Economic Performance Analysis of Selected Military Hospitals Using Hospital Indicators and Inpatient Bed-Day Cost

Ehsan Teymourzadeh,Javad Khoshmanzar,Sayyed-Morteza Hosseini-Shokouh,Mohammadkarim Bahadori,Mohammad Meskarpour-Amiri

doi:10.15171/hpr.2019.05

Ehsan Teymourzadeh, Javad Khoshmanzar + Show 3 more

Open Access

https://doi.org/10.15171/hpr.2019.05

Copy DOI

Abstract

Background: Hospitals, the main providers of healthcare services, are costly centers which account for about 80% of the health sector budget and have a huge share of resources. Objective: This study aimed to analyze the economic performance of selected military hospitals in Tehran using hospital indicators and inpatient bed-day costs. Methods: This descriptive, cross-sectional, retrospective study conducted in hospitals affiliated with a military medical university. Data was collected with forms completed by referring to the hospitals’ finance and accounting, medical records, staffing, and logistics departments. The extracted data converted to hospital indicators using the appropriate formulas and analyzed using Excel and SPSS software with the T-test. Results: The average bed occupancy rate (BOR) was 71%, the average length of stay (ALOS) was 2.5 days, the average bed turnover (BT) was 31 times, and the average bed turnover interval (BTI) was one day. The comparison of means of all the above-mentioned indicators other than BOR with the national standards was statistically significant (P < 0.05). Inpatient bedday costs with and without capital costs were calculated to be 3312353 IRR and 12253775 IRR, respectively. Conclusion: Higher BOR and BT and lower ALOS and BTI indicators were appropriate compared with the national standards, but the cost performance was not appropriate. An unreasonable increase in inpatient bed-day cost revealed that there were unused beds and that hospitals had no monitoring systems for revenues and expenditures. Therefore, serious attention must be given to the scientific criteria and principles of health economics to improve resource productivity.

Highlights

Hospitals, the main providers of healthcare services, are costly centers which account for about 80% of the health sector budget and have a huge share of resources
The results indicated that the value of bed occupancy rate (BOR) in Hospital A during the 12-month period studied ranged from 58.36% (March) to 86.98% (April) with an average of 79.16% (SD=7.30%)
The results of the present study showed that the average values of BOR, average length of stay (ALOS), bed turnover (BT), and bed turnover interval (BTI) of the studied hospitals were 71.42%, 2.47 days, 30.86 times, and 0.98 days, respectively

Summary

Introduction

The main providers of healthcare services, are costly centers which account for about 80% of the health sector budget and have a huge share of resources. Results of a study carried out in selected hospitals of Iran University of Medical Sciences referred to the increase in inpatient bed-day cost, ALOS, the average BTI, and the low BOR and BT as the main reasons for inefficiency and non-effectiveness and, the nonoptimal utilization of resources in the studied hospitals.[7] Shepard et al concluded in studies in the United States that every country should design and implement costing strategies and its own methods for analyzing hospital costs based on managerial needs and accessibility to necessary information.[9] Another important point is that the elevated cost of healthcare services today has led public and private healthcare systems to show more willingness to conduct applied health economics studies[10,11,12] and even consider health economists as advisers and an integral part of the healthcare team.[10]

Methods

Results

Discussion

Conclusion