Bread and butter hospital administration statistics for practitioners

1. PATIENT MOVEMENT STATISTICS
for primary care physicians
Rafiu Ariganjoye, MBBS, MBA, FAAP, FAIHQ, CHCQM,CPE
Consultant Pediatrician
Dr. Sulaiman Al-Habib HMG Hospital, Riyadh, KSA

2. What is recorded?
• Admission
• Duration of stay
• Discharges and deaths

3. Usefulness
• Indicator of hospital utilization
• Indicator of operational efficiency

4. Average daily census (ADC)
• Average number of inpatients (excluding newborns) receiving care in
the hospital at midnight
= Total number of patient-days for period (except newborn)/
Total number of days in the same period
e.g. if there were 25,000 patient-days of care during the year , the ADC
for that year will be 68 ( 25000/365)
For the month of February, if there were 280 patient days, the ADC will
be 10 (280/28)
*Represent the average daily load of patients for that unit over a
given period

5. Percentage of occupancy (bed occupancy rate)
Total number of patient- days for period (except newborn) x 100/
Total number of days in the same period x no of available beds
i.e Ratio of ADC to available beds x 100
(ADC / no of available beds ) x100
*Optimum for good patient care & hospital economics = 75-85 %
occupancy rate
*Higher occupancy= overutilization and lowering quality of care

6. Glossary
Length of Stay (LOS) (For One Inpatient): The number of calendar days
from admission to discharge.
Total Length of Stay (For All Inpatients): The sum of the days of stay of
any group of inpatients discharged during a specified period of time.
Discharge Days (DD): Same as Length of Stay or Total Length of Stay
(see above).
Average Length of Stay (ALOS): The average length of hospitalization of
a group of inpatients discharged during the period under consideration

7. Average length of stay (ALOS)
The average number of patients days of service rendered to each
inpatient during a given period (The average length of hospitalization of
a group of inpatients discharged during the period under
consideration)
*Any patient admitted and discharged on the same day accumulates a
length of stay of one day.
*No patient admitted to the hospital ever has 0 (zero) days or negative
days credited as a length of stay.
*A patient who is admitted one day and discharged the following day
also is credited with a length of stay of one day.

8. ALOS contd
*Each day counts as a discharge day except the day of discharge
* All days are counted in determining LOS, except the day of discharge,
unless the patient the patient was admitted and discharged on the
same day

9. ALOS- contd
*Each day counts as a discharge day except the day of discharge
* All days are counted in determining LOS, except the day of discharge,
unless the patient the patient was admitted and discharged on the
same day

10. ALOS- contd
*Method A ( based on daily census)
= Total no of patient days (sum of daily census) during a period /
Total no of discharges and deaths during the same period
• *Useful in acute hospital with a quick turnover
• *Not useful during the period when LOS is unusually long

11. ALOS- contd
Method B (based on discharges instead of daily census)
= Total discharge days (=total length of stay)/
Total discharges (including deaths)
Total discharge days ( total LOS of discharged patients for a given
period)= Total no of patients discharge x no of days spent in the
hospital=Total length of stays

12. Bed Turnover Rate
* Another measure of hospital utilization of bed
*Use in conjunction with % of occupancy and LOS
* The mean no of patients “passing through” each bed during a period
a) Direct Bed Turnover Rate
Total no of d/c (including deaths) in a period/
Average bed count during the period

13. Bed Turnover Rate
• b) Indirect Bed Turnover Rate
Occupancy rate (in decimal) x no of days in a period/
Average Length of Stay (ALOS)
i.e (ADC/ ALOS ) x (nos of days in a period/ no of available beds )

14. Bed Turnover Ratio
• Indicate the number of times there is change occupant for a bed
during a given time period (the speed with which patient on any bed
are rotated)
= Total patient admission/
Number of beds