square foot, and cost per bed, than those built in nonmetropolitan
areas. Contributing to the higher total and unit costs of large urban area
hospitals is the vastly increased amount of built-in equipment unique to a
hospital such as that described above. This equipment and the structural
features necessary to accommodate it are included in the construction contract
cost of the projects studied.
Additions were constructed at an average cost of $27 per square foot
compared with $25.49 for new hospitals.
This slightly higher cost appears to
be attributable mainly to the added labor required to make the necessary
alterations and repairs which were a part of almost all the construction con­
tracts for additions.
Despite variations in size and location of the sample projects, there was
considerable uniformity in most hospital construction features, except for
structural framing. Reinforced concrete was used for framing on 37 percent of
the projects, steel on 30 percent. Both types were employed in all regions
and for buildings of all heights. Load-bearing masonry was used for 28 percent
of the projects. Of these, all were one-story buildings except one which had
two stories. The remaining projects were framed in wood.
Concerning the more uniform construction features, masonry was the prin­
cipal exterior wall material in 85 percent of the hospitals, and formed some
part of the outer walls in most of the other projects. Extensive use was made
also of exterior trim in the form of metal (aluminum and steel), glass,and
tile. Roof decks were usually of concrete (poured, mainly, with a few precast),
although some gypsum and steel were used. They were invariably covered with a
built-up composition surface. All floors were of concrete; most were poured,
some were precast. Asphalt and vinyl tile were by far the commonest floor
covering. However, terrazzo and ceramic tile were used extensively for oper­
ating, laboratory, kitchen, and lavatory areas. In the operating room suites,
specially mixed cement containing some carbon black v;; s used in conjunction
with the terrazzo to provide conductive flooring. This has the effect of




10

making all equipment and personnel in the area nonconductive by drawing-off
or "bleeding" static electricity. Most permanent interior walls were of
plaster. Ceilings were either of plaster or acoustical tile. Lead-lined
doors, walls and ceilings were commonly used in X-ray equipment areas as a
radiation shield. Most buildings had preglazed aluminum window sashes and
frames. Air conditioning, central or unit, was installed in almost all the
hospitals.
Elevators were provided for all buildings with more than one story
above grade. All the new hospitals had fully equipped kitchens and laundries.
This construction was accomplished within the 3%-year period from the
summer of 1958 to the fall of 1961. Most of the construction, however, took
place during 1959-60.




11

On-Site Man-Hour Requirements
Average man-hours at the construction site, obtained by dividing total
man-hours by total construction contract cost, numbered 88.8 per $1,000 of
construction contract, for all the hospital projects.
About 54 percent of the individual projects ranged from 80 to 100
man-hours. However, the overall range was much wider, reflecting special
circumstances associated with the projects which tended to increase or decrease
unit labor requirements. Apart from the variation in labor requirements exhib­
ited by a ranking of individual projects, the survey also disclosed the exist­
ence of marked differences in group averages when the data were analyzed by
various criteria such as size, location, characteristics of construction, and
by whether the projects represented construction of new hospitals or of addi­
tions.
(See table 2.) For some of these criteria, group averages revealed
that man-hour requirements per dollar paralleled requirements per square foot;
in others, the measures took divergent paths. Differences in design, materi­
als, and relative costs affect the comparisons, particularly between regions.
Construction of new hospitals generally required fewer man-hours per
$1,000 than additions.
The higher man-hour requirements for additions
appeared to be due to some alteration work on preexisting structures as a
part of the construction contract of most additions. This work, consisting
largely of tearing down or breaking through wall, floor, and ceiling areas,
required added labor of both skilled (carpenters, plumbers, electricians) and
unskilled workers— to raze in order to rebuild. Thus, compared with new hos­
pitals, the ratio of labor to materials costs would necessarily be higher.
The extent of such work varied with the degree of accommodation necessary to
merge the old and the new structures.
In some situations, the additions were used mainly to provide added bed
space and nurses stations, with the changes involving only minor tearing out
and rebuilding of wall areas and tying together the necessary supporting
facilities (e.g., plumbing, heating, and electrical) in order to link the
addition to an existing structure.
In other cases, particularly among larger
hospitals in metropolitan areas, the hospital authorities used the additions
to house newer, more modern and efficient medical, surgical, and administrative
equipment.
In such instances, more extensive changes were sometimes required
in the older structures to fit them into the new arrangement in which the
addition became the core of the hospitals' patient servicing functions.
Analysis of the man-hour requirements for all the projects by size and
location further emphasized the effect of the higher man-hour requirements per
$1,000 for additions. When considered by cost class, as construction contract
cost of the projects rose, man-hours per $1,000 remained relatively constant.
Projects in metropolitan areas were found to use slightly more man-hours than
those in nonmetropolitan areas. However, when new hospitals only were consid­
ered,
(less two atypical hospital projects in the South), there emerged a




Table 2.

On-Site Man-Hour Requirements for Hospital Construction Projects, by Selected Characteristics and Region, 1959-60 1/

Characteristic

United States

Northeast

North Central

South

West

Man-hours per—

Man-hours per—

Man-]hours per—

Man-hours per—

Man-hours per—
$1,000
of
cost

1,000
square
feet

1,602

81.1

2,404

1,615

2,262
2,196

1,704
1,102

78.6
87.5

2,396
2,423

1,631
1,580

95.6
94.7

2,149
2,480

1,654
1,513

82.6
71.4

2,505
1,841

1,740
1,046

1,122
1,326
1,820
1,829

92.5
91.2
104.9
94.3

2,050
2,138
2,524
2,253

1,194
1,092
1,378
1,901

78.3
—
87.4
78.9

2,188
—
2,247
2,513

978
—
1,885
1,640

2,039
2,778
1,990
—

1,130
2,564
1,289
—

84.8
99.8
84.3
(2/)

2,564
2,288
1,833
(2/)

1,473
1,823
1,005
(2/)

75.6
89.7
—
(2/)

2,331
2,521
—
(2/)

1,622
1,611
—
(2/0

82.2
91.9
82.3

1,935
2,588
2,447

1,383
2,443
1,338

91.9
(2/)
93.5

2,090
(2/)
2,228

1,144
(2/)
1,746

67.5
92.5
81.0

1,683
2,741
2,476

1,200
1,415
1,757

1,054
(2/)

85.7
86.7

2,379
2,057

1,678
1,221

95.8
93.1

2,282
2,134

1,746
1,164

82.9
62.7

2,501
1,579

1,641
1,331

(2/)
2,238
—

(2/)
990
—

85.3
82.4
117.6

2,453
1,947
1,909

1,726
1,367
1,016

95.6

1,613
—

(2/)

2,263
—
(2/)

(2/)

82.8
78.7
94.4

2,247
2,466
2,338

1,550
1,590
1,910

95.1
86.3

2,234
2,117

886
1,399

86.1
83.3

2,398
2,083

1,671
1,417

92.5
106.4

2,197
2,482

1,626
1,520

80.7
82.8

2,438
2,294

1,699
1,383

91.4
—

2,185
—

1,040
—
—

90.9
72.8
—

2,480
2,030
--

2,032
1,016
—

95.3
94.3
—

2,263
2,071
—

1,652
969
——

82.4
(2/)
91.1

2,203
(2/)
2,647

1,465
(2/)
1,664

$1,000
of
cost

1,000
square
feet

1.634

95.3

2,254

1,991
2,985

1,204
2,791

96.1
89.1

87.3
82.5

2,621
1,928

1,764
1,409

(2/)
(2/)
1,391
873

91.0
79.7
82.6
87.1

1,869
1,879
2,045
2,757

2,407
1,896
(2/)
—

947
1,391
(2/)
—

74.0
95.4
85.2
—

(2/)
91.4
92.3

(2/)
1,955
2,454

(2/)
1,480
873

1,557
1,169

91.9
(2/)

2,217
(2/)

2,316
2,293
2,140

1,646
1,260
1,461

(2/)
92.0
—

88.0
91.5

2,310
2,273

1,523
1,442

92.0
76.6
91.1

2,300
2,258
2,647

1,560
1,282
1,664

$1,000
of
cost

1,000
square
feet

1.040

85.7

2,353

2,076
2,263

1,383
893

76.9
98.9

94.4
86.8

2,208
2,146

883
1,487

1,098
1,272
1,597
1,602

(2/)
(2/)
87.4
92.3

(2/)
(2/)
1,896
2,454

2,295
2,403
1,889
1,391

1,232
1,888
1,113
816

94.1
87.4
(2/)

83.8
95.4
87.9

1,950
2,486
2,351

1,221
1,909
1,479

Elevators ..................
No elevators ...............

89.1
85.8

2,344
1,995

Air-conditioned:
Full .....................
Partial ..................
Not air conditioned .....

90.6
84.0
95.9

Full or partial basement ...
No basement ................
Exterior:
Masonry ..................
Curtain wall .............
Other ....................

$1,000
of
cost

1,000
square
feet

1.504

91.4

2.185

2,202
2,546

1,516
1,481

86.1
95.4

89.5
87.1

2,362
2,169

1,540
1,426

Construction cost group:
Under $500,000 ...........
$500,000-1999,999 .......
$1,000,000-$l,999,999
$2,000,000 and over .....

