Bed Turnover Research Articles

Analysis of the costs and clinical outcomes of a minimally invasive cardiac surgery program in a colombian teaching hospital

Background: The aim of this study was to describe the experience with minimally invasive cardiovascular surgery (MICS) by evaluating the costs and clinical outcomes in a university hospital in Bogota, Colombia. As a comparison, a series of patients submitted to open heart surgery (OHS) was used. Methods: Through a retrospective analysis of clinical records, from January 2014 to September 2018, data from 56 patients submitted to either MICS or OHS were collected. A comparison between these two types of approaches evaluating relevant clinical outcomes and demographic differences was performed. Direct costs for each hospitalization were analyzed and discriminated by categories. Costs are presented in 2018 US dollars (USD). Results: Thirty-four patients were included in the MICS group, with ages ranging from 17 to 63 years; 22 patients were included in the OHS group, with ages from one to 74. The mean length of stay was 6.9 days (SD 3.4) in the MICS group and 10.3 (SD 6.5) in the OHS (p = 0.046). The average cost for MICS was $8 345 ± 2 522 and for OHS was $9 422 ± 3 090 (p=0.08). Higher costsin procedures in MICS where compensated by lower costs in hospitalstay, laboratory tests, medications and transfusions. Conclusion: MICS can be performed safely in a middle-income country like Colombia, at a fraction of the costs incurred in developed countries, while improving hospital bed turnover rate.

Performance Evaluation of Community Hospitals in Thailand: An Analysis Based on the Balanced Scorecard Concept

Although the concept of the Balanced Scorecard (BSC) was designed for profit-based organisations, the application of the BSC in public and nonprofit organisations (NPOs) could be performed within the NPOs and public health sector, as the conceptual foundation of this system was developed from community hospitals performance. This study used the BSC concept to analyse the 16 key performance indicators and trends of performance during the last five years of 52 community hospitals located in upper southern Thailand in 2017 and tendency of 2013-2017. The instruments included an annual report and a questionnaire. A statistical analysis to determine percentages, means and standard deviations was performed. The major findings of the community hospitals performance were as follows: Customer perspective: 1. Patient complaint rate of 0.0097% and 2. Outpatient waiting time of 91.89 minutes, Financial perspective: 1. Ratio of total revenue to total expense at 0.9949 and 2. Cost of drugs and materials to total expense at 13.32%, Internal process perspective: 1. Bed turnover at 88.16 and 2. Hospital infection rate of 0.379 times:1,000 patient days, Learning and growth perspective: 1. Staff turnover rate of 4.69% and 2. Number of research studies at 3.77 articles. Trends and performance of hospitals in every perspective of the BSC in the last 5 years showed no differences. The community hospitals offer services such as treatment of common diseases. If the community hospitals could not assist, they will go to referral system by referring patients to secondary and tertiary care respectively.

Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit.

Background There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU. Methods We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135). Results Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2. Conclusions Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

A novel DEA model for hospital performance evaluation based on the measurement of efficiency, effectiveness, and productivity

Abstract Hospitals are the most important and costly component of the healthcare system. Therefore, hospital performance evaluation (HPE) is an important issue for the managers of these centres. This paper presents a new approach for HPE that can be used to calculate the efficiency, effectiveness, and productivity of hospitals simultaneously. Efficiency refers to the ratio of inputs and outputs, effectiveness refers to the extent to which outputs align with predetermined goals, and productivity refers to the sum of both efficiency and effectiveness. To this end, a Data Envelopment Analysis (DEA) model is developed to simultaneously measure the efficiency, effectiveness, and productivity (DEA-EEP) of hospitals. DEA is a linear programming technique that in its traditional form, calculates the performance of similar decision-making units (DMUs) that have both inputs and outputs. In this study, the inputs are the number of health workers, the number of other staff, and the number of patient beds; while the outputs are the bed occupancy rate and the bed turnover rate. A target value is set for each output to measure the effectiveness of hospitals. The advantage of the developed model is the ability to provide a solution for non-productive units so that they can improve their performance by changing their inputs and outputs. In the case study, data of 11 hospitals in Tehran were evaluated for a 3-year period. Based on the results, some hospitals experienced an upward trend in the period, but the efficiency, effectiveness, and productivity scores of most hospitals fluctuated and did not have a growing trend. This indicates that although most hospitals sought to improve the quality of their services, they needed to take more serious steps.

Application of six sigma and 5 S to improve medication turnaround time

ABSTRACT Purpose: The purpose of this study is to improve the medication turnaround time of a tertiary care hospital in Bangalore. The goal for improvement was set as 1 h based on the voice of external and internal customers and benchmark of two studies where the improvement results were 70 min and 66 min. Background: There is documentary evidence that timely administration of medicines such as antibiotics results in a significant decrease in mortality and length of stay. The increased length of stay increases the cost of treatment for the patients and reduces the bed turnover rate for the hospital. Method: DMAIC approach of Six Sigma together with the ‘Seiton’ principle of 5 S quality tool is used to reduce the medication turnaround time and to improve the sigma level of the process. Results: At the end of the study the mean total turnaround time of 1 hr 29 min got reduced to 48 minutes and the sigma level got improved from 1.22 sigma level to 2 sigma level. Conclusion: This study showcases that Six Sigma and 5 S can be used effectively to reduce the medication turnaround time, which enables in achieving the long term goals of patient satisfaction.

On the issue of standards of organization of hospital psychiatric care

In the conditions of reforming psychiatric service in the Russian Federation, the procedure of organizing psychiatric care of patients in hospital, the effectiveness of treatment of patients in psychiatric hospital during 2015-2017 were analyzed. The article presents the results of study of organization of psychiatric care of patients in specialized hospital on the basis of Psychiatric clinical hospital № 13. The analysis covered number of patients treated in hospital by nosological forms; number of patients by gender. The age categories of mental patients and the format of professional status of patients were considered. The main indicators of psychiatric hospital activity were investigated: average duration of stay of patient in hospital, annual bed using, bed turnover, number of bed days. The attention was paid to primary output of patients with disabilities, number of re-hospitalizations and compulsory hospitalization. The analysis of financing of inpatient psychiatric care of treated patients for the study period of time was implemented. The vector of providing psychiatric care to patients at the stage of out-patient and hospital-replacing cases.

IMPACT OF THE COVID-19 PANDEMIC UPON THE OPHTHALMOLOGICAL CLINICAL PRACTICE

Introduction. With more than 1,000,000 infections around the world, SARS-Cov 2 is responsible for the most severe healthcare crisis in the last 100 years. Aim. The paper analyzes the impact of COVID 19 pandemic upon the current ophthalmological clinical activity. Materials and Method. A comparative analyses was carried regarding the clinical activity in March 2019 and March 2020: the number of one day hospitalizations, of continuous hospitalizations, the percentage of emergencies, the number of surgeries, bed turn over, mean hospital stay. The protocols for the health care personnel protection and decontamination were analyzed. Results. During March 2019, 381 patients were treated in the day hospitalization and 297 patients in the continuous hospitalization regime, with an average length of hospitalization of 3.2 days, and a bed turnover of 6.05. Of these, 76.43% underwent ophthalmic surgery and 14.1% represented ophthalmological emergencies. The comparative analysis shows that in March 2020, the number of one day hospitalizations decreased by 87.4%, and that of the hospitalizations continued with 89.2%. Of the patients admitted, 46.8% were in emergency. Clinical ophthalmological practice has been deeply changed in the context of the COVID 19 pandemic in order to prevent contamination both for patients and medical personnel. Conclusions. The ocular manifestations associated to SARS-Cov 2 infection are self-limited, but the possibility of infection due to the presence of the virus at the level of the tear secretion is an aspect that we must consider in the ophthalmological clinical practice.

Analysis of statistic health care as indicators of efficiency service in Semen Padang Hospital through Barber Johnson graph

Background: The efficiency of service delivery is very important for hospitals. One measurement of service indicators that can be used is the Barber Johnson graph (GBJ). GBJ is needed to see and measure the level of service efficiency in hospitals. The indicators used are bed occupancy rate (BOR), bed turnover rate (BTR), turnover interval (TI), and length of stay (LOS). This graph can also be used to compare or view hospital developments at different times, and to increase the likelihood of changes in one variable by changing other variables. This research was conducted at Semen Padang Hospital (SPH), Padang, West Sumatera, Indonesia.Methods: The purpose of this study was to determine the statistical value of hospital and hospital service efficiency levels by using the Barber Johnson graphic. This research method is descriptive by direct observation of the medical record file of inpatients since the January to December 2017 period.Results: Statistical data obtained from SPH in 2018 showed the value of service days 30132, and the Number of beds 144 units. From the data processing results obtained a total bed occupancy rate 60.83%, bed turnover rate 6.86 times, turnover interval 2 days and average length of stay 3 days.Conclusions: Statistical data obtained from SPH in 2018 shows the value of BOR, TI is in an efficient, while BTR and LOS are inefficient.

Comparison of results of statistical analysis of health care for inpatients of Islamic hospitals in Padang city in 2019

Background: The success of hospitals in providing services seen from the results of health care statistics, in the form of daily census, day of service, average length of stay (ALOS), bed occupancy rate (BOR), bed turnover rate (BTR), turnover interval (TI), coding disease diagnoses in the of Islam Islamic hospital.Methods: Research uses descriptive method with qualitative approach. Data collection technique used is the observation method that is direct observation of medical records and the method is done by collecting data from the Islamic Hospital in the city of Padang for processing statistical data.Results: During the period of June 1 to June 30, 2014 there were 330 outpatients, 127 bed units in IbnuSina while in Siti Rahmah outpatients were recorded 264 patients with 48 beds. From data it appears that the most patients entering in the city of Padang are Siti Rahmah with the difference in the number of patients 66 patients with 79 beds. And information is obtained that this is influenced by the availability of adequate facilities and services.Conclusions: The highest of patients from the Islamic hospital is Siti Rahmah with a diagnosis of dengue hemorrhagic fever (DHF) (A91), the main diagnosis frequency of chapter XI is 15.45% with the most patients coming from in Padang as many as 194 patients. From the results of statistical data, it can be analyzed that the TLOSis 1357 days and ALOS is 4.11 or 4 days. BOR is 32.94%, The BTR 2.60, TI 7.74 days.

Minimizing Hospital Acquired Infections in Post- Hematopoietic Stem Cell Transplant Pediatric Recipients: Impact on Hospital - Metrics of a Tertiary Care Centre

Introduction Hematopoietic Stem Cell Transplantation (HSCT) recipients are at an increased risk of infections including but not limited to Hospital-acquired infections (HAIs), extrinsic factors such as health-care workers and visitors plays a vital role in minimizing HAIs. Pediatric Stem Cell Transplant Program at King Faisal Specialist Hospital & Research Centre, Riyadh is the national referral center for malignant and non-malignant cases indicative of a transplant, an average of 140 transplants performed per year Method Stringent compliance to institutional visiting hour's policy and hand-hygiene campaign in pediatric post-HSCT inpatient unit was reinforced in early 2017; a pre -/post intervention HAI rate is being reported as data analyzed retrospectively Results A total of 269 transplants performed on 260 recipients during 2015 to 2016 (pre-intervention), while 279 transplants on 262 recipients during 2017 to 2018 (post-intervention), a 33% decrease in HAI episodes (57 vs. 38) was observed with a decrease in HAI rate of 2.5% (4% vs. 6.5%); while the incidence density of HAI post-intervention was 2.69 per 1,000 patient-days, which reduced by 36% (4.2 per 1,000 patient-days). An increase in Average Length of Stay by 19% (19.15 days vs. 16.14 days) in relation to 4% increase in transplant episodes was observed; a decrease in long- stay (>60 days) patients by 2%, while the Bed Turnover rate improved by 4%. A major drop in Drug-resistant bacteremