scholarly journals Trends in hospital service provision

2002 ◽  
Vol 25 (5) ◽  
pp. 2 ◽  
Author(s):  
Jenny Hargraves ◽  
Narelle Grayson ◽  
Ian Titulaer
Keyword(s):  
Service Provision ◽  
Health Expenditure ◽  
Average Length ◽  
Public Hospitals ◽  
Hospital Service ◽  
Private Hospitals ◽  
For Profit ◽  
Average Length Of Stay ◽  
Acute Hospitals ◽  
Using Data

In this paper,trends in hospital service provision are measured using data on the numbers and nature of hospitals,on hospital expenditure and on hospital activity over recent years.The number of public acute care hospitals was fairly stable,however,bed numbers decreased.Hospital numbers rose for private hospitals,as did numbers of beds,particularly for group for-profit private hospitals.Recurrent health expenditure on hospitals as a proportion of all recurrent health expenditure fell,although it rose for private hospitals, and real increases in expenditure occurred for both public acute and private hospitals.Population rates for separations and patient days rose for private hospitals and were stable and fell, respectively,for public acute hospitals. Average length of stay decreased for both public acute and private hospitals, with increasing numbers of separations occurring on a same day basis.Increasing proportions of procedures were undertaken during same day stays,and in private hospitals.Separation rates varied geographically, with highest rates overall,and for public hospitals and overnight separations,for patients resident in remote centres and other remote areas.Highest rates for private hospitals were for patients resident in capital cities,other metropolitan centres and large rural centres.

scholarly journals Australian hospital services: An overview

2002 ◽  
Vol 25 (1) ◽  
pp. 2 ◽  
Author(s):  
S.J. Duckett
Keyword(s):  
Length Of Stay ◽  
Private Health Insurance ◽  
Average Length ◽  
Admission Rate ◽  
Public Hospitals ◽  
State Governments ◽  
Hospital Services ◽  
Private Hospitals ◽  
Average Length Of Stay ◽  
Australian Hospital

Hospital services in Australia are provided by public hospitals (about 75% of hospitals, two-thirds of separations) and private hospitals (the balance). Australians use about one bed day per person per year, with an admission rate of about300 admissions per thousand population per annum. Provision rates for public hospitals have declined significantly (by 40%) over the last 20 years but separation rates have increased. Average length of stay for overnight patients has been stable but, because the proportion of same day patients has increased dramatically, overall length of stay has declined from around seven days in the mid 1980s to around four days in the late 1990s. Overall, the Commonwealth and state governments each meet about half the costs of public hospital care, private health insurance meets about two-thirds of the costs of private hospitals.

scholarly journals Length of stay comparisons for private and public hospitals

2000 ◽  
Vol 23 (3) ◽  
pp. 162 ◽  
Author(s):  
Jennifer Badham ◽  
Jason Brandrup
Keyword(s):  
Length Of Stay ◽  
Public Hospital ◽  
Average Length ◽  
Public Hospitals ◽  
Private Hospitals ◽  
The Public ◽  
Average Length Of Stay ◽  
Private And Public

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospitalsectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care providedby private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector.The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

scholarly journals Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Royi Barnea ◽  
Adi Niv-Yagoda ◽  
Yossi Weiss
Keyword(s):  
Health Insurance ◽  
Surgical Procedures ◽  
Health Expenditure ◽  
Medical Center ◽  
Waiting Times ◽  
Publicly Funded ◽  
Private Hospitals ◽  
The Public ◽  
For Profit ◽  
Elective Surgical Procedures

Abstract Background The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures. Methods Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics. Results Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%. Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%. Conclusions and policy implications In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals. Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.

scholarly journals The epidemiological study of migraine and other headache syndromes in southern Brazil: hospitalizations and average length of stay in 2020.

2021 ◽  
Author(s):  
Júlia Maria Orsini Zava ◽  
Tais Lorrane Mendes Silva ◽  
Gabriela Biazi Barbosa ◽  
Fabio Rosnei da Silva ◽  
Gabriela Dias Silva Dutra Macedo
Keyword(s):  
Average Length ◽  
Length Of Hospital Stay ◽  
Epidemiological Survey ◽  
Cross Sectional Study ◽  
Age Group ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Southern States ◽  
Average Length Of Stay ◽  
Using Data

Introduction: Migraine is one of the most common headaches and a frequent population complaint, presenting different symptoms and intensities. Objective: The objective is to carry out an epidemiological survey and the average length of hospital stay in the southern states of Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study. Design and setting: Is a carried out using data collected from DATASUS, during 2020 year in southern Brazil. Results: In the proposed period, there were 2,662 hospitalizations, with the state of PR the largest number (1,760). As for the average hospitalization, the RS stands out with 4 days, SC presents 2.8 and PR with 2.3. Regarding the age group, in PR it is between 40-49 years old, SC between 30-39 and in RS 50-59. As for gender, the prevalence is higher among women, with 63.11% of the total. Conclusion:The data are in agreement with the literature, confirming that women are more affected, being justified by numerous factors, from hormonal variations to different responses to the perception of stress and pain. The high average length of hospitalizations indicates the need to develop policies to discuss the issue, providing adequate prophylaxis and therapy, reducing the number of the cases, the intensity of crises and hospitalizations.

scholarly journals P111: Presentations for hypoglycemia associated with diabetes mellitus to emergency departments in a Canadian province: a database and epidemiological analysis

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S115-S115
Author(s):  
C. Alexiu ◽  
S. Jelinski ◽  
A. Chuck ◽  
B.H. Rowe
Keyword(s):  
Diabetes Mellitus ◽  
Rural Areas ◽  
Emergency Departments ◽  
Urban Areas ◽  
Average Length ◽  
Data Extraction ◽  
Descriptive Analysis ◽  
Administrative Database ◽  
Average Length Of Stay ◽  
Using Data

Introduction: Diabetes mellitus (DM) is a major chronic disease. Prevalence of diabetes was 9% globally in 2014 and 9.3% in Canada and 7.2% in Alberta in 2015. Complications of the disease are numerous and frequent. Hypoglycemia is one complication of diabetes treatment. The objective of this study was to quantify and characterize presentations by adults to Alberta emergency departments (EDs) for hypoglycemia associated with type 1 (T1DM) or type 2 (T2DM) diabetes. Methods: A retrospective cohort study was conducted using data for Alberta for a five-year period (fiscal years 2010/11-2014/15). Data were sourced from an administrative database: National Ambulatory Care Reporting System (NACRS). Records of interest were those with an ICD-10-CA diagnosis of DM-associated hypoglycemia (i.e., E10.63, E11.63, E13.63, or E14.63). A descriptive analysis was conducted. Results: Data extraction yielded 7,835 presentations by 5,884 patients. The majority of presentations were by males (56.2%) and median patient age was 62. These episodes constituted 0.08% of presentations to Alberta EDs and they occurred at an event rate of 0.67 episodes per 100 patient-years (95% CI: 0.66-0.69). The annual rate of presentations decreased by 11.8% during the five-year period. Most presentations (63.4%) involved transportation to the ED via ambulance. Relative to LOS for ED presentations for all reasons, average length-of-stay (LOS) was 3.2x longer and 1.4x longer for discharged and admitted patients, respectively. For 27.5% of presentations, an X-ray was obtained. Most hypoglycemic episodes (65.2%) were considered to be of moderate severity while 34.3% were considered to be severe. None were mild because all involved access to an ED. The condition mainly (absolute terms) afflicted people with T2DM and urban areas; however, it disproportionately afflicted people with T1DM and rural areas. Conclusion: For a condition that is largely preventable with effective blood glucose management, DM-associated hypoglycemia incurs significant healthcare resource use. People with DM would be better served with more effective and safer euglycemic agents.

scholarly journals A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

2020 ◽  
Author(s):  
Akoria Obehi ◽  
Franklyn Osian ◽  
Blossom Akene ◽  
Eunice Ugorji ◽  
Oluwaseun Kubeyinje ◽  
...  
Keyword(s):  
Average Length ◽  
First Year ◽  
Electronic Patient Records ◽  
Turnover Rates ◽  
Quality Healthcare ◽  
Average Length Of Stay ◽  
Quality Improvement Interventions ◽  
Using Data ◽  
Set Up ◽  
Occupancy Rates

Abstract Background: Quality healthcare requires learning organizations who demonstrate commitment to evaluation and improvement. The Geriatrics Unit in the 850-bedded University of Benin Teaching Hospital (UBTH), Nigeria, was set up in 2014 to provide quality healthcare to older persons. The goal of this evaluation was to assess the extent to which that initiative met its objectives. Methods: Using the Donabedian's framework, we undertook a formative review of key service elements in the Geriatrics Unit of UBTH from April 1, 2014 to March 31, 2018, using data from routine ward documentation. Results: The unit had a multidisciplinary team of doctors, nurses, physiotherapists, occupational therapists, pharmacists, medical social workers and support staff throughout the period in focus. All records were manually kept. In-patient numbers more than doubled within the first year, from 62 to 133. Increasing utilization was also evident in bed occupancy rates that rose from 20.1% in 2014 to a peak that exceeded the maximum capacity of open beds (112%) in 2017, and required closed beds to be opened. Bed turnover rates increased from 3.7 in 2014 to 22.2 in 2017. The median average length of stay was 13.9 days. Gross mortality rate ranged between 23% and 31.8%; annual fall rates between 0.4 and 3.0 falls per thousand patient days, and discharges against medical advice (DAMA) between 0.8% and 6.1%.Conclusion: Multi-disciplinary care was maintained in the geriatrics unit, and available beds were oversubscribed within the 4 years reviewed. Opportunities for improvement include moving on to electronic patient records; increasing the number of functional beds; achieving lower mortality rates. Our findings also provide benchmarks against which future evaluations and quality improvement interventions will be measured.

scholarly journals Investigating the effect of health transformation plan on the public hospitals performance indicators; a case study from Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Ranjbar ◽  
Mohammad Bazyar ◽  
Hassan Jafari ◽  
Mohsen Pakdaman ◽  
Vahid Pirasteh
Keyword(s):  
Performance Indicators ◽  
Average Length ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Hospitalization Rates ◽  
Research Findings ◽  
Yazd City

Abstract Background Health systems need constant changes and reforms in their structure to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in Yazd city, Iran. Methods This cross-sectional study was carried out in all public hospitals in city of Yazd. Six performance indicators were examined monthly and in two time periods of 12 months before and 12 months after the implementation of Health Transformation Plan (HTP). The data was analyzed by SPSS software program version 22, using the paired T-test, and the Interrupted Time Series (ITS) model. Findings Findings showed that the performance indicators of the studied hospitals have improved after the implementation of the HTP. According to the ITS model, the implementation of HTP did not have a significant effect on the level and trend of the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators. However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates. Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy rate, but did not have a significant effect on the trend of this indicator. Conclusion Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which showed the effect of this plan on the performance of hospitals. However, not all indicators were statistically significant as the findings sub-section revealed.

scholarly journals Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; a case study in Iran

2020 ◽  
Author(s):  
Mohammad Ranjbar ◽  
Hassan Jafari ◽  
Mohammad Baziyar ◽  
Mohsen Pakdaman ◽  
Vahid Pirasteh
Keyword(s):  
Performance Indicators ◽  
Average Length ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Health Coverage ◽  
Monthly Basis ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Before And After

Abstract Introduction: Health systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. Methods: The present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. Findings: The implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).Conclusion: Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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 Differences in the cost of admitted patient care for Indigenous people and people from remote locations

2013 ◽  
Vol 37 (1) ◽  
pp. 26 ◽  
Author(s):  
Rosalyn Malyon ◽  
Yuejen Zhao ◽  
Brett Oates
Keyword(s):  
Indigenous People ◽  
Average Length ◽  
Diagnosis Related Groups ◽  
Multivariate Regression Analysis ◽  
Public Hospitals ◽  
Payment Systems ◽  
Remote Areas ◽  
Remote Locations ◽  
Average Length Of Stay ◽  
The Cost

The introduction of activity-based funding (ABF) means that Australian Refined Diagnosis Related Groups and their relative costs will become the basis for reimbursing public hospitals for admitted patient services. This study sought to investigate the variation in admitted patient costs for Indigenous people and people from remote areas that cannot be explained by variation in the clinical mix of cases, and to interpret this variation within an ABF framework. The study used a dataset of discharges from public hospitals of Northern Territory residents between July 2007 and June 2009. Multivariate regression analysis was used to estimate the variation in average costs, using the logarithm of patient cost as the dependent variable and Major Diagnostic Categories (MDCs), hospitals and population subgroups (Indigenous v. non-Indigenous; urban v. remote) as independent variables. Although much of the additional cost of Indigenous and remote patients was found to be due to differences in severity and complexity between MDCs, there were extra costs for remote Indigenous patients that were not captured by the classification system. Hospitals servicing larger than average proportions of these patients could be systematically underfunded within an ABF framework unless a price adjustment is applied. What is known about the topic? Indigenous people and people living in remote locations have a greater burden of disease and injury and are high users of hospital services. Past studies have quantified the relative cost of providing admitted patient services to these groups using survey data or the average length of stay as a proxy for cost. What does this paper add? This study provides estimates of the additional costs of providing admitted patient services to Indigenous people and people from remote areas and interprets these within an activity-based funding framework. What are the implications for practitioners? This paper provides information on the importance of recognising high cost populations in payment systems for public hospitals.

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