88.6
87.6
90.2
88.5

1,969
2,019
2,178
2,455

Type of structural framing:
Steel .....................
Reinforced concrete
.....
Load-bearing masonry ....
Wood .....................

80.6
95.8
84.4
74.4

1 story ....................
2-4 s t o r i e s .... ...........
5 or more stories .........

$1,000
of
cost

1,000
square
feet

All hospitals ...........

88. S

2.301

N e w ................. .......
Additions ..................

86.4
94.3

In a metropolitan area ....
Not in a metropolitan area .

1/
2/

Bed

—

—

Bed

Bed

Bed

Although construction of projects studied extended over a 32-year period, most of the construction took place in 1959-60.
Insufficient coverage to warrant presentation.




Bed

13

pattern of lower man-hour requirements for the larger projects and for those
in metropolitan areas where, obviously, larger hospitals predominate.
By
size of hospital, the following appeared:
Construction contract cost

Man-hours per $1,000

Under $500,000 ..............................
$500,000 to $999,999 ........................
$1,000,000 to $1,999,999 ....................
$2,000,000 and over ...............

86.1
83.5
83.0
76.5

By location, the new metropolitan area hospitals required 77.0 man-hours and
the noranetropolitan, 83.1. Contributing to the lower man-hour requirements
per $1,000 of the costlier, larger projects was the fact that such projects
afforded maximum utilization of laborsaving equipment, such as cranes, eleva­
tors, and conveyors, and more efficient organization. These same advantages
were available to contractors for the larger addition projects which also
would probably have reflected the same pattern of lower man-hour requirements
as project cost rose but for the additional "tearing down" hours involved in
necessary changes.
Generally, for most projects, lower man-hour requirements were associated
with greater than average use of skilled craftsmen. Higher proportions of
laborers and helpers were usually related to higher man-hour requirements per
$1,000 of contract (table 3).
Regional Group Comparisons
Man-hour requirements on the site of construction varied by region.
(See table A.) The factors previously discussed, affecting the man-hours,
were also responsible, to a considerable degree, for the regional variations.
Half of the projects in the Northeast were additions and, except for one small
new hospital, they accounted for all the metropolitan area hospital construc­
tion in the region. This is reflected in the more-than-average man-hour
requirements for the region and the substantially higher man-hours for metro­
politan hospitals compared with those in nonmetropolitan areas. When only new
hospitals are considered, man-hours are below the average for every region
except the South. In that region, the higher requirements reflect a more
frequent use of laborers and helpers. Moreover, the two atypical projects
previously noted were in the upper range of man-hour requirements and substan­
tially influenced the total man-hour requirements for the region. One of these
two projects was a large nonmetropolitan hospital on which the workers received
the second lowest average hourly earnings and total man-hours were the highest
of all the projects studied. The other project, in an urban area, contained
many expensive, custom-built features.




14

Table 3. On-Site Man-Hour Requirements per $1,000 of Hospital Construction
Contract, by Proportion of Lower Skilled Labor Employed 1/ and Region,
1959-60 2/

Percent lower skilled
workers of total

Man-hours per :£1,000 of contract
United
States

Northeast

All workers ..............

88.8

2 5 .0 and un d e r .......... .
25.1-35.0 ...................
35.1 and o v e r ..... ..........

80.6
95.8
111.2

North
Central

South

West

91.4

85.7 _ 95.3

81.1

92.5
90.3

76.2
96.5

81.4
76.3

'

77.5
98.0
111.2

1/ For purposes of this comparison, laborers, helpers, and tenders were
considered lower skilled.
2/ Although construction of projects studied extended over a 32-year
period, most of the construction took place in 1959-60.

Table 4. Distribution of Hospital Construction Projects, by Number of
On-Site Man-Hours Required for Each $1,000 of Construction Contract,
by Region, 1959-60 l/

Percent of man-hours required
Average man-hours for all
projects ...................

United
States

Northeast

North
Central

South

West

88.8

91.4

85.7

95.3

81.1

Man-hour ranee
Under 70.0 ...................
70.0-79.9 ....................
80.0-89.9 ....................
90.0-99.9 ....................
100.0-109.9 ..................
110.0-119.9 ..................
120.0 and o v e r .......... .

Percent of projects
4.3
19.6
39.1
15.2
8.7
8.7
4.4

16.7
50.0
16.7
16.7
—

—

25.0
43.8
12.5
6.2
12.5
“

18.8
31.2
12.5
12.5
12.5
12.5

25.0
12.5
37.5
25.0

1/ Although construction of projects studied extended over a 3-r-year
period, most of the construction took place in 1959-60.




—
—

“

15

Labor Requirements in Earlier Periods
It would be of considerable interest to compare labor requirements on
current hospital construction with those on construction in earlier periods.
Unfortunately, however, only a limited amount of information is available and
it cannot readily be used for comparison with current data. The two major
problems are the change in cost (price) of construction and changes in physi­
cal specifications.
Changes in costs of materials and of labor, and of the relative propor­
tions of each, affect the total price of construction. Adequate price indexes
are not available for adjusting satisfactorily the dollar values of building
construction costs over periods of time. However, a very rough adjustment for
price change indicates that the total value of materials put in place per man­
hour (in constant prices) for hospital construction has declined by approxi­
mately one-third in the past 20 years. 5/
This decrease reflects several factors. One is the efficiency resulting
from increased mechanization of tools and of materials handling equipment.
Another is the greatly increased amount of built-in modern hospital equipment
(physiotherapy, diagnostic, etc.) owing to advances in medical techniques.
This equipment substantially increases the construction contract dollar total,
yet requires relatively little on-site labor for installation.
Still another
factor is the transfer of some operations from site to shop, as in the case
of concrete batching and mixing, and some cabinetry and other carpentry work.
Changes in design are also a factor. However, in some situations, design
changes and other factors may have been responsible for some increase in on­
site man-hours, thus nullifying part of the decrease in hours.
It is interesting to note that the decrease over the 20 years in the
total value of materials put in place per man-hour appears to be about the
same as that for schools and about twice as large as that for Federal build­
ings. 6/ Although too much significance should not be attached to the precise
degree""of difference, because of a lack of comparable data over the period, it
does appear that the decreases in requirements for the three types of construc­
tion are in reasonable relation. For some time, rapidly expanding school
population and hospital patient needs have brought extreme pressures on local
communities and private groups to provide additional facilities as rapidly as
possible. Architects, materials suppliers, and contractors have cooperated
in providing construction using a larger amount of subassemblies and prefabri­
cated items. No such extreme pressures on cost and speed have been exerted

5_! Based on unpublished BLS data for public works projects built in the
late 1930’s.
6/ Labor Requirements for School Construction (BLS Bulletin 1299, 1961),
p. 9. Labor Requirements for Federal Office Building Construction (BLS Bulletin
1331, 1962), n. 9.



16

on Federal office building construction. Thus, Federal buildings for the most
part continue to use large areas of exterior and interior stonework and present
an appearance of permanence and a somewhat monumental quality which is tradi­
tional. Most hospital and school construction, built to accommodate urgent
and immediate need, is without some of these massive building features.
Requirements by Occupation
Distribution of man-hour employment by broad skill areas disclosed that
68 percent of the total on-site man-hours were worked by those in the skilled
trades. Semiskilled and unskilled workers accounted for 28 percent of the
hours, and nonproduction employees (supervisors, engineers, and clerks), 4
percent (table 5).
Within the skilled trades, the workers in three predominant crafts—
plumbers, carpenters, and electricians— accounted for 54 percent of all skilled
man-hours. Plumbers worked 21 percent of the skilled hours and 14 percent of
total on-site hours. Carpenters were next in occupational importance with a
little more than 19 percent of the skilled hours; electricians followed with
13 percent. Although there were variations among projects in the proportion
of hours worked by each of these crafts, as well as the others, there were
relatively few exceptions in the order of skilled craft importance.
The lead position of plumbers reflects the extensive work required in
hospitals to provide for general sanitation and nursing needs, laboratory and
therapy installations, and adequate patient lavatory and toilet facilities.
The proportion of electricians* hours also attests to the broad application
of electrical usages in connection with proper lighting, surgical and medical
equipment, calling and signaling systems, and control systems.
Variations from region to region in ratios of man-hours worked by differ­
ent trades reflect, for example, differences in regional design and construction
needs, as well as work practices.
In the West, for instance, plumbers and
carpenters each worked 17 percent of total on-site man-hours. This equal
sharing of on-site time appears to reflect added carpenter hours owing to
greater-than-average use of wood products in the West. In the Northeast,
where carpenter hours were also about the same as those of plumbers, the higher
proportion of construction cost devoted to additions (including the related
changes to existing buildings) may be responsible for the use of more carpen­
ters. This also appears to account for the fact that a higher proportion of
electricians were employed in the Northeast than elsewhere.
In the matter of work practices, a number of factors affect the regional
distribution by occupation, apart from the construction requirements. For
example, organization of work crews and job classification may be affected
by the relative participation of local unions. Local custom Influences the




Table 5.

On-Site Man-Hour Requirements per $1,000 of Hospital Construction Contract, by Occupation and Region, 1959-60 1/
Northeast

United States
Occupation

Man-hours
Percent
worked

North Central

Man-hours
Percent
worked

Man-hours
Percent
worked

South

West

Man-hours
Percent
worked

Man-hours
Percent
worked

All occupations ......

88. S

100.0

91.4

100.0

85.7

100.0

95.3

100.0

81.1

100.0

General supervisors .....

2.8

3.1

2.8

3.0

3.0

3.5

3.1

3.2

1.9

2.3

Professional, technical,
and clerical ..........

.7

.8

1.3

1.4

.3

.4

1.1

1.2

.3

•4

14.6
11.6
8.7
6.4
5.4
3.1
.7
1.3
1.2
2.7
2.5
3.0
2.0
1.3

12.0
11.4
7.2
5.8
3.8
3.1
.4
1.5
1.2
3.0
2.3
2.5
1.7
1.7

12.6
12.0
7.5
6.1
4.0
3.3
.5
1.6
1.2
3.1
2.4
2.6
1.7
1.8

14.1
14.0
7.5
1.4
5.9
3.2
.8
1.4
.9
3.1
3.7
2.3
1.2
1.2

17.4
17.3
9.2
1.8
7.3
3.9
1.0
1.8
1.1
3.8
4.6
2.9
1.5
1.4

Plumbers...... .
Carpenters .............
Electricians ...........
Bricklayers ............
Sheet-metal workers .....
Ironworkers ••••••••••••••
Ornamental ...........
Reinforcing ...........
Structural ...........
Plasterers .............
Lathers ................
Painters ...............
Asbestos workers..... .
Operating engineers ......
Terrazzo workers and
tile setters ..........
Cement finishers.... .
Roofers ................
Elevator mechanics ......
Glaziers ...............
Soft floor layers.... .

12.7
11.7
7.8
4.8
4.3
3.1
.6
1.4
1.1
2.9
2.7
2.5
1.5
1.4

14.3
13.2
8.8
5.4
4.8
3.5
.7
1.6
1.3
3.2
3.0
2.8
1.7
1.6

12.4
12.7
11.1
5.9
1.9
3.9
.7
1.7
1.6
3.4
3.3
2.3
1.1
1.4

13.5
13.9
12.1
6.4
2.1
4.3
.7
1.8
1.7
3.7
3.6
2.5
1.2
1.5

12.7
9.9
7.4
5.5
4.6
2.7
.6
1.1
1.0
2.4
2.2
2.6
1.7
1.1

1.4
1.3
.6
.6
.5
.4

1.6
1.5
.7
.7
.6
.4

1.1
1.4
.6
.7
.4
.7

1.2
1.5
.6
.8
.5
.7

1.8
1.0
.5
.6
.6
.3

2.1
1.2
.6
.7
.7
.4

1.2
1.3
.7
.6
.6
.1

1.3
1.3
.7
.6
.6
.1

1.3
1.8
.5
.8
.3
.7

1.6
2.2
.7
.9
.4
.8

Laborers .............. .
Helpers and tenders .....
Truckdrivers ............
Watchmen............. ..
Other ............ ......

17.4
6.3
.6
.3
.5

19.6
7.1
.7
.4
.6

18.8
3.7
.5
.2
.1

20.5
4.1
.5
.2
.1

16.6
6.1
.9
.1
1.0

19.4
7.2
1.1
.1
1.1

21.8
8.6
.6
.8
.4

22.9
9.1
.6
.8
.4

10.6
4.5
.5
—
.4

13.0
5.6
.6

1/ Although construction of projects studied extended over a 3^-year period, most of the construction took place in
1959 -60.
NOTE:

Because of rounding, sums of individual items may not add to totals




_

.4

18

opportunity of union membership and journeyman jobs for minority groups 7/.
Finally, local availability of lower-paid labor may affect the extent to
which laborsaving equipment is employed.
These factors particularly influence the division between skilled and
unskilled workers. In the South, unskilled and semiskilled employees accounted
for 34 percent of total man-hours, compared with 20 percent in the West; the
percentages for skilled trades were 62 and 78 percent, respectively.
The persistence in all regions of a relatively large proportion of man­
hours by lesser skilled workers is noteworthy, particularly in view of the
complexity of hospital construction. Approximately 28 percent of all on-site
employment was by unskilled and semiskilled employees, despite considerable
mechanization in materials handling, excavating, cleaning, and similar jobs
formerly performed almost exclusively by laborers. This suggests that the
nature of construction operations may limit the degree of mechanization that
can profitably be used.
Apprentices. Apprentices in formal, registered apprenticeship programs
accounted for 3.3 percent of all man-hours worked at the site of the sample
projects, or 8.1 percent of skilled-trade man-hours (table 6). Apprentice
electricians accounted for 18 percent of the total hours worked in their
craft, a greater proportion than in any other trade. For three trades—
asbestos workers, elevator mechanics, operating engineers— which reported no
apprentices, formal programs do not exist or are just evolving. Training is
usually acquired on an informal basis by assisting a journeyman in his work
until the trainee is regarded as fully qualified to perform at the journeyman
level. In some instances, fixed time periods at the Job before becoming eli­
gible for upgrading have been informally established through local work prac­
tices. Workers in a learning status, whether called ’’improvers'* in the case
of asbestos work, "helpers” in elevator work, or "oilers" in equipment opera­
tion, are grouped with Helpers and tenders in this report. High rates of
apprentice employment are generally associated with shortages of skilled
journeymen in the craft, or with some smaller crafts.
General and Special Trade Contractors* Shares
Employees of the general contractors and three special trade contractors,
Plumbing and heating, Electrical, and Plastering and lathing, accounted for
79 percent of the total man-hours required for the construction of all the
hospital projects. (See table 7.) The general contractors' share, averaging
39.1 percent of all the projects, was highest in the South (42.0). There, a
preponderance of smaller hospital projects resulted in the general contractors'
assumption of some of the special trade duties because the amount of work
requiring certain special trade workers was insufficient to warrant use of a
separate subcontractor.

7/

Employment Outlook in the Building Trades (BLS Bulletin 967, 1949).




19

Table 6. Apprentices as Percent of On-Site Employment on Hospital
Construction Projects, by Occupation and Region, 1959-60 1/

Occupation

United
States

North­
east

North
Central

South

West

Percent of apprentices
All workers ..................

5.3

4.2

6.0

5.1

5.3

Skilled trades only .............

8.1

6.1

9.0

8.2

7.4

7.4
4.2
5.0
18.2
7.8
2.7
4.2
2.1
2.7
10.6
4.9
4.6
10.1
7.4
11.2
6.0
4.2

4*4
3.2
12.2
12.2
2.8
.5
2.7
—
—
8.1

8.5
6.8
2.7
11.2
2.4
4.5
9.2
.9
5.6
7.4
5.4
9.4
11.9
13.0
18.5
10.1
3.6

7.9
2.6
4.9
27.2
12.0
1.9

1.4
4.7
.2
20.9
23.6
5.2

Bricklayers .....................
Carpenters ......................
Cement finishers ............. .
Electricians ....................
Glaziers.... ....................
Ironworkers .....................
Ornamental ....................
Reinforcing ...................
Structural....................
Lathers .........................
Painters........................
Plasterers ............... ......
Plumbers ........................
Roofers .........................
Sheet-metal workers ............ .
Soft floor layers ................
Terrazzo workers and tile setters .

—

(2/)
9.9
—

1.2
3.1
8.7

—

2.5
1.8
12.4
5.8
3.2
9.5
6.7
6.2
—

2.7

—

8.6
—
17.7
6.0
2.5
5.4
3.4
7.5
3.1
11.0

1/ Although construction of projects studied extended over a 3^-year
period, most of the construction took place in 1959-60.
2/ Less than 0.05 percent.




20

Table 7. Percent of Total On-Site Man-Hour Requirements for Hospital
Construction, by Type of Contractor and Region, 1959-60 1/
United
States

North­
east

North
Central

South

West

All typ e s...................

100.0

100.0

100.0

100.0

100.0

General........... ............

39.1

35.9

37.4

42.0

34.7

Plumbing and heating ...........
Electrical .....................
Plastering and lathing .........
Masonry ...................... .
Tile and terrazzo work .........
Structural and ornamental metal ..
Painting .... ...................
Roofing and sheet metal ........
Site preparation and excavation ..
All other types ................

22.1
9.2
8.1
4.1
4.0
2.7
2.5
1.3
.8
6.0

16.8
14.2
9.8
7.4
3.3
3.2
2.5
•6
1.3
4.9

23.7
8.8
7.2
3.7
5.1
3.1
2.5
1.5
.5
6.5

22.2
8.0
8.1
3.3
3.6
2.4
2.5
1.2
1.0
5.6

23.4
8.6
9.2
5.3
2.3
1.8
2.9
2.5
.8
8.5

Type of contractor 2/

1/ Although construction of projects studied extended over a 3|—year
period, most of the construction took place in 1959-60.
2/ Based on data from federally aided hospital projects only.
NOTE:

Table 8.

Because of rounding, sum of individual items may not equal 100.

Average Number of Contractors per Hospital Construction Project,
by Cost Group and Region, 1959-60 1/
United
States

North­
east

All groups ..................

26

27

Under $500,000 .................
$500,000-$999,999 ..............
$1,000,000-$!,999,999 ..........
$2,000,000 and over ............ .

17
21
31
41

(2/)
(2/)
26
34

Cost group

North
Central
_____25.. 19
22
25
43

South

West

-.23 ..... „3JL
14
22
24
42

1/ Although construction of projects studied extended over a 3^-year
period, most of the construction took place in 1959-60.
2/ Insufficient coverage to warrant presentation.




20
—46
42

21

Plumbing and heating and Electrical contractors together accounted for
31.3 percent of the total man-hour requirements nationally.
This percentage
varied but slightly among the four regions, including the South, reflecting
the relatively heavy requirements for these services in the construction of
hospital facilities. Plastering and lathing contractors accounted for 8.1
percent of the total man-hour requirements nationally and this was close to
the percentage among the various regions, evidencing the almost universal use
of plaster for interior walls as well as its substantial use for ceilings in
the sample projects.
The average number of prime and subcontractors on each project was 26.
(See table 8 .)
However, this number varied considerably with size of project,
because the larger and more costly ones required a higher degree of contractor
specialization.
The Cost of Direct Wages 8 /
Wage payments to on-site labor averaged 28.8 percent of the total contract
amount for the 36 hospitals, (new construction and additions, combined), for
which such data were available.
(See table 9.) New construction averaged
27.8 percent for wages; additions averaged 31.6 percent. The percentages
reflect the combined effect of man-hour requirements and wage rates for indi­
vidual projects.
Higher-than-average hourly earnings were generally accompanied by above
average wages as a percent of contract amount, where s man-hours remained
relatively constant. However, for new hospitals only, higher-than-average
hourly earnings among the projects were partially offset by lower man-hour
requirements.
Variations in average hourly earnings probably reflect the distribution
of work between metropolitan and nonmetropolitan areas more than any other
single factor. Usually, wage rates tend to be higher in metropolitan areas
than in less densely populated areas in the same region. Among other things,
this appears to account for the fact that multistory buildings, buildings with
several elevators, and in general, costlier projects, are associated with
higher average hourly earnings, since these projects are usually in the larger
ur’ an centers.

8 / For this study, as in prior publications in this series, "direct
wages" include pay for all hours worked, including premium overtime pay.
Excluded are vacation and holiday pay or other labor costs, such as employer
contributions to social security, insurance, and welfare, and pension funds.




Table 9.

Average On-Site Hourly Earnings on Hospital Construction Projects, by Selected Characteristics and Region 1/, 1959-60 2/
United States

Characteristic

All hospitals ..........................
New ........................................
Additions ..................................

Average
hourly
wage

Wages as
percent of
contract

Average
hourly
wage

Wages as
percent of
contract

Average
hourly
wage

Wages as
percent of
contract

Average
hourly
wage

Wages as
percent of
contract

Wages as
percent of
contract

28.8

$3.43

31.9

$3.30

28.1

$2.94

28.2

$3.72

30.3

3.15
3.26

27.8
31.6

3.31
3.54

28.7
35.1

3.29
3.31

25.3
33.1

2.96
2.75

28.7
24.5

3.79

30.8

(2/)

(2/)

3.33
3.22

28.8
26.3

3.17
2.51

30.5
23.9

3.85
3.55

35.1
25.3

2.98
3.31
3.37
3.32

25.7
26.4
27.3
29.0

2.66
2.28
2.34
3.19

24.8
22.2
24.5
30.0

3.40
—

26.6
—
31.9
—

3.05
3.30
3.78
—

22.6
31.6
32.2

2.95
2.97
2.65
—

25.0
29.6
23.2

3.66
3.76
—
(2/)

24.8
34.8
—

3.13
3.24
3.44

25.7
29.6
28.3

2.49
(2/)
3.16

23.6

(2/)
29-6

3.66
3.76
—

24.7
34.8
—

3.32
3.01

28.2
2 6 .1

3.03
2.41

29.0
23.3

3.71
3.75

33.7
23.5

2.95
—
a/)

28.4
—

3.85
3.50
(3/)

31.9
26.4

3.13
2.20

2 9 .2

3.50
3.80

26.4
31.2

2.97

28.4

(2/)

(2/)

3.55
—

25.3
—
35.1

3.31
2.94-

30.6
25.6

3.54
3.31

35.1
28.7

Construction cost group:
Under $500,000 ..........................
$500,000-$999,999 .......................
$1,000,000-$1,999,999 ...................
$2,000,000 and over .....................

2.92
2.91
3.11
3.28

25.5
25.9
28.0
30.0

—
(2/)
Q/)
3.51

(2/)
(2/)
32.4

Type of structural framing:
Steel ....................................
Reinforced concrete ....................
Load-bearing masonry ....................
Wood .....................................

3.20
3.K
3.35
(2/)

26.2
30.6
28.9
(3/)

3.44
(2/)
—

32.4
(2/)
—

1 s t o r y ....................................
2-4 stories ...............................
5 or more stories .........................

2.943.11
3.29

24.8
30.1
29.7

Elevators ..................................
No elevators ..............................

3.23
2.76

Air-conditioned:
Full .....................................
Partial .................. ...............
Not air-conditioned ................ .

—

—

—

—

_

_

3.24
3.51

30.7
32.4

3.43
—

31.9

2 4 .0

3.14
3.41
2.84

28.6
30.4
24.7

(2/)
3.44
—

(2/)
32.4
—

3 .3 0
3 .3 0

(2/)

2 8 .1
2 7 .2
(3/)

Full or partial basement ..................
No basement ...............................

3.25
2.97

29.2
27.4

3.50
(2/)

33.6

3.29

28.1

(2/)

3 .3 2

2 7 .6

Exterior:
Masonry .................................
Curtain wall ............................
O t h e r ......... ..........................

3.17
3.05
3.85

29.3
23.3
35.1

3.43
—
—

31.9
—

3.32
3.24
—

30.0
23.6
—

29.4

—

—

—

—

(2/)
23.8

—

Based on federally aided projects only.
Although construction of projects studied extended over a 3^-year period, most of the construction took place in 1959-60.
Insufficient coverage to warrant presentation.




Average
hourly
wage

53.18

In a metropolitan area ....................
Not in a metropolitan area ................

1/
2/
2/

west

South

North Central

Northeast

3.85
—

3.85

(2/)

(2/)

23

Some of the hospital projects differed substantially in the ratio of
wages to total construction. Aside from the extent of alteration work which
generally accompanied construction of additions, there were special conditions
involved such as site problems, or unusual labor arrangements such as travel
time included at regular hourly rates. The range of wages as a percent of
contract for which a distribution of hospital projects could be made (36
hospitals) was as follows:
Percent wages
were of contract cost
Under 2 0 . 0 .... .....................
20.1- 22.5 ..........................
22.6- 25.0 ..........................
25.1- 27.5 ..........................
27.6- 30.0 ..........................
30.1- 32.5 ..........................
32.6 and o v e r .................. .




Percent of
hospitals studied
5.6
11.1
22.2
19.4
19.4
5.6
16.7

24

Off-Site Employment
For each man-hour of employment performed on the construction sites, an
additional 1.5 man-hours of work were required to produce and distribute the
necessary construction materials, supplies, and equipment used in construction
of general hospitals. These projects, thus, gave rise to 134 man-hours of
such employment per $1,000 of contract, compared with 89 hours on-site.
Off-site employment is generated in many places, but can be classified
in the following categories:
1. Construction industry--off-site:
warehousing functions.

administrative, estimating, and

2. Manufacturing activities producing fabricated and raw materials and
equipment.
3. Transportation, warehousing, and distribution of fabricated and raw
materials and equipment.
4. All other industries directly or indirectly affected by the produc­
tion of fabricated and raw materials.
Various interindustry transactions
eventually affect all additional industries such as agriculture, forestry,
and mining.
There are, of course, o -V ~ people affected in types of employment which
this study -id not attempt to cover.
Some of these are mentioned on page 2*
Of the workers omitted, the most numerically important groups, who would be
directly affected by a hospital construction program, were employees in archi­
tectural firms, utility companies, and State and local governments. These
employees and their functions were not included in the construction contract
cost. A large area of employment also excluded from the calculations of
man-hour effects, as mentioned earlier, is that created by the respending and
investing of wages and profits arising in various areas of economic activity
within the scope of this study.
Although the ratio of on-site to off-site employment requirements is
commonly used in analyzing employment requirements in the construction indus­
try, another type of distinction based upon the economic relations of the
labor-generating areas is also useful.
Therefore, employment requirements
have also been divided into primary and secondary man-hour needs. As shown in
the following tabulation and chart 1, the primary man-hour requirements, esti­
mated at 162, arise in the activities at the site and those most directly
related to the construction activity. Included in these, in addition to site
employment, are off-site construction employment, employees of manufacturing
industries represented at the "last stage of manufacturing" for materials
prior to shipment to the site, and employees in transportation, trade, and
service organizations dealing in materials used at the site.




25

Secondary man-hour requirements have been defined as those associated
with all other requirements indirectly related to the needs at the site.
Such activities totaling 61 hours or 27 percent of total man-hour requirements
affect all parts of the economy as the impact of primary activity is reflected
in demand for basic materials and related transportation, trade, and ser­
vices. 9/ The following tabulation shows man-hours of employment associated
with $1,000 of hospital construction.

Total

Primary
activities

All industry g r o u p s ...... .

162

Construction .....................
On-site ........................
Off-site .......................
Manufacturing ........... .........
Transportation ......... ........ .
Trade and s e r v i c e .............
Other ............................

100
89
11
44
5
13
—

Secondary
activities
61

- -

33
4
9
13

Some industries are represented in both the primary and secondary sec­
tors.
For example, the sand and gravel industry furnishes material directly
to the construction inC stry and also to the ready-mix concrete industry
which in turn sells to the construction industry.
Builders* Off-Site Employment
An exact study of off-site employment of contractors was not attempted,
since it was almost impossible to relate accurately such employment to the
projects being studied.
Builders* off-site employment was occupied not only
with the projects studied but also with other current or future projects of
the builders.
The estimate of 11 man-hours of such work for each $1,000 of contract is
based on the difference between construction vjorker employment and total
employment in the contract construction industry. 10/ This estimate also
includes self-employed craftsmen who ma; have worked at the site.

97 Secondary man-hours were estimated on the basis of a study made by
the Bureau of 1947 interindustry relationships.
See W. Duane Evans and Marvin
Hoffenberg, Interindustry Relations Study for 1947, Review of Economics and
Statistics, Vol. XXXIV (1952), Cambridge, Mass.
For methods employed, see
anpendix A.
10/ Administrative, engineering, estimating, and clerical workers
accounted for about 14 percent of total employment in the construction indus­
try. About one-fourth of this employment was involved at the site.




26

Combining this employment with on-site employment results in an estimate
of 100 hours of employment in the construction industry for each $1,000 of
general hospital construction.
Employment in Transportation, Trade, and Service
Distribution of construction materials from the producing industries
requires employment of workers in the transportation, warehousing, and trade
industries. The estimate of 18 hours of primary employment per $1,000 of
contract is based on the difference between producer’s value and delivered
value of materials used at the site. This estimate covers only the distribu­
tion of materials from the producers to construction site and does not include
the distribution of materials among industries prior to shipment of the com­
pleted products.
"Last Manufacturing Stage” Employment
The sector of the economy most affected by hospital construction, other
than the construction industry, is manufacturing. An estimated 44 man-hours
were required for each $1,000 of total contract for production of the construc­
tion materials used in the building of hospitals. This estimate, however,
includes only employment required in the last manufacturing process of the
materials. 11/ Employment generated by this activity is distributed in many
industries directly affected by construction activity. For example, it in­
cludes sawmills cutting rough lumber for forms, and establishments making
millwork items from lumber, but does not include employment in sawmills pro­
ducing lumber for millwork products. The latter is included in the estimate
of secondary employment discussed below.
Employment in Secondary Activities
In addition to the 44 man-hours previously noted for primary employment
for each $1,000 of hospital construction contract in the factories making
construction materials, an additional 35 hours were required in secondary
manufacturing activities.
Transportation industries required 4 hours of employment to transport the
materials to and from the industries indirectly affected.
Trade and service industries as a group required 9 hours of employment
for each $1,000 of hospital construction to meet the needs of secondary busi­
ness activity.
Other business activities, primarily agriculture, forestry, and mining,
accounted for the remaining 13 hours of secondary man-power requirements.

11 / Included in the bill of materials were the supplies and the expended
value of the equipment used by construction contractors.



27

Construction Time
Average construction time required for the projects surveyed was approxi­
mately a year and a half.
(See table 10.) The construction period varied on
individual projects, however, from 21 weeks on the smallest to 151 weeks on
one of the largest.
Significant differences existed not only by size of project but also by
region, due to the influence of climatic conditions. In the Northeast and
North Central regions, more-than-average construction time was required, in
contrast with the West and South, where less-than-average time was used. In
fact, in the South, where construction is usually a year-round industry, con­
struction time for comparable projects was consistently below average.
Employment by Construction Periods
Construction time for each hospital was divided into 10 equal parts. For
example, a hospital which took 15 months to complete was studied in ten 1.5
month periods. This permitted the combination of projects of various sizes
to obtain a typical employment pattern. Thus, the percent of total man-hours,
for all the hospitals by decile, were as follows:
1 s t .... .
2d ........ ......
3d ..... . ......
4th ........ ......
5 t h ...... .

8,4
11.9
13*4

6th .........
7 t h ........
8 t h ........ .......
9th ........ ,.....
1 0 t h .......

13 •0
10.5
7.1

Generally, employment started slowly, built up to a peak in the fifth
period, and dropped off sharply in the last two. Seventy-seven percent of the
on-site employment occurred in the third through the eighth periods, that is,
in the middle 60 percent of the elapsed time. Employment accounted for about
4 percent of the total man-hours in both the first and the last periods.
(See chart 3.)




28

Table 10.

Average Number of Weeks Required for Construction of Hospitals,
by Cost Group and Region, 1959-60 1/

United
States

Northeast

North
Central

South

West

All groups .................

77

90

81

68

7A

Under $500,000 ...............
$500,000-$999,999 ............
$1,000,000-41,999,999 ........
$2,000,000 and over ...........

53
69
79
118

(2/)
(2/)
82
125

66
70
81
126

50
62
80
109

IS

Cost group

1/ Although construction of projects studied extended over a 3^-year
period, most of the construction took place in 1959-60.
2/ Insufficient coverage to warrant presentation.




—

76
1H

29

Chart 3. On-Site Man-Hours of Construction Labor
for Each $1,000 of Hospital Construction Contract
By Decile of Construction Time
Man-Hours




Deciles of Construction Time

30

Materials Used
Costs of materials represented 54.4 percent of total contract value of
all projects. For new hospital projects only, the average materials value
was 55.7 percent, and for additions projects the average was 51.3 percent.
These totals include depreciation charges or rental costs for construction
equipment used and costs of the small amounts of supplies consumed, in addi­
tion to the materials or fixed equipment incorporated in the structures.
Although the lower materials value of the additions projects may reflect some
reduced materials requirements for a few operations, it appears primarily to
be due to the higher percentage of total contract amount paid to on-site labor
as a result of alteration and repair work on such projects* The majority of all
the projects were within 5 percent of the overall average for materials
costs:
Percent materials cost of
total contract amount
45-49 ......................................
50-54 ......................................
55-59 ......................................
60-64 ......................................
65 and over ..................

Percent of
projects
22
26
28
20
4

The difference between the total construction contract value and the sum
of materials and wage costs amounted to 16.8 percent of the cost of all the
projects. This represented the total of those overhead costs \diich cannot be
attributed to specific projects, such as administrative off-site salaries,
expenses of central office and yard operation, insurance and taxes, plus other
overhead, and profit. These two components (overhead costs and profit) could
not be separated in this survey.
Table 11 presents the costs of major materials and groups of materials
used in each $1,000 of construction for all the hospital projects, and also
shows these cost breakdowns for new projects and for additions. The groups,
and the items within the groups are ranked by amounts spent for the products,
on all projects. Although the table presents the costs of materials in terms
of their dollar value, the individual items may be readily reduced to the
familiar magnitudes of percentages. Thus, the sum of $543.80 shown for ”A11
hospital projects” under ”A11 products” would be 54.4 percent.
The proportion of total materials costs per $1,000 of contract amount for
new hospital projects was somewhat higher than that for additions. However,
analysis of the relative materials costs by each of the major materials groups
for all of the projects, and separately, for new projects and additions, indi­
cated fairly constant relationships between and within each of the construction
categories.




Table 11.

T o t a l C ost of Material Com p o n e n t s for E a c h $1,000 o f H o s p i t a l C o n s t r u c t i o n Contract,
1959-60 1/

All
hospital
projects

New
hospital
projects

Hospital
addition
projects

All products ................................ ...............

$54-3.80

$556.70

$512.80

Metal products (except plumbing and heating) ................... .

14-5.90

150.00

136.10

Fabricated structural metal products ..........................
Reinforcing bars and joists ................................
Structural steel ............................. .............
Fabricated sheet-metal ................................. .
Metal windows .............................................
Metal doors ................. ......... .
Ornamental metal ............................. .............
Other ............................ ......... ................

97.20
36.50
21.50
K .60
12.20
7.80
3.90
.80

102.50
38.80
23.60
15.30
12.00
8.00
4-.20
.70

84.70
31.00
16.20
13.10
12.50
7.40
3.30
1.10

Other fabricated metal products ..............................
Builder's hardware ......... ...............................
Other ......... .......... .

10.90
10.60
.4-0

10.30
9.90
.30

12.60
12.10
.40

Other metal products ................................ .........
Metal casework .............. ...............................
Copper products ....... ....................................
Galvanized sheet-metal ................ .....................
Partitions, lockers, and shelves ............................
Other ......... .

37.70
13.60
8.30
4-.90
3.80
7.10

37.30
13.80
8.4-0
4 .10
3.40
7.60

38.80
13.10
8.30
6.80
4.70
6.00

105.50

103.60

110.00

51.60
27.60
8.80

51.80
26.00
8.50

51.30
31.50
9.50

Selected products and product groups

Stone, clay, and glass products ............................ .
Cement, concrete, and gypsum products .........................
Ready-mix concrete .........................................
Gypsum products ................. ..........................
See foot n o t e at end of table.




Table 11.

Tot a l Cost of Material Components for E a c h $1,000 of H o s p i t a l C o n s t r u c t i o n Contract,
1959-60 l / ~ C o n t i n u e d

All
hospital
projects

New
hospital
projects

Hospital
addition
projects

Cement, concrete, and gypsum products— Continued
Concrete block ................................................
Cement .............................................. .
Precast concrete prod nets
Concrete pipe ........ ..... .................... ..... .
Other .......... ......... ............................ .

$6.30
3.80
3.50
.70
1.00

$7.10
3.70
4.60
.90
1.00

$4.30
4.00
.70
.20
1.00

Structural clay products ............ ..........................
Brick and structural tile
....
Ceramic tile .t.... 11....... . .... t................ ...... . ....
Other ................................ .....................

21.70
12.10
8.10
1.60

19.50
10.40
7.20
1.90

27.20
16.30
10.20
.70

Other stone, clay, and glass products ........................ .
Fiber glass products ........ ...............
Cut stone .....................................................
Vlmrl tile ( incl udincr vinvL—asbestos} ...................... .
Window glass ............................... .
Sand and gravel ........... ..... ...........................
Asphalt tile ............ ......... ............... .
Other ........................... .......... .............. .

32.10
9.70
6.40
5.50
3.30
2.30
1.50
3.40

32.40
9.60
6.60
5.10
3.10
2.10
1.90
4.10

31.60
10.00
5.90
6.60
3.60
2.90
.70
1.90

77.70
22.50
12.80
12.20
7.20
6.70
4.90
3.40

81.20
19.80
15.10
13.20
9.70
6.50
5.00
3.70

69.20
29.00
7.30
9.70
1.00
7.20
4.60
2.80

Selected products and product groups

Fixed hosoital eauioment ....................... .
E l evators ......................
X—ray and related equipment ........... .
Sterilizers and autoclaves ................................ .
Kitchen equipment.... .................... .
Refrigerators ........... .................... .............. .
Laundry equipment
R a n g e s.... ............... ....................... ...........
See footnote at end of table.




Table 11.

T o t a l Cost of Material Com p o n e n t s f o r E a c h $1,000 o f H o s p i t a l C o n s t r u c t i o n Contract,
19 5 9 - 6 0 l / — C o n t i n u e d

All
hospital
projects

New
hospital
projects

Hospital
addition
projects

Fixed hospital equipment— Continued
Laboratory equipment .................... .....................
Compressed air and oxygen systems ........................... .
Other 11 r111111 f .... f111.......... ..... .......................

$2.90
2.50
2.60

$2.70
2.80
2.60

$3.30
1.60
2.70

Electrical equipment, fixtures, and wire ........................
Lighting fixtures ............................................
Noncurrent-carrying devices ......................... .........
Switchboards and panelboards .................................
Intercom and fire alarm system.............................
Electric generating units ....................................
Wire and cable ...............................................
Transformers tf11....... ............ .
t.. t....... .............. .
Program systems ........................................... .
O t h e r ............... ............ ........ ......... ........ .

65.30
15.40
10.80
10.70
6.00
5.80
5.10
3.20
1.90
6.40

68.20
15.90
10.90
11.40
5.70
6.50
5.30
3.80
2.70
6.10

58.50
14.20
10.70
9.10
6.70
4.20
4.90
1.80
.10
6.90

Heating, ventilating, and air-conditioning equipment ............
Radiators, convectors, and boilers ............................
Air-conditioning equipment ...................................
Temperature controls ...................................... .
Blowers, exhaust, and fans ...................................
Unit heaters and ventilators .................................
Warm air furnace ......................... ...................
Other ... ...... ......... ..................... ........... .

53.80
14.90
14.60
10.30
4.80
2.40
.10
6.80

57.90
16.30
16.30
11.30
4.50
2.70
.10
6.70

44.10
11.70
10.40
8.00
5.60
1.40
.10
7.00

Plumbing products ............... ..............................
Plumbing fixtures ................................. ..........
Steel and galvanized pipe ....................................
Valves and specialties .......................... .............

47.00
15.50
14.50
10.00

46.90
16.20
13.10
10.00

47.10
14.00
18.00
10.20

Selected products and product groups

See f o o t n o t e at end of table.




Table 11.

T o t a l C ost o f Material Components for E a c h $1,000 o f Hospi t a l C o n s t r u c t i o n Contract,
1959-60 1 / — C o n t inued

All
hospital
projects

New
hospital
projects

Hospital
addition
projects

Plumbing products— Continued
Cast iron pipe ..........
Other ..................

$5.80
1.1 0

$6.50
1.2 0

$4 .1 0
.90

Lumber and lumber products
Millwork ..............
Rough and dressed lumber
Other ................

22.60

16.20
5.40
1.00

21.10
14.70
5.10
1 .3 0

26.40
19.70
6 .1 0
.50

Petroleum products ......
Asphalt paving .......
Asphalt and tar pitches
Asphalt felts ........
O t h e r ...............

5.30
1 .4 0
1.30
1 .0 0
1.70

5.90
1 .9 0
1 .3 0
.90
1.80

4 .0 0

Paint and other chemical compounds
Paint ........................
O t h e r .......... .............

4.40
2.50
1.9 0

4.50
2.60
2.00

4 .0 0

16.30
11.20
.50
4.60

17.40
1 1.90

13.60
9.50
.30
3.80

Selected products and product groups

All o t h e r ...... ......
Construction equipment
Insulating board ....
Other ..............

4.90

.40
1.20
1 .0 0
1.30
2.40
1 .6 0

1/ Although construction of projects studied extended over a 3^-year period, most of the
construction took place in 1959-60.
NOTE: Group totals include products not shown separately.
components may not equal totals.



Because of rounding, sums of

35

The most important broad materials category, "Metal products (except
plumbing and heating)," accounted for almost 15 percent of the total construc­
tion contract amount of all the projects studied. 1_2/ The items used in
structural framing— "Reinforcing bars and joists," and "Structural steel"-tnade up about two-fifths of the "Metal products" group, and metal doors and
windows, about one-seventh.
This group does not represent the total contri­
bution of the metalworking industries, since it excludes the metal products
shown separately in the equipment categories.
By far the largest single item among "Stone, clay, and glass products"
was ready-mixed concrete, which at 2.8 percent, accounted for more than onequarter of the value of the group. This material constituted the frames of
more than one-third of the projects, and the floors and roof decks of most of
them. The small amounts of the raw materials of concrete separately shown—
cement, sand, and gravel— were used in specialized applications such as terraziio
'■^rk.

"Fixed hospital equipment," the third most important broad materials
category, accounted for almost 8 percent of the total contract cost of all the
hospital projects.
Elevators accounted for more than one-quarter of the value
of this group. The "X-ray" and "Sterilizers and autoclaves" items together
made up almost one-third.
For additions alone, these latter two items were
considerably below the percentage shown for all projects and the somewhat
higher percentage shown for new hospitals. This reflected, in part, some
additions in which this type of equipment was not required because the exist­
ing structures were adequately equipped with them. This was also true with
regard to "Kitchen equipment."
"Electrical equipment, fixtures, and wire" amounted to 6.5 percent of the
total cost of all the projects.
The proportion, 5.4 percent, shown for the group "Heating, ventilating,
and air-conditioning equipment" completely covers equipment requirements for
this type of work. The extensive duct materials needed for air exchange
throughout a building are included in "Fabricated sheet-metal products" or in
"Galvanized sheet-metal" under the "Other metal products" group.
Other major materials groups were "Plumbing products," representing 4.7
percent of total projects cost, and "Lumber products," 2.3 percent.
"Millwork"
accounted for almost three-quarters of the total cost of the latter group and
included wood casework. The largest amount of lumber products was used in the
West.

12/ Each "percent of construction contract" represents about $11.6
million of annual expenditures at the current (1961) annual rate of all hospi­
tal and related medical facilities construction (e.g., $169.4 million of metal
products is represented by the 14.6 percent).




36

Changes in Materials
A comparison of construction costs in the present study with those in the
study made about 20 years ago indicates that the proportion that materials
represent of total construction cost has changed only moderately between the
two periods, increasing from 50 percent to 54 percent. However, the propor­
tions that individual materials represent shows some very marked changes,
reflecting different materials usages for similar purposes, changing standards
and requirements, and different price movements. The following tabulation
presents some of these changes for a number of groups of materials. Data from
the current survey are shown for all projects studied. Although little is
known of the characteristics of the projects in the older survey, it is be­
lieved that they were relatively comparable with those in the current study as
they included only new construction, presumably, of new hospitals and additions.
Percent of total
materials cost
Materials group 1/
“
All m a t e r i a l s ............................
Iron and steel and their p r o d u c t s ...................
Structural steel ......................
Reinforcing steel ..............................
Plumbing supplies and fixtures ....................
Heating and ventilating e q u i p m e n t ........
Hardware, miscellaneous ..................
Metal doors, windows, shutters, and t r i m .........
Wire and wire works p r o d u c t s .......
Other iron and steel products .....................
Stone, clay, and glass p r o d u c t s .............
Cement ...........................
Brick, hollow tile, and other clay p r o d u c t s ..... .
Sand, gravel, and crushed s t o n e ...................
Marble, granite, slate, and other stone products ..
Concrete and concrete p r o d u c t s ....... ........ .
Wall plaster and wall b o a r d ...........
Tiling, floor and wall, and terrazzo
......
G l a s s ..............................................
Forest p r o d u c t s ............................
Electrical wiring, fixtures, and supplies ...........
Roofing, insulation, and waterproofing *............
Paints, varnishes, and other c h e m i c a l s .......
Sheet metal ....................................
All other materials ............................
1/

Current
study

100.0

100.0

36.0
6.5
3.5
8.2
10.1
2.4
2.5
.4
2.4
32.5
7.5
9.5
5.0
2.2
3.6
1.5
2.4
.8
15.5
5.4
2.7
1.1
.9
5.9

Products were grouped to conform with the previous study.

Note:



20 years
a 8°

Because of rounding, group totals may not add to 100.

44.3
4.0
6.9
8.8
10.2
2.0
3.8
.1
8.5
18.2
.7
2.6
.7
1.2
7.1
1.7
1.7
2.5
4.4
11.2
.6
.5
2.3
18.6

37

These comparisons illustrate some basic shifts over the years. Additional
new fixed equipment has had the effect of reducing the relative importance of
older materials, even though the latter are still used extensively. Thus, al­
though some masonry such as brick, hollow tile, and other clay products was
used as the exterior material in nearly all of the projects in the current
study, it accounted for only 3 percent of total materials cost, compared with
10 percent in the earlier study.
A change in construction method during the period is strikingly illus­
trated. Twenty years ago, concrete was commonly batched and mixed at the con­
struction site; the use of ready-mixed concrete was just beginning to assume
significance. Today, ready-mixed concrete is more commonly used on construc­
tion jobs. This accounts in part for the decline in the total for cement, and
sand, gravel, and crushed stone (the raw materials of concrete) from almost
13 percent of material cost to 1 percent, and for the increase in concrete and
concrete products from almost 4 to 7 percent. The rise in use of new types of
materials, not necessarily serving entirely new purposes, and the decline in
more traditional materials are reflected in the increases for glass and metal
doors, windows, shutters and trim, and the decrease in forest products. For
example, 20 years ago, fiberglass was a novel building material; today, it is
preferred for several acoustical and thermal applications.




38

Requirement Comparisons With School, Public Building,
and Highway Construction
A comparison of requirements for the four types of construction studied
by the Bureau for this series of reports reveals that although total man-hours
per $1,000 of contract are remarkably similar, there is some variation in
requirements among the affected industries:
Total man-hour requirements per
______ $1,000 of construction contract________
Buildings
Highways 1/
All industries....... <
Construction, on site .... ___

94

Off-site ..................
Construction ............ ___
Manufacturing ...........
Transportation .........
Trade and service ......
Mining ..................___
Other ...................

5

23

Schools

Federal
office
buildings

Hospitals

212

227

223

84

97

89

128

130

134

10
78
8
20
(2/)
12

10
79
9
20
(2/)
12

11
79
9
22
(2/)
13

1/ Data for highways relate to 1958; data for schools and Federal build­
ings relate to 1959. If the highway data were adjusted for increases in prices
and productivity between 1958 and 1959, the total hours would probably not
differ substantially from those for schools.
2/ Included in "Other."
Comparison of data for the "Buildings" group shows that on-site time for
hospitals was approximately 6 percent more than that for schools, and 8 percent
less than that for public buildings. However, schools and public buildings
involved the construction of new buildings only, whereas the hospital projects
included additions to existing buildings. When new hospitals only were con­
sidered, the on-site hours were virtually the same as those for schools. The
higher requirements for public buildings appear to reflect their previously
noted more monumental quality. The somewhat higher off-site requirements for
hospitals than for schools or public buildings appear to be due in some measure
to the relatively large amount of fixed, built-in hospital equipment. Requireing relatively little time at the site in relation to its cost, this type of
equipment tends to increase the off-site hours in the manufacturing and nonman­
ufacturing industries.




39

When "Buildings" are compared with "Highways" it should be borne in mind
that because of the basic differences in locations and construction processes,
relatively more operations are performed at the site of highway than of build­
ing construction. For example, the bulk of the concrete used in highway work
is batched and mixed on-site by the contractor’s own forces; ready-mixed con­
crete is used only for the smaller applications. On the other hand, as
previously noted, most concrete used in building construction is ready-mixed.
Moreover, the highway contractor’s forces produce and process more than half
of the aggregate required in their concrete, using sources as close as possible
to the batch plants. Further, maintenance and other supporting services are
necessarily performed on-site to a greater extent for highway than for build­
ing construction. This in part accounts for the differences shown in off-site
requirements in the construction industry.
Differences in industry impact between highways and the buildings segments
reflect differences in the construction process.
In the case of highways,
skilled workers operate extremely expensive units of equipment to move earth
and place materials of a relatively low order of fabrication; in building con­
struction, most of the journeymen manually place materials of relatively high
cost and degree of fabrication. Thus, in the preceding tabulation, manufac­
turing man-hours are considerably lower for highway than for building construc­
tion, whereas mining hours are higher, reflecting the labor used in extracting
rock, sand, and gravel.
Some of the basic differences are further illustrated by the percent
distribution of construction costs:
Buildings
Highways

Total .................
M a t e r i a l s ..................
On-site wages .............
Equipment 2/ .......... .
Other 2/ ...................
1/

7J
2/

\J

Schools

Federal
office
buildings

Hospitals

100.0

100.0

100.0

54.1
25.7
1.4
18.8

51.3
29.0
1.9
17.8

53.3
28.8
1.1
16.8

Based on data from the U.S. Bureau of Public Roads.
Rental or depreciation charges.
Overhead and profit.

Materials requirements for highways and buildings, although similar in
percent of total construction cost, are different in type. For highways, fourfifths of the total materials value was accounted for by concrete (cement and
bituminous), structural and reinforcing steel, and equipment fuels and lubri­
cants. These represented a relatively minor portion of total materials costs
for buildings.



40

Similarly, the share of total on-site wages received by some construction
trades differed radically on the two types of construction.
Thus, on highway
construction nearly one-third of all on-site wages were paid to equipment
operators (excluding truckdrivers), compared with less than one-thirtieth on
building construction.
Truckdrivers received more than 10 percent of all
on-site wages for highway construction, but less than 1 percent for building
construction.
Unskilled workers, however, appeared to receive only a little
more of the on-site wage dollar in high ay than in building construction,
although available data do not afford a precise comparison.




41

APPENDIX A.

Scope and Method of Survey

This study was designed to develop estimates of man-hour requirements
associated with the construction of both public and private profit or nonpro­
fit general hospitals. Project data obtained from or relating to activity at
the construction site, as well as information based on secondary data such as
the Census of Manufactures, were utilized.
General hospitals, as defined by the Department of Health, Education, and
Welfare, are for inpatient medical or surgical care of acute illness or injury
and for obstetrics, of which not more than 50 percent of the total patient days
during the year are customarily assignable to the following categories of
cases: chronic convalescence and rest, drug and alcoholic, epileptic, mental
deficiency, mental, nervous and mental, and tuberculosis. Construction of
hospitals (or nursing homes) primarily engaged in serving the medical needs of
patients with illnesses falling in the latter descriptive categories was not
included in the study.
Characteristics of the Universe and Selection of the Sample
A single, complete listing of all public and private general hospital con­
struction started between mid-1958 and mid-1959, the period selected for study,
was not available.
It was, therefore, necessary to use several sources to
obtain what was considered to be a representative, if not exhaustive, universe
from which to draw a sample of projects for survey purposes. 13/ Approximately
four-fifths of the projects in the universe so established consisted of nonprofit
public and voluntary general hospitals, constructed with Federal financial
assistance (as provided in the Hill-Burton Act), and the remaining fifth were
not so assisted.
(Hospitals built entirely with Federal funds--!.e., for
veterans, armed service personnel, etc.--were excluded.)
As distinguished from the earlier studies concerning public school and
Federal public building construction, vrtiere only new schools or buildings were
considered, the hospital projects studied included new hospitals, additions to
existing hospital structures, and alterations to the existing structures where
these were part of the construction contracts for the addition projects. Situa­
tions involving renovations only, as distinct from alterations as part of an
addition project, were not studied.

13/ Sources included contract award reports of F. W. Dodge Corp., Modern
Hospital Publishing Co., Inc., and Construction Statistics Office of the Bureau
of the Census. Also, the "Hospital and Medical Facilities Project Register,
December 31, 1959," Division of Hospital and Medical Facilities, the Public
Health Service, U. S. Department of Health, Education, and Welfare. All sources
were crosschecked and project duplications eliminated.




42

Additions (and alterations incident thereto) were felt to be too impor­
tant a part of total hospital construction to be excluded from the study. In
1959 and 1960, approximately 63 percent of Federal assistance funds for hospi­
tal and related projects were provided for additions and alterations projects.
Moreover, the demand for construction of additions was believed comparable to
that for new hospital construction.
The projects in the universe were stratified by four geographic regions
(Northeast, North Central, South, and West), by total construction cost, and
by metropolitan and nonmetropolitan area. 14/
A sample of 46 projects, approximately one-quarter of known units of the
total universe, was selected. The projects were selected at random from the
above three groupings. Although construction of the projects studied extended
over a 3%-year period, most of the construction took place in the period July
1959 through June 1960.
Man-Hour Estimates. The customary presentation of employment data for
construction projects includes estimates for on-site and off-site employment.
Such a presentation is followed by this study. In addition, however, there is
an economic distinction which can be made in analyzing man-hour requirements
for construction. The basic grouping in this instance would be the primary
and secondary labor effects of construction expenditures, with the primary
sector including the on-site employment plus the off-site employment directly
related to the activity at the site.
Primary man-hour requirements, for purposes of this report, include, in
addition to all on-site labor, the construction contractor’s office employment,
the labor required in those manufacturing industries trfiich fabricate the con­
struction materials used on the site--that is, the "last stage of manufacturing”
companies, plus all trade, distribution, and services involved in placing the
construction materials at the site. Secondary employment includes all other
labor requirements necessary to produce and transport the raw materials and
semifinished products to the factories which finally produce the items used at
the site.

14/ The States included in each of the regions were as follows:
Northeast— Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New
York, Pennsylvania, Rhode Island, and Vermont; North Central— Illinois, Indiana,
Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio,
South Dakota, and Wisconsin; South— Alabama, Arkansas, Delaware, District of
Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North
Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West
Virginia; and West— Arizona, California, Colorado, Idaho, Montana, Nevada,
New Mexico, Oregon, Utah, Washington, and Wyoming.




43

Data for on-site hours were generally collected from payroll sources.
All other labor requirements discussed below, whether considered primary or
secondary, were established by use of secondary data.
Collection of On-Site Man-Hour Data
Although the type of construction labor and materials requirements data
sought was similar for both nonfederally and federally aided hospital projects,
the sources for the data differed. For the construction of nonfederally
assisted hospitals, those financed entirely by various levels of local govern­
ments, private individuals or voluntary groups, data were obtained by field
representatives from local authorities, hospital administrators, architects,
contractors, and other direct participants in these projects. For the feder­
ally assisted hospital projects, man-hour data were made available from records
which were required under the Federal assistance program. Access to these
records made possible the collection of some additional detail for these pro­
jects. This included information on wage relationships, timing of construc­
tion operations, and requirements by type of contractor.
Under the Federal legislation whereby Federal assistance may be granted
for the construction of public and voluntary nonprofit hospitals of all types,
after study and survey by a State substantiates the need, the individual States
are given the authority for administering the program /Hospital Survey and
Construction Act of 1946 (Hill-Burton); now referred to, with its amendments,
as Title VI of the Public Health Service Act/. 15/ General coordination and
supervision are exercised by the Public Health Service of the U.S. Department
of Health, Education, and Welfare. Financing is by all parties, jointly,
under a variable matching formula, depending on need and ability to pay.
When a hospital is built with a Federal grant, each prime contractor and
subcontractor engaged on the project is required by the legislation to submit
to the administrator of the sponsoring hospital, a copy of each weekly payroll
showing (with other information) the daily and weekly hours worked, the gross
weekly earnings, and the occupation of each mechanic and laborer on the partic­
ular project. Through the cooperation of HEW, the Departments of Health of
the various States, and the hospital administrators, copies of the payrolls
for the federally aided hospital projects in the sample, along with lists of
the contractors on the jobs, were made available to the Bureau. These payrolls
provided the data for estimating on-site man-hour requirements, as well as data
on wages for all hourly rated workers on the projects. Data for on-site
salaried employees, not accounted for on the payrolls, were obtained by the
field agents from the contractors. In a few cases, the requested payroll
records were not available or were inadequate as data sources. For these situ­
ations, alternate projects were substituted.

15/

Public Law 725, 79th Congress, as amended, approved August, 1946




44

In the nonfederally aided hospitals, the data for on-site labor require­
ments were generally derived from payroll or labor cost records, or daily work
force reports, obtained directly from the contractors engaged on the projects.
Only summary man-hour data by occupation were requested from the contractors.
For a small number of contractors whose records could not be used to isolate
the data for specific hospital projects, estimated hours and materials costs
were substituted.
Off-Site Man-Hours
From contractors and subcontractors cooperating in the study, a price list
was obtained of the value of each type of material used in the sample projects.
These material listings were classified into categories consistent with 5-digit
Census of Manufactures product groups. For each of these product groups, the
average amount used per $1,000 of contract construction was determined. Once
the average use was calculated, each figure was reduced by a ratio representing
the difference between valuation by the purchaser and valuation by the pro­
ducer. 16/ Since all data reported by contractors were in purchasers* value,
reduction to producers* value made the figures consistent with Census data
published on these various components. These figures on average dollar value,
stated in producers* value of each construction material used per $1,000 of
contract value were necessary for each of the succeeding steps.
Primary Distribution Industries Employment
Man-hours in the distribution industries (trade, transportation, ware­
housing, freight forwarding, etc.) at the primary level with respect to con­
struction activity were estimated from the difference between producer and
purchaser value for each construction material. The differences were summed
and allotted to trade or transportation sectors by a ratio obtained from inputs
by these sectors to new construction found in the 1947 input-output analysis.
A second allocation was made among industries within the transportation
sector (rail, truck, etc.) on the basis of 1959 value of production of the
industry. The man-hours for each distribution sector were then determined by
multiplying the value allotted to this sector by man-hours needed to produce
$1,000 of product in the distribution sectors.
Primary Manufacturing Employment
Primary employment in manufacturing was considered to be that required to
produce items in the construction bill of materials in their final stage of
fabrication.
In this stage, man-hours resulting from hospital construction
were developed by multiplying average value of each construction component by
a ratio of manufacturing man-hours to $1,000 of production. 17/
16/ The ratio used for this reduction was the purchaser-to-producer ratio
for these components in hospital construction, as developed for use in the 1947
interindustry analysis.
17/ This ratio was established by using the 1959 Survey of Manufactures.



45

Secondary Employment in All Industries
Secondary employment is defined as the employment in all industries in­
volved in the production and transportation of building materials and equip­
ment, from basic extraction to, but not including, the final manufacturing
stage.
To determine all the secondary man-hours involved in each construction
product, it was necessary to determine the contribution from each of the sec­
tors of the economy to the construction bill of materials. To obtain these
contributions from each sector, an interindustry inverse matrix was used. The
matrix was calculated for the United States economy in 1947 by the Bureau of
Labor Statistics. 18/ Since this matrix is stated in 1947 prices, all prices
of the construction components were deflated to 1947 levels and then grouped
into industry classifications which were consistent with the interindustry
study’s 57-sector aggregation. This provided the value of construction goods,
stated in 1947 prices, for each interindustry sector. Each of these figures
was in turn multiplied by the corresponding coefficients of the inverse matrix.
This procedure indicated the contribution necessary from each of the sectors
to produce the specified construction item used. These products which were
stated in 1947 prices were then reinflated to 1959 prices (the year consistent
with the bill of materials).
Sector contributions to each of the separate construction items were
summed to obtain total contributions from each sector of the economy to the
construction bill of materials. To translate dollars of product contributed
by each sector into employment required by this sector, a ratio of employment
to $1,000 of production was used. These ratios were developed for each of 57
interindustry sectors. 19/
Total Man-Hour Requirements
From each off-site stage (primary distribution, primary manufacturing,
and secondary industry), a man-hour figure per $1,000 of hospital construction
contract was obtained. When these were summed with direct or on-site man-hours
the total employment effect, within the definition used by the study, was deter
mined. However, the procedures used in estimating employment generated by
hospital construction did not include all such employment. The technique used

18/ For a further description, see the article by W. Duane Evans and
Marvin Hoffenberg, op. cit.
19/ Both price and unit employment ratios were actually calculated on a
450-order aggregation and summed to the 57-order aggregation. The employment
figure was converted to man-hours using 3LS average annual hours in each of
the separate sectors.




46

for the off-site segment covers only employment generated by direct purchases
of materials and supplies and implicit in depreciation of construction equip­
ment. The following areas of employment related to the volume of construction
activity were not covered:
(1) Architectural, surveying, estimating, and other
planning employment; (2) inspection or supervision by the architect or the
government during construction; (3) the labor time involved in installations
of public utility employees, as well as any site preparation not covered by
the construction contract; (4) the labor generated by the money expended for
contractors* overhead, other than off-site administrative salaries; (5) employ­
ment generated by purchases of movable furniture and equipment; (6) the
"multiplier" effect of the respending of wages and profits; and (7) the con­
struction and equipment of new production facilities, if needed to supply
construction materials.




*

U .S. G O V E R N M E N T P R IN T I N G O F F IC E : 1962 0 — 659571