This document discusses various standards and indices used to measure hospital utilization. It defines utilization as how a community uses available hospital resources. Commonly used standards include resource utilization, control standards, intangible standards, and inventory levels. Control standards are classified as output, activity, and financial ratios. The document also outlines several quantitative indices to measure hospital utilization, including bed occupancy rate, bed turnover rate, bed turnover interval, average length of stay, and bed distribution ratios.
3. UTILIZATION STANDARDS
β’ Measuring the performance and correcting deviations ,it is necessary
to establish standards.
β’ Standards are criteria of performance, made to give managers signals
or warnings as to how things are going without their having to watch
every step, every day.
β’ It is the development of a system for a particular procedure.
β’ Commonly used standards are resource utilization, control standards,
intangible standards, resource allocation, staff turnover, consumption
of stores & material, equipment utilization, inventory control levels
and payroll expenses, infection control , and surgery review.
4. CONTROL STANDARDS;
In hospitals, control standards can be classified into
1] output controls.
2] Activity controls.
Length of stay(ALOS), bed occupancy, number of OPD patients per
speciality .
3] Revenue to expense ratio to monitor financial activity.
4] utilization of new services to monitor growth.
5. Intangible standards;
Medical services are intangible services & hence very difficult to
measure their performance.
For example, assembly line type of jobs like,
1] CSSD (CENTRAL STERILE SERVICES DEPARTMENT)
2] Laundry
3] Nurses services & quality etc.
7. BED OCCUPANCY RATE (BOR)
β’ It is expressed as percentage by either of the following two methods.
1] Ratio of actual patient days to the maximum possible patient days during a given
period.
β’ BOR indicates the relationship between availability and utilization of hospital beds
and facilities
2] Ratio of the average daily census to the bed complement.
Average Daily Census
BOR= ------------------------------------ x 100
Bed Complement
8. BED TURNOVER RATE (BTR)
β’ Bed turnover rate given the number of discharges per hospital bed
over a given period, i.e. how many times a bed was β turned overβ
during the period . It is directly related to the average length of stay (
ALOS) and bed turnover interval (BTI).
Total number of patients discharged ( including deaths)
BTR = -------------------------------------------------------------------------------------
-
Bed complement
9. BED TURNOVER INTERVAL (BTI)
β’ It denotes the average time in days elapsing between the discharge of one patient
and the admission of the next on that bed, i.e. the time a bed remains vacant
between admission.
10. AVERAGE LENGTH OF STAY (ALOS)
β’ ALOS Is the average period in hospital ( in days ) per patient admitted, i.e. the
average number of days of service rendered to each inpatient.
Number of inpatient days care ( excluding healthy new born) during the
year
ALOS = ------------------------------------------------------------------------------------------------------------
---
Total number of discharges and deaths
11. BED DISTRIBUTION & POPULATION RATIO
β’ To determine hospital capacity of beds, one must decide on service capacity to be
provided.
A x S x 100
Bed population=----------------------
365 x PO
Where, A = Number of inpatient admission per thousand population per year
S = average length of stay (ALOS)
PO= Percentage occupancy
12. BED DISTRIBUTION
β’ Following ranges confirm to general hospitals distribution pattern.
β’ Medical----- 30 to 40 %
β’ Surgical----- 20 to 25%
β’ Obestetrical-----15 to 18%
β’ Paediatric------ 10 to 12%
β’ Miscellaneous----10 t0 15% ( including ent
