A Study of the Variations in Reports on Hospital Facilities and Their Use

Abstract

Facilities represented by a hospital have been for many years an essential element in medical care, but they are now assuming increasing importance in programs of community health service. Because of this broadening base, hospital superintendents, practicing physicians, health officials, and persons concerned with community-service institutions all have occasion to consult data bearing on the existence of hospital facilities, their use, and the costs of operation. The items of information commonly used in expressing hospital accommodations and utilization are bed capacity, number of patients admitted, average daily census, and number of out-patient visits. These also constitute the bases for computing many of the unit costs of operation. For some time persons interested in hospital statistics and cost accounting have suspected that there must be some confusion in terms used by those responsible for the administrative records of hospitals, since data on facilities and use from similar hospitals were not comparable, and the reports of individual hospitals failed to check from year to year. The nature and extent of the discrepancies, however, were not fully understood. In an effort to clear up these points, the several national agencies concerned with collection of hospital statistics joined in requesting that the Public Health Service conduct an inquiry into the matter. It so happened that the information desired by all agencies was of particular interest to the Public Health Service, since the Service at the time was charged with conducting that part of the 1935 Census of American Business which pertained to hospitals. The national agencies which normally compile hospital statistics kindly agreed to the use of their basic data. Surveys then in progress and others that had recently been completed furnished additional opportunities for securing from the same group of hospitals corresponding schedules which were suitable for comparative analysis. Random samples were selected from reports received by five of the agencies and matched, for each group in turn, with schedules from the sixth which were used as a basis for measuring the extent of variation. These five groups of reports and the agencies which received them are herein designated by the letters A, B, C, D, and E, and the sixth is known as the basic group or agency. The number of hospitals represented in study groups A, B, C, D, and E were 654, 304, 329, 701, and 379, respectively.