Example: Indicators that determine the activities of the polyclinic. Indicators of inpatient (hospital) care
bunk function) bed utilization rate: the average number of patients per one actually deployed bed per year.
1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.
See what "Bunk turnover" is in other dictionaries:
- (syn. bed function) bed utilization rate: the average number of patients per one actually deployed bed per year ... Big Medical Dictionary
TURNOVER (FUNCTION) BED Glossary of terms on social statistics
TURNOVER (FUNCTION) BED- characterizes the activity of the hospital and is calculated as the ratio of the number of used patients to the average annual number of beds or as the ratio of the average number of days of bed operation to the average duration of the patient's stay in bed ... Social statistics. Dictionary
See bunk turnover... Big Medical Dictionary
MENTAL Ills- MENTAL PATIENTS. With pronounced, fully developed mental illnesses, there are a number of features that distinguish P. b. from all others and leading to a special attitude towards them in legal terms, to special care for them, a kind of ... ...
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STATISTICS- STATISTICS. 1. Brief history, subject and basic concepts of general statistics. The subject of S. is the study of collections of internally connected, though externally isolated elements. The internal regularity of the latter finds its manifestation ... ... Big Medical Encyclopedia
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- (Deutsche Demokratische Republik) GDR (DDR). Tab. 1. Administrative division (1971)* | Districts | Area, | population, | Adm. center |… … Great Soviet Encyclopedia
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Table 14
The available number of beds does not fully meet the needs of the district, determine the required number of beds using the standards.
Calculation of the needs of the population in hospital beds for the main specialties in the Hvorostovsky district.
1. Therapy. According to Appendix 5 (Indicative morbidity rates by referrals in medical institutions and indicators of the use of hospital beds), the number of initial referrals for therapy per 1000 population is 416, therefore, per 76,800 population - 31948. The percentage of selection per bed per 100 applicants is 10%, therefore , the standard of need for hospitalization for the district for therapy will be 3194 (the need of the population for hospitalization, P. people).
The bed turnover (O) for therapy (the ratio of the average annual bed occupancy (in days) to the average duration of the patient's stay in bed) according to the standard will be: 343/19 = 18. The need for hospital beds (K) for therapy will be (Rosenfeld's formula):
K = F/R, K = 3194/18 = 177 treatment hospital beds. 30% of the beds are located in the regional hospital, therefore, the district needs = 124 therapy beds.
P \u003d 0.15 * 19660 \u003d 2949 O \u003d 335/13 \u003d 25.8
K = 2949/25.8 = 114 hospital beds for surgery. Subtracting 30% gives you 80.
P \u003d 1 * 1920 \u003d 1920
O = 300/10 = 30
K = 1920/30 = 64 - 30% = 45 hospital beds for obstetrics.
P \u003d 0.7 * 3840 \u003d 2688
O \u003d 340/8 \u003d 42.5
K \u003d 2688 / 42.5 \u003d 62-30% \u003d 43 hospital beds in gynecology.
P \u003d 0.1 * 18739 \u003d 1874
O = 340/15 = 22
K = 1874/22 = 82-30% = 57 pediatric hospital beds.
P \u003d 0.17 * 7142 \u003d 1214
O = 310/13 = 24
K = 1214/24 = 50-30% = 35 hospital beds for infectious diseases.
P \u003d 0.14 * 2304 \u003d 322
O \u003d 340/22 \u003d 15.5
K \u003d 322 / 15.5 \u003d 21-30% \u003d 15 hospital beds in neurology
P \u003d 0.25 * 1997 \u003d 499
K = 499/4 = 125-30% = 88 TB hospital beds
P = 0,08*2688 = 215
O \u003d 344/20 \u003d 16.7
K \u003d 215 / 16.7 \u003d 13-30% \u003d 9 hospital beds in dermatovenereology
Conclusion: Thus, for the therapeutic profile, it is necessary to add 4 beds, for the surgical one - 10, for the pediatric one - 3, for the infectious disease - 15 beds, and in the obstetric departments there are 10 more beds than the need.
Draw up a plan for the Central District Hospital for the next year in terms of the number of patients treated, taking into account the profile of beds (Table 16).
Calculation of the number of bed days:
Number of bed days = average annual bed occupancy (standard) average annual number of hospital beds
Number of bed-days for therapy = 343*60 = 20580
Number of bed-days for surgery = 335*45 = 15075
Number of bed-days in the maternity ward = 300*25 = 7500
Number of bed-days in gynecology = 340*20 = 6800
Number of bed-days in pediatrics = 340*25 = 8500
The number of bed-days in the infectious department = 310 * 25 = 7750
Number of bed-days in neurology = 340*20 = 6800
Number of bed-days in dermatovenereology = 334*10 = 3340
Number of bed-days in phthisiology = 320*30 = 9600
Number of patients treated = number of bed-days / average length of stay of a patient in a bed
Number of treated patients by therapy = 20580/19 = 1083
Number of patients treated by surgery = 15075/13 = 1160
Number of treated patients in the maternity ward = 7500/10 = 750
Number of patients treated in gynecology = 6800/8 = 850
Number of pediatric patients treated = 8500/15 = 567
The number of treated patients in the infectious department = 7750/13 = 596
Number of patients treated in neurology = 6800/22 = 309
Number of treated patients in dermatovenereology = 3340/20 = 167
Number of patients treated for phthisiology = 9600/81 = 119
Conclusion: Taking into account the profile of beds for the next year, 1083 patients with a therapeutic profile, 1160 with a surgical profile, 750 with an obstetric and 850 with a gynecological profile, and 567 patients with a pediatric profile can be treated in the Central District Hospital.
Rational use of the actually deployed bed fund (in the absence of overload) and compliance with the required period of treatment in departments, taking into account the specialization of beds, diagnosis, severity of pathology, concomitant diseases, are of great importance in organizing the work of a hospital.
To assess the use of the bed fund, the following most important indicators are calculated:
1) provision of the population with hospital beds;
2) average annual hospital bed occupancy;
3) the degree of use of the bed fund;
4) turnover of a hospital bed;
5) the average duration of the patient's stay in bed.
Provision of the population with hospital beds (per 10,000 population):
total hospital beds x 10,000 / population served.
Average annual employment (work) of a hospital bed:
number of bed days actually spent by patients in the hospital / average annual number of beds.
Average annual number of hospital beds is defined as follows:
number of actually occupied beds per month of the year in hospital / 12 months.
This indicator can be calculated both for the hospital as a whole and for departments. Its assessment is made by comparison with the calculated standards for departments of various profiles.
Analyzing this indicator, it should be taken into account that the number of actually spent hospital days includes days spent by patients on the so-called side beds, which are not counted among the average annual beds; Therefore, the average annual bed occupancy may be more than the number of days in a year (over 365 days).
The work of a bed less or more than the standard indicates, respectively, an underload or an overload of the hospital.
Approximately this figure is 320 - 340 days a year for city hospitals.
Degree of use of beds (fulfillment of the plan for bed days):
number of actual hospital days spent by patients x 100 / planned number of hospital days.
The planned number of bed days per year is determined by multiplying the average annual number of beds by the standard bed occupancy per year (Table 13).
Table 13
Average number of days of use (occupancy) of a bed per year
This indicator is calculated for the hospital as a whole and for departments. If the average annual bed occupancy is within the norm, then it approaches 30%; if the hospital is overloaded or underloaded, the indicator will be respectively higher or lower than 100%.
Hospital bed turnover:
number of discharged patients (discharged + deceased) / average annual number of beds.
This indicator indicates how many patients were "served" by one bed during the year. The speed of bed turnover depends on the duration of hospitalization, which, in turn, is determined by the nature and course of the disease. At the same time, a decrease in the length of stay of a patient in a bed and, consequently, an increase in the turnover of a bed largely depend on the quality of diagnosis, the timeliness of hospitalization, care and treatment in the hospital. The calculation of the indicator and its analysis should be carried out both for the hospital as a whole and for departments, bed profiles, and nosological forms. In accordance with the planned standards for general city hospitals, the bed turnover is considered optimal in the range of 25-30, and for dispensaries - 8-10 patients per year.
Average length of stay of a patient in a hospital (average bed day):
number of hospital days spent by patients per year / number of discharged patients (discharged + deceased).
Like the previous indicators, it is calculated both for the hospital as a whole and for departments, bed profiles, and individual diseases. Tentatively, the standard for general hospitals is 14-17 days, taking into account the profile of beds, it is much higher (up to 180 days) (Table 14).
Table 14
Average number of days a patient stays in bed
The average bed-day characterizes the organization and quality of the treatment and diagnostic process, indicates the reserves for increasing the use of the bed fund. According to statistics, reducing the average length of stay in bed by only one day would allow more than 3 million additional patients to be hospitalized.
The value of this indicator largely depends on the type and profile of the hospital, the organization of its work, the quality of treatment, etc. One of the reasons for the long stay of patients in the hospital is insufficient examination and treatment in the clinic. Reducing the duration of hospitalization, freeing up additional beds, should be carried out primarily taking into account the condition of patients, since premature discharge can lead to re-hospitalization, which ultimately will not reduce, but increase the indicator.
A significant decrease in the average hospital stay compared to the standard may indicate insufficient justification for reducing the duration of hospitalization.
The proportion of rural residents among hospitalized patients (Section 3, subsection 1):
the number of rural residents hospitalized in a hospital for the year x 100 / the number of all admitted to the hospital.
This indicator characterizes the use of city hospital beds by rural residents and affects the indicator of provision of the rural population of a given territory with inpatient medical care. In city hospitals, it is 15 - 30%.
MODULE 3.2. METHODOLOGY FOR CALCULATION AND ANALYSIS OF STATISTICAL INDICATORS OF THE ACTIVITY OF HOSPITAL INSTITUTIONS
MODULE 3.2. METHODOLOGY FOR CALCULATION AND ANALYSIS OF STATISTICAL INDICATORS OF THE ACTIVITY OF HOSPITAL INSTITUTIONS
The purpose of studying the module: emphasize the importance of statistical indicators for assessing and analyzing the performance of hospitals.
After studying the topic, the student should know:
Basic statistical indicators of the work of hospitals;
Basic accounting and reporting statistical forms used to analyze the activities of hospitals;
Methods of calculation and analysis of statistical indicators of the work of hospitals.
The student must be able to:
Calculate, evaluate and interpret statistical indicators of the work of hospitals;
Use the information obtained in the management of hospitals and clinical practice.
3.2.1. Information block
Based on the data presented in statistical reporting forms approved by the Ministry of Health and Social
development of the Russian Federation, statistical indicators are calculated to analyze the activities of hospitals.
The main reporting forms characterizing the activities of hospitals are:
Information about the medical institution (f. 30);
Information about the activities of the hospital (f. 14);
Information about medical care for children and adolescent schoolchildren (f. 31);
Information about medical care for pregnant women, women in childbirth and puerperas (f. 32);
Information about termination of pregnancy up to 28 weeks (f. 13). Based on these and other forms of medical records, statistical indicators are developed that are used to analyze the medical activities of the hospital and hospital care in general. These statistics, methods of calculation, recommended or average values are presented in section 7 of chapter 13 of the textbook.
3.2.2. Tasks for independent work
1. Study the materials of the corresponding chapter of the textbook, module, recommended literature.
2. Answer security questions.
3. Parse the task-standard.
4. Answer the questions of the test task of the module.
5. Solve problems.
3.2.3. test questions
1. What are the main reporting statistical forms used to analyze the activities of hospitals.
2. What statistical indicators are used to analyze the activities of hospitals? Name the methods of their calculation, recommended or average values.
3. List the statistical indicators for the analysis of continuity in the work of outpatient clinics and hospitals. Name the methods of their calculation, recommended or average values.
4. Name the main reporting statistical forms used to analyze the activities of the maternity hospital.
5. What statistical indicators are used to analyze the activities of the maternity hospital? Name the methods of their calculation, recommended or average values.
3.2.4. Reference task
The state of inpatient care for the population of a certain subject of the Russian Federation is analyzed. The table presents the initial data for calculating the statistical indicators of the provision of the population with inpatient care, as well as the activities of the city hospital and maternity hospital.
Table.
The end of the table.
* As an example, for calculating the workload indicators of the staff, the data of the therapeutic department were taken.
Exercise
1.1) indicators of satisfaction of the population of the subject of the Russian Federation with inpatient care;
City hospital;
Maternity home.
Solution
To analyze the state of inpatient care for the population of a certain subject of the Russian Federation, we calculate the following indicators.
1. Calculation of statistical indicators of inpatient care for the population of a constituent entity of the Russian Federation
1.1. Indicators of satisfaction of the population of the constituent entity of the Russian Federation with inpatient care
1.1.1. Provision of the population with hospital beds =
1.1.2. Bed structure =
Similarly, we calculate: surgical profile - 18.8%; gynecological - 4.5%; pediatric - 6.1%; other profiles - 48.6%.
1.1.3. Frequency (level) of hospitalization =
1.1.4. Provision of the population with inpatient care per person per year =
1.2. Indicators of the use of the city hospital bed fund
1.2.1. Average number of bed occupancy days per year (hospital bed function) =
1.2.2. The average length of stay of a patient in a bed =
1.2.3. Bed turnover =
1.3. Indicators of the workload of the staff of the inpatient department of the city hospital
1.3.1. Average number of beds per position of a doctor (middle medical staff) =
Similarly, we calculate: the average number of beds per post of nursing staff is 6.6.
1.3.2. The average number of bed-days per position of a doctor (middle medical staff) =
Similarly, we calculate: average number of bed-days per position of nursing staff - 1934.
1.4. Quality indicators of inpatient care in a city hospital
1.4.1. Frequency of discrepancy between clinical and pathoanatomical diagnoses =
1.4.2. Hospital mortality =
1.4.3. Daily lethality =
1.4.4. Postoperative mortality =
1.5. Continuity indicators in the work of the city hospital and polyclinic
1.5.1. Hospitalization Refusal Rate =
1.5.2. Timeliness of hospitalization =
2. Performance indicators of the maternity hospital 2.1. The proportion of physiological births =
2.2. Frequency of caesarean section in childbirth =
2.3. Frequency of operative aids for childbirth =
2.4. The frequency of complications in childbirth 1 =
2.5. Frequency of complications in the postpartum period 1 =
The results of the calculation of statistical indicators are entered into a table and compared with the recommended values or the prevailing average statistical corresponding indicators given in section 7 of chapter 13 of the textbook and the recommended literature, after which we draw the appropriate conclusions.
Table. Comparative characteristics of statistical indicators of inpatient care for the population of a constituent entity of the Russian Federation
1 The indicator can be calculated for certain types of complications.
Continuation of the table.
The end of the table.
** As an example, the indicators are calculated for the therapeutic department.
Conclusion
The analysis showed that the provision of the population of the subject of the Russian Federation with hospital beds - 98.5 0 / 000, the level of hospitalization - 24.3% and the provision of the population with inpatient care - 2.9 bed-days exceed the recommended values, which is the basis for restructuring (optimization) network of healthcare institutions of the given subject of the Russian Federation.
Indicators of the use of the bed fund of the city hospital (average number of days of bed occupancy per year - 319.7, average -
naming the duration of the patient's stay in bed - 11.8, bed turnover - 27) also does not correspond to the recommended values. The indicator of the average number of beds per position of medical personnel, calculated using the example of a therapeutic department, significantly exceeds the indicator of the number of beds per position of nursing staff compared to the recommended load standards. Accordingly, the indicator of the average number of bed-days per position of nursing staff - 1934 bed-days is also significantly higher than the recommended standard. An analysis of the quality indicators of inpatient care in this city hospital indicates serious shortcomings in the organization of the treatment and diagnostic process: the rates of hospital (2.6%), daily (0.5%) and postoperative (1.9%) mortality exceed the recommended values. The rates of refusals in hospitalization (10.0%) and the timeliness of hospitalization (87.6%) indicate shortcomings in the organization of the succession of the work of this city hospital and outpatient clinics located in the area of medical care for the population. Thus, the analysis of the activities of the in-patient department of the city hospital revealed significant shortcomings in the organization of medical and diagnostic care and the use of hospital beds, which, in turn, adversely affects the quality indicators of in-patient care.
An analysis of the results of the maternity hospital's activities showed that the statistical indicators calculated on the basis of the initial data given in the table correspond to the recommended and average values, which is evidence of a good level of organization of preventive and medical diagnostic work.
3.2.5. Test tasks
Choose only one correct answer.1. Name the indicators characterizing the activities of hospitals:
1) the average number of days a bed is occupied per year;
2) the average duration of the patient's stay in bed;
3) bed turnover;
4) hospital mortality;
5) all of the above.
2. What statistical reporting form is used to analyze inpatient care?
1) medical card of an inpatient (f. 003 / y);
2) information about the activities of the hospital (f. 14);
3) a sheet of daily records of the movement of patients and hospital beds (f. 007 / y-02);
4) information about injuries, poisonings and some other consequences of external causes (f. 57);
5) information about medical care for children and adolescent schoolchildren (f. 31).
3. Specify the data required to calculate the rate (level) of hospitalization:
1) the number of emergency hospitalizations, the total number of hospitalizations;
2) the number of people admitted to hospitals, the average annual population;
3) the number of retired patients, the average annual population;
4) the number of planned hospitalizations, the average annual population;
5) the average number of hospitalized, the number of registered patients per year.
4. Enter the data needed to calculate the average number of bed occupancy days per year:
1) the number of bed-days spent by patients in the hospital; the number of days in a year;
2) the number of bed-days spent by patients in the hospital; the number of patients who left the hospital;
3) the number of bed-days spent by patients in the hospital, the average annual number of beds;
4) the number of patients transferred from the department, the average annual number of beds;
5) average annual number of beds, 1/2 (admitted + discharged + deceased) patients.
5. What data is used to calculate the average length of stay of a patient in a bed?
1) the number of bed-days actually spent by patients; average annual number of beds;
2) the number of bed-days spent by patients in the hospital; number of treated patients;
3) the number of retired patients, the average annual number of beds;
4) the number of bed-days actually spent by patients, the number of days in a year;
5) the number of days in a year; average bed occupancy, bed turnover.
6. What formula is used to calculate the hospital mortality rate?
1) (Number of deceased patients in the hospital / Number of discharged patients) x 100;
2) (Number of deceased patients in the hospital / Number of admitted) patients x 100;
3) (Number of deceased patients in the hospital / Number of discharged patients) x 100;
4) (Number of deceased patients in the hospital / Number of admitted patients) x 100;
5) (Number of deceased patients in the hospital / Number of autopsies) x 100.
7. What data is used to calculate the postoperative mortality rate?
1) the number of deaths in the surgical hospital; the number of people admitted to the hospital;
2) the number of deaths; the number of those operated on;
3) the number of deaths among those operated on; the number of people discharged from the hospital;
4) the number of deaths among those operated on; the number of those operated on;
5) the number of deaths; the number of people discharged from the hospital.
8. What data is needed to calculate the proportion of physiological births?
1) the number of physiological births; total number of births;
2) the number of physiological births; the number of live and dead births;
3) the number of physiological births; number of births with complications;
4) the number of physiological births; number of live births;
5) the number of physiological births; the number of women of childbearing age.
3.2.6. Tasks for independent solution
Task 1
Table. Initial data for calculating statistical indicators of inpatient care for the population of a constituent entity of the Russian Federation
The end of the table.
* As an example, for the calculation of personnel load indicators, data from the traumatology department were taken.
Exercise
1. Based on the initial data given in the table, calculate:
1.1) indicators of satisfaction of the population of the constituent entity of the Russian Federation with inpatient care;
1.2) statistical indicators of the activities of hospitals:
City hospital;
City maternity hospital.
2. Analyze the data obtained, comparing them with the recommended or average values given in the textbook and recommended literature.
Task 2
Table. Initial data for calculating statistical indicators of inpatient care for the population of a constituent entity of the Russian Federation
The end of the table.
