Hospital Performance Indicator

Hospital Performance Indicators

1. Bed Occupancy Rate.

            It is calculated by the following formula         

                        BOR(%)=   Cumulative IP days x100

                                      Number of Beds x days

Bed occupancy ratio reflects the popularity of the hospitals in terms of Inpatients. The level of occupancy also varies with the type of facilities available in the hospital. Usually larger the number of beds, the larger is the number of Doctors also. As a result more facilities are provided and the level of medical care tends to be of a higher magnitude. Given this, it is normally the case that the bed occupancy ratio in District Hospitals is higher than the bed occupancy ratio in the Area and Community Health Centers. The bed occupancy ratio, and in general, the utilization of hospitals is also set to vary with the medical facilities available in the private sector.

2. Turn Over Rate

            It is calculated by the formula

            TOR=    No. of Admissions                                 

                 No. of Beds

The turn over rate essentially defines the period for which a bed is occupied. As against the number of beds occupied which is indicated by the bed occupancy ratio, the turn over rate indicates the speed with which patients on any bed are rotated. Obviously the more complicate the case dealt with by the hospitals, the smaller the turn over rate. Too large a turn over rate indicates that only simple type of treatment  is being provided. Too small a turn over rate would indicate fewer people utilizing the hospital and patients being unnecessarily retained on the premises. Both are not desirable. However in the case of hospitals dealing with chronic diseases like T.B. and so on, a low turn over rate is a must. Given these facts, it is obvious that on the average the turn over rate of a District Hospital should be lower than the turn over rate of a Community Health Center.

3. Average Length of Stay .

            It is calculated by the formula

            AVLS                         = Cumulative IP days

                                       No. of Admissions.

            The average length of say is a parameter similar to the turn over rate and is inversely related. The average length of stay as the name suggests represents the time the patient is retained in the hospital. As in the case of the turn over rate, a longer average length of stay is to be expected in the case of hospitals having better facilities such as the District Hospitals. In the case of Community Health Centers where the level of treatment in general is lower, the average length of stay is likely to be less.

4. Outpatient / Inpatient Ratio

            OP/IP= No of OP

                         No of Admissions

            This is a good indicator of the manner in which Inpatients service is being utilized in the hospital. In general, the number of outpatients should be broadly related to the number of inpatients. If a hospital is reporting very high number of out -patients as opposed to inpatients then obviously the type of inpatient care in relation to the demand for medical services is poor.

On the other hand, a low outpatient/inpatient ratio would suggest that there is excessive concentration of providing inpatient care facilities and smaller ailments are not being dealt with.

5. Number of surgeries

            The provision and utilization of surgical operations facilities is also a good indicator of the functioning of the hospital.

6. Number of deliveries

             The functioning of this facility is another parameter to judge the functioning of a hospital. This indicates the confidence with which women patients view these institutions.

7. Number of X-rays/scans

The utilization of X-rays and scanning machines provides a good indicator of how the hospital is functioning. In the past, due to lack of films and other basic equipment this equipment was lying idle. As far as Punjab Health Systems Corporation hospitals are concerned all facilities have now been provided. Under these circumstances it is possible now to utilize this equipment as an index of the performance of the hospital. A very low utilization indicates a diversion of patients away from the hospitals to private sector health care.

8. No of lab tests

            This indicates the availability & efficiency of diagnostic facilities in a hospital.

            In order to use the data more effectively the following procure is suggested.

In case of district level hospitals, bed occupancy rate and turn over rate should be compared with the average of only district level hospitals.

In case of sub – divisional hospitals, bed occupancy rate and turn over rate should be compared with the average of only sub –divisional level hospitals.

In case community Health Centers, bed occupancy rate and turn over rate should be compared with the average of only Community Health Centers.

In order to assess the functioning of each hospital the Corporation is making a basic analysis of the data. The entire effort should be to ensure general increase in bed occupancy rate while maintaining a reasonable turn over rate.

If the bed occupancy rate is above average and the turn over rate is within 10% of the mean, than the hospital is functioning reasonably well. In all other cases some correction is required.