scholarly journals Effect of the Health Promotion Plan on the Performance of Hospitals: Evidences from East of Iran

2021 ◽  
Author(s):  
Javad Ghoddoosi Nejad ◽  
Morteza Arab-Zozani ◽  
Rouhollah Yaghoubi
Keyword(s):  
Length Of Stay ◽  
Health Reform ◽  
Average Length ◽  
Health Sector ◽  
Public Hospitals ◽  
Public Expenditures ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Reform Plan ◽  
South Khorasan

Background: Hospitals are considered as the most central and resource-consuming units in the healthcare system. They use from 50 to 80% of public expenditures. As hospitals become more efficient, the better the allocated resources in health sector will be used. Objectives: The aim of this study was to assess hospitals’ efficiency in South Khorasan using the Pabon Lasso model. Methods: In this quasi-experimental and time-series study, we investigated the efficacy of South Khorasan hospitals during 2010 - 2018 (before and after the implementation of the health reform plan). All public hospitals in South Khorasan province were enrolled. Data including bed occupancy rate (BER), bed turnover (BT), and patient length of stay (LOS) were collected from hospitals in summer 2018 and analyzed using SPSS, version 21. Results: The means of the Pabon Lasso performance indicators for eight years were 74.4% for bed occupancy rate, 89.9 times for bed turnover, and 3.01 days for the length of stay. The coefficient of occupancy index after the implementation of the health reform plan was 5.7% higher than before, the bed turnover index increased 4.1 times, and the average length of stay increased by 0.08 day. On average, 35% of the hospitals were located in region 1, while 38% in region 2, 21% in Region 3, and 6% in Region 4 in the Pabon Lasso Diagram. Conclusions: Only 21% of the hospitals were in the region 3 of the Pabon Lasso Diagram, which is the desirable region for the efficiency of hospitals. This situation is not desirable and acceptable for hospitals. To increase productivity, interventions are required, and health planners and authorities need to apply economic tools for the improvement of this situation.

The Health Sector Evolution Plan and the Technical Efficiency of Public Hospitals in IranBackground: Iranian public hospitals have been excessively changing during the healthcare reform since 2014. This study aimed to examine the technical efficiency of p

2020 ◽  
Author(s):  
Edris KAKEMAM ◽  
Hossein DARGAHI
Keyword(s):  
Length Of Stay ◽  
Technical Efficiency ◽  
Healthcare Reform ◽  
Average Length ◽  
Health Sector ◽  
Public Hospitals ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Tobit Regression ◽  
Average Length Of Stay

Background: Iranian public hospitals have been excessively changing during the healthcare reform since 2014. This study aimed to examine the technical efficiency of public hospitals during before and after the implementation of Health Sector Evolution Plan (HSEP) and to determine whether, and how, efficiency is affected by various factors. Methods: Forty-two public hospitals were selected in Tehran, Iran, from 2012 to 2016. Data envelopment analysis was employed to estimate the technical and scale efficiency sample hospitals. Tobit regression was used to relate the technical efficiency scores to seven explanatory variables in 2016, the last year. Results: Overall, 24 (57.1%), 26 (61.9%), 26 (61.9%), 24 (57.1%) and 21 (50%) of the 42 sample hospitals ran inefficiently in 2012 to 2016, with average technical efficiency of 0.859, 0.836, 0.845, 0.905 and 0.934, respectively. The average pure technical efficiency in sample hospitals increased from 0.860 in 2010 (before the HSEP) to 0.944 in 2012 (after the HSEP). Tobit regression showed that average length of stay had a negative impact on technical efficiency of hospitals. In addition, bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusion: Despite government support, public hospitals operated relatively inefficien. Managers can enhance technical efficiency by increasing bed occupancy rate through shortening the average length of stay, proportioning the number of doctors, nurses, and beds along with service quality assurance.

scholarly journals The efficient of beds used based on graphic Barber Johnson at Semen Padang Hospital in 2017

2019 ◽  
Vol 6 (12) ◽  
pp. 5071
Author(s):  
Sayati Mandia
Keyword(s):  
Statistical Analysis ◽  
Length Of Stay ◽  
Medical Record ◽  
Medical Records ◽  
Average Length ◽  
Sampling Technique ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

Background: Quality of hospital services can be seen from the bed usage. Statistical analysis of efficiency bed usage can be mesured based on inpatient medical records. To determine the efficiency requires four parameters namely bed occupancy rate (BOR), average length of stay (ALoS), turnover interval (TI), and bed turnover (BTR). parameters can be presented using Graphic Barber Johnson. This study aims to determine the efficiency of bed usage at Semen Padang Hospital in 2017.Methods: This research was conducted at Semen Padang Hospital, West Sumatera, Indonesia from January to December 2017. The study used a descriptive method with a qualitative approach. The data was collected from medical records department. The population is all abstraction data of in-patient medical record in 2017, 9796 medical record used total sampling technique. Data analysis was performed by calculating the values of ALoS, BOR, BTR, and TI. Data will be presented based on graphic Barber Johnson. Excel 2010 and graphic Barber Johnson method were applied for data analysis.Results: Number of daily inpatient censuses in 2017 are 31227 and number of service days are 31362. Number of beds 144. Statistical analysis results obtained total BOR 60%, BTR 67 times, TI 2 days and ALoS 3 days. The highest value of bed occupancy rate is 66% on August.Conclusions: Based on statistical, value of bed occupancy rate (60%) and turnover interval (2 days) are efficient at Semen Padang Hospital in 2017. Average length of stay (3 days) and bed turnover rate (67 times) are not efficient.

scholarly journals ANALISIS KINERJA KEUANGAN DAN NON KEUANGAN RUMAH SAKIT SEBELUM DAN SESUDAH BADAN LAYANAN UMUM DAERAH

ProBank ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 25-35
Author(s):  
Khairana Amalia Chrishartoyo ◽  
Sri Rahayu ◽  
Djusnimar Zutilisna
Keyword(s):  
Length Of Stay ◽  
Death Rate ◽  
Average Length ◽  
T Test ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Paired Sample ◽  
Average Length Of Stay ◽  
Turn Over

Diterbitkannya Peraturan Menteri Dalam Negeri Nomor 61 Tahun 2007 tentang Pedoman teknis Pola Pengelolaan Keuangan Badan Layanan Umum Daerah mengharuskan Pemerintah Daerah menganut PPK - BLUD dalam manajemen Rumah Sakit dalam rangka meningkatkan pelayanan kesehatan bagi masyarakat. Penelitian ini bertujuan untuk melihat perbedaan kinerja keuangan dan non keuangan RSUD Dr Moewardi sebelum dan sesudah berstatus BLUD. Kinerja keuangan diukur dengan rasio likuiditas, rasio aktivitas, rasio profitabilitas, dan rasio struktur modal. Sedangkan kinerja non keuangan diukur dengan rasio efisiensi pelayanan yaitu Bed Occupancy Rate, Bed Turn Over, Turn Over Interval, Average Length Of Stay, Gross Death Rate dan Net Death Rate. Teknik analisis yang digunakan adalah Paired Sample T Test. Hasil uji statistik menunjukkan tiga dari empat kelompok rasio keuangan yang diuji memiliki nilai Asymp. Sig. (2-tailed) kurang dari 0,05 sehingga dapat disimpulkan terdapat perbedaan signifikan pada kinerja keuangan RSUD Dr Moewardi sebelum dan sesudah BLUD, sedangkan pada rasio efiseiensi pelayanan hanya dua dari enam rasio yang memiliki nilai Asymp. Sig. (2-tailed) kurang dari 0,05 sehingga dapat disimpulkan tidak terdapat perbedaan signifikan pada kinerja efisiensi pelayananRSUD Dr Moewardi sebelum dan sesudah BLUD.Kata kunci :BLUD, kinerja keuangan, kinerja efisiensi pelayanan, rasio keuangan

scholarly journals National University Hospital discharge survey in the Islamic Republic of Iran

2000 ◽  
Vol 6 (2-3) ◽  
pp. 402-408
Author(s):  
S. M. Reza Khatami ◽  
S. K. Kamrava ◽  
B. Ghatehbaghi ◽  
M. Mirzazadeh
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Discharge ◽  
Average Length ◽  
Health Care Service ◽  
Health Care Facilities ◽  
University Hospital ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

We aimed to determine the rate of hospital discharge, average length of stay and bed occupancy rate in different hospital wards around the country. The survey consisted of health care service activities from 452 university-related hospitals in the country with a total of 59 348 beds. Because of missing data, the use of 56 315 of these beds was analysed. The countrywide discharge rate was 68.32 patients/1000 population per year with an average length of stay of 3.60 days and a bed occupancy rate of 57.44%. The data could be used to design a framework for prediction of inpatient health care facilities needed in the future

scholarly journals Penilaian Tingkat Efisiensi Pengelolaan Rumah Sakit Denganaplikasi Grafik Barber-Johnson Di Rumah Sakit Usada Sidoarjo

2015 ◽  
Vol 1 (1) ◽  
pp. 74
Author(s):  
Dyan Angesti
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Visual Basic ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Turn Over ◽  
Visual Basic 6.0

ABSTRAKUpaya pemberian pelayanan terbaik kepada customer oleh pihak manajemen rumah sakit tidak dapat dipungkiri apabila membutuhkan cost yang tidak sedikit. Langkah ataupun kebijakan yang akan diambil pihak manajemen haruslah merupakan langkah yang bijak. Disinilah informasi yang dihasilkan oleh unit rekam medis memegang peranan penting. Informasi yang berkualitas menjadi bermanfaat bagi pengambil keputusan baik keperluan internal maupun eksternal rumah sakit tersebut. Penelitian ini dilakukan pada bulan Maret sampai dengan Juli 2010 bertempat di Rumah Sakit Usada Sidoarjo.Variabel pada penelitian ini adalah Bed Occupancy Rate (BOR), Bed Turn Over (BTO), Average Length of Stay (AvLOS), Turn Over Interval (TOI). Penelitian ini merupakan penelitian pengembangan dengan tujuan mengembangkan laporan rumah sakit menjadi sebuah grafik Barber Johnson menggunakan Microsoft Visual Basic 6.0 sehingga dapat dipergunakan sebagai alat bantu pengambilan keputusan bagi pihak manajemen.

scholarly journals Percent Bed occupancy rate in a selected specialized tertiary care hospital in Dhaka city

1970 ◽  
Vol 11 (1) ◽  
pp. 18-24 ◽  
Author(s):  
H Rahman ◽  
SME Haque ◽  
MA Hafiz
Keyword(s):  
Length Of Stay ◽  
Tertiary Care Hospital ◽  
Average Length ◽  
Tertiary Care ◽  
Calculated Data ◽  
Care Hospital ◽  
Dhaka City ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

Background and Aims: Providing a necessary care for a sick person outside home 'in hospes or hospital' dates back to nearly 300 century BC. In the present day hospital care facilities has been taken an institutional shape both in public and private sector. A hospital bed is both a scarce and expensive commodity in healthcare. Administrators running 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. The present study was undertaken to explore utilization of bed in a specialized tertiary care hospital in the Dhaka city. Methods: Hospital records of the year were reviewed- age, gender, disease profile, duration of hospital stay, outcome of treatment were recorded and bed occupancy rate was calculated. Data were presented as number, percentage and/ or mean SD, as appropriate. The dada were managed by Statistical Package for Social Science (SPSS) for Windows Version 10. Results: The results showed in the year 2001 total number of admissions were 13,305 of which 9953 (74.8%) were male and 3352 (25.2%) female. Average monthly admission was 1109. Maximum number of admissions (1304) was observed in the month of September of that year. Male admission rate was higher than female admission throughout the year. Among all the admission 27.2% were of road traffic accident cases. Among the admitted patients there was 57.3% discharge with advice, 1.9% death, 14.6% discharge on request bond, 12.7% discharge on request. Of all the admission there 12.5% found to be absconded. Bed occupancy rate was 79.75% and average length of stay in the hospital 18.47 days. Conclusions: The present data suggest that (i) in terms of bed occupancy rate the NITOR found to run in optimal capacity which, however, might be attributed to the relative high rate of ascendance and discharges on requests; (ii) average length of stay of patients appeared to be relatively longer and (iii) the management need to look into the issue and take appropriate measures to reduce patients unwanted long duration of stay and make the tertiary care hospital improve the quality of services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9817 BJMS 2012; 11(1): 18-24

scholarly journals Technical Efficiency of Public and Private Hospitals in Beijing, China: A Comparative Study

2019 ◽  
Vol 17 (1) ◽  
pp. 82 ◽  
Author(s):  
Rize Jing ◽  
Tingting Xu ◽  
Xiaozhen Lai ◽  
Elham Mahmoudi ◽  
Hai Fang
Keyword(s):  
Technical Efficiency ◽  
Average Length ◽  
Public Hospitals ◽  
Scale Efficiency ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Tobit Regression ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals

Objective: With the participation of private hospitals in the health system, improving hospital efficiency becomes more important. This study aimed to evaluate the technical efficiency of public and private hospitals in Beijing, China, and analyze the influencing factors of hospitals’ technical efficiency, and thus provide policy implications to improve the efficiency of public and private hospitals. Method: This study used a data set of 154–232 hospitals from “Beijing’s Health and Family Planning Statistical Yearbooks” in 2012–2017. The data envelopment analysis (DEA) model was employed to measure technical efficiency. The propensity score matching (PSM) method was used for matching “post-randomization” to directly compare the efficiency of public and private hospitals, and the Tobit regression was conducted to analyze the influencing factors of technical efficiency in public and private hospitals. Results: The technical efficiency, pure technical efficiency and scale efficiency of public hospitals were higher than those of private hospitals during 2012–2017. After matching propensity scores, although the scale efficiency of public hospitals remained higher than that of their private counterparts, the pure technical efficiency of public hospitals was lower than that of private hospitals. Panel Tobit regression indicated that many hospital characteristics such as service type, level, and governance body affected public hospitals’ efficiency, while only the geographical location had an impact on private hospitals’ efficiency. For public hospitals in Beijing, those with lower average outpatient and inpatient costs per capita had better performance in technical efficiency, and bed occupancy rate, annual visits per doctor, and the ratio of doctors to nurses also showed a positive sign with technical efficiency. For private hospitals, the average length of stay was negatively associated with technical efficiency, but the bed occupancy rate, annual visits per doctor, and average outpatient cost were positively associated with technical efficiency. Conclusions: To improve technical efficiency, public hospitals should focus on improving the management standards, including the rational structure of doctors and nurses as well as appropriate reduction of hospitalization expenses. Private hospitals should expand their scale with proper restructuring, mergers, and acquisitions, and pay special attention to shortening the average length of stay and increasing the bed occupancy rate.

scholarly journals Analysis of statistic health care as indicators of efficiency service in Semen Padang Hospital through Barber Johnson graph

2020 ◽  
Vol 7 (2) ◽  
pp. 427
Author(s):  
Nurhasanah Nasution
Keyword(s):  
Length Of Stay ◽  
Turnover Rate ◽  
Statistical Data ◽  
Average Length ◽  
Level Of Service ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Johnson Graph ◽  
Average Length Of Stay ◽  
Service Efficiency

