SC Hospital

Building large new hospitals in the bistate area would constitute a wasteful use of resources, on the basis of avoidance of duplicated facilities alone.

(A) on the basis of avoidance of duplicated facilities alone
(B) on the grounds of avoiding duplicated facilities alone
(C) solely in that duplicated facilities should be avoided
(D) while the duplication of facilities should be avoided
(E) if only because the duplication of facilities should be avoided

The OA is E, but makes little sense to me. Actually, the whole question makes little sense to me.

This is what one guy wrote, ant it makes some sense

I still think E is best.

This is what i would call a 'meaning' question. Apart from the grammar rules, you are tested on what sentence fragment actually makes the correct sense.

Lets turn E around.

If only because duplication of facilities should be avoided, building new hospitals in the new bistate area would constitute a wasteful use of resources.

In other words, Its like saying,

[If your only criterion is no duplication of facilities, then building new hospitals in the new bistate area would constitute a wasteful use of resources.]

Another way of explaining it is:

[ Hospitals already exist , so if you build new hospitals , it would duplicate facilities and would consitute an wasteful use of resources]

IMO, E conveys the intended meaning clearly. Other choices fall way short of introducing the conditional clause necessary for the sentence to make sense.