Is bed turnover rate a good metric for hospital scale efficiency? A measure of resource utilization rate for hospitals in Southeast Nigeria

Henry E. Aloh,Obianuju G. Aloh,Obinna E. Onwujekwe,Chijioke J. Nweke

doi:10.1186/s12962-020-00216-w

Abstract

BackgroundNigeria health sector, like that of other sub-Saharan African countries, increasingly faces critical resource constraints. Thus, there is need to seek for ways of improving efficient use of scarce health resources. The aim of this study was to determine resource utilization rate of teaching hospitals in Southeast Nigeria as a means of estimating their efficiency.MethodsThe study is a longitudinal cross sectional study. It applied ratio indicators and Pabon Lasso model using data on the number of hospital bed, number of inpatients and total inpatient-days from purposefully selected teaching hospitals in Southeast Nigeria to measure efficiency over a period of 6 years (2011–2011).ResultsThe hospitals’ mean bed occupancy rate was as low as 42.14%, far below standard benchmark of 80–85%. The mean average length of stay was as high as 8.15 days and observed mean bed turnover was 21.27 patients/bed/year. These findings portrayed high level of inefficiency in Nigeria teaching hospitals, which was further illustrated by Pabon Lasso graph, with only 10–20% of the hospital-years located within or near the efficient zone or quadrant.ConclusionThe study was able to show that health ratio indicators such as hospital bed turnover rate (BTR) and bed occupancy rate (BOR), as well as patients’ average length of stay (ALS) can be used as tools for assessing hospital performance or its efficiency in resource utilization. Thus, in low and middle income countries where medical record keeping may be inadequate or poor, ratio indicators used alone or with Pabon Lasso graph/chart could be an optional metrics for hospital efficiency.

Highlights

IntroductionLike that of other sub-Saharan African countries, increasingly faces critical resource constraints
Nigeria health sector, like that of other sub-Saharan African countries, increasingly faces critical resource constraints
The study used health ratio indicators such as bed occupancy rate (BOR), bed turnover rate (BTR), average length of stay (ALS) and turnover interval (TI) [20] to evaluate efficiency in resource utilization of 3 teaching hospitals that were selected by simple random sampling

Summary

Introduction

Like that of other sub-Saharan African countries, increasingly faces critical resource constraints. Healthcare is one of the most important services provided by the government in every country of the world. It is regarded as a critical resource in the process of economic development. Performance evaluation has become central to the concept of quality improvement It provides a means of defining what hospitals are doing and compare it with expected targets [4]. It enhances greater accountability and stimulates continuous quality improvement. The challenges facing low-income countries is that many keep on struggling without much success to develop and implement feasible strategies to monitor hospital nationally [6]

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Discussion

Conclusion