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Indian Journal of Community Medicine

Bed Utilization Rates at a Tertiary Care Hospital in Goa

Author(s): FS Vaz, AMA Ferreira, DD Motghare, MS Kulkarni

Vol. 31, No. 3 (2006-07 - 2006-09)

A hospital bed is both a scarce and expensive commodity in healthcare. Administrators running these hospitals are in a dire need of objective measures and methods for efficient management of their limited financial resources. Bed utilization rates can be of immense help in realistic and effective decision making.

A descriptive study was carried out in an 845 bedded tertiary care public hospital in Goa. Hospital data for the entire year 2003 was collected and was analyzed using the various hospital indices. Internationally accepted working definitions and calculations were used for calculating the indices1.

Total OPD attendance for the year 2003 was 363,949. There were a total of 40,262 admissions, 38,204 discharges and 2058 deaths. The average length of stay in the hospital was 5.9 days (Table 1). The longest length of stay was for the skin ward (21.7 days) reflecting the chronic nature of several skin diseases, while the lowest was for the ophthalmology ward (4.2 days). E Ravi Kiran et al2 reported an average length of stay of 9 days in a tertiary care teaching hospital. The overall bed occupancy rate for the hospital was 77.4%. The orthopaedics wards had the highest bed occupancy of 97.4% followed closely by surgery wards (94.5%), neurosurgery (89.6%) and ophthalmology (86.7%). The lowest bed occupancy was seen in the skin ward which had occupancy of only 28.1% reflecting the declining prevalence of leprosy in Goa. Bed turnover interval which expresses the average period in days during which a hospital bed remains vacant was 1.7 days. A very low turnover interval was seen in orthopaedics wards (7 hours), surgery wards (9 hours) and neurosurgery (12 hours) while, the skin ward had the highest turnover interval (55.4 days). The bed turnover ratio for the hospital was 47.6. The turnover ratio indicates the number of turnovers in one year for the given bed complement. Saha JB et al3 reported a bed turnover ratio of 20-40 in their study in west Bengal1. A further disease-wise or department-wise analysis would give valuable information about the requirements of drugs, equipments and manpower so that advance planning could be done. The study highlighted the urgent expansion needed by orthopaedics, surgery and neurosurgery branches. Shifting of the skin ward to a smaller location and reuse of the skin ward for some other clinical branch was recommended.

Table I: Bed Utilization Rates for the Year 2003

Department Bed
Comp-
lement
Average
length
of stay
(days)
Bed
Occu-
pancy
Rate (%)
Turnover
Interval
(days)
Turnover
Ratio
Hospital 845 5.9 77.4 1.7 47.6
Medicine 205 4.8 72.1 1.9 54.2
Surgery 150 7.2 94.5 0.4 47.9
Obstetrics 155 5.9 79.5 1.5 48.6
Orthopaedics 90 10.6 97.4 0.3 33.4
Ophthalmology 30 4.2 86.7 1.9 59.7
Skin 30 21.7 28.1 55.4 4.7
Neurosurgery 30 5.0 89.6 0.5 65.3

Financial management has always been a hospital administrator’s nightmare. Peoples unending demands on one hand and severe budgetary constraints on the other have always weighed down heavily on the administrator. The decisions have always been dictated more by emotions and politics rather than by pragmatism. Hospital utilization indices are an objective measure of the efficiency of the hospital management system. Their consistent use will help the administrators in making their decisions more realistic, scientific and free from subjective bias.

References

  1. Llewelyn-Davies R, Macaulay HMC. Hospital planning and administration. WHO Monograph series No.54. Geneva, 1966.
  2. Ravi Kiran E, Vijaya K. Utilization of beds in a tertiary hospital. Journal of Association of Hospital Administrators 2004; 15(2):13-17.
  3. Saha JB, Mitra J, Mondal A. Length of stay of in-patients of a gynecological ward in a sub-divisional hospital in West Bengal. Indian Journal of Public Health 1991; 35(3):71-74.

FS Vaz, AMA Ferreira, DD Motghare, MS Kulkarni
Deptt. of Preventive and Social Medicine,
Goa Medical College Bambolim, Goa-40302.
E-mail: [email protected]

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