Background: The efficiency of service delivery is very important for hospitals. One measurement of service indicators that can be used is the Barber Johnson graph (GBJ). GBJ is needed to see and measure the level of service efficiency in hospitals. The indicators used are bed occupancy rate (BOR), bed turnover rate (BTR), turnover interval (TI), and length of stay (LOS). This graph can also be used to compare or view hospital developments at different times, and to increase the likelihood of changes in one variable by changing other variables. This research was conducted at Semen Padang Hospital (SPH), Padang, West Sumatera, Indonesia.Methods: The purpose of this study was to determine the statistical value of hospital and hospital service efficiency levels by using the Barber Johnson graphic. This research method is descriptive by direct observation of the medical record file of inpatients since the January to December 2017 period.Results: Statistical data obtained from SPH in 2018 showed the value of service days 30132, and the Number of beds 144 units. From the data processing results obtained a total bed occupancy rate 60.83%, bed turnover rate 6.86 times, turnover interval 2 days and average length of stay 3 days.Conclusions: Statistical data obtained from SPH in 2018 shows the value of BOR, TI is in an efficient, while BTR and LOS are inefficient.

scholarly journals Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathanael Lapidus ◽  
Xianlong Zhou ◽  
Fabrice Carrat ◽  
Bruno Riou ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Parametric Method ◽  
Estimation Methods ◽  
Unbiased Estimation ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Discharged Patients ◽  
First Admission

Abstract Background The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Methods Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. Results LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Conclusions Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Funding Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).

Safety and feasibility of a nurse-led ambulatory abdominal paracentesis service.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 63-63
Author(s):  
Kim Hua Lee
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Average Length ◽  
Symptom Relief ◽  
Bleeding Complications ◽  
Inpatient Setting ◽  
Bed Occupancy ◽  
Abdominal Drain ◽  
Hospital Bed ◽  
Abdominal Paracentesis

63 Background: Ascites is a common complication of cancer. Symptomatic ascites contributes to cancer-related morbidity and is distressing for patients (pts). Therapeutic abdominal paracentesis (TAP) provides symptom relief but requires specialized procedural knowledge and is usually performed in the inpatient setting with several days of hospitalization. Additionally, high hospital bed occupancy during the COVID-19 pandemic prevented timely admission for TAP. An Advanced Practice Nurse (APN)-led ambulatory TAP service was introduced at our center, with the aim of improving access to TAP and reducing hospital bed occupancy. Methods: A multidisciplinary team developed workflows and safety guidelines for TAP to enable right-siting of pts in a cancer day care unit. Pts were scheduled for radiologically guided insertion of abdominal drains in the morning before 10am to allow adequate time for drainage. Pre-procedure clinical examination and safety checks were performed by APNs in the day unit. Following the procedure, abdominal fluid was drained with concurrent administration of 20% IV albumin. Drains were removed by the APN and pts were examined before discharge on the same day. Data for all cancer pts requiring TAP in the day unit and hospital from 1 Jan to 30 Nov 2020 were extracted from the electronic medical record system. The primary outcome was length-of-stay (LOS). The primary safety outcome was adverse events in the day unit. Continuous data were compared using the t-test. Data analysis was done in SPSS version 22. Results: The number of TAPs performed in the day unit and general ward requiring hospitalization were 102 and 133, respectively. There was a significant reduction in average LOS with TAPs performed in the day unit vs. hospitalization (1.48 vs. 5.82 days, p<0.001) (Table). The mean difference was 4.34 (95% confidence interval 3.33 - 5.34) days saved per pt, or a saving of 443 inpatient bed days. The TAP day unit service encountered 10 adverse events (AEs) requiring admission to the ward for continued drainage. AEs were borderline baseline blood pressure, pt frailty and inability to care for an indwelling catheter. There were no infective or bleeding complications. The majority of TAPs (86.8%) were performed in one day, with the remainder over 2-days with the abdominal drain left in-situ and reattendance at the day unit the next day for further drainage. Differences in average length-of-stay with TAP in the hospital vs. day unit. Conclusions: An APN-led ambulatory abdominal paracentesis service is a safe alternative to inpatient paracentesis. Optimal utilization of a day unit enabled reduced LOS for pts with advanced cancer. This reduction in LOS was critical during a pandemic where bed demand was high. This was possible from advanced scheduling and control over the day unit capacity.[Table: see text]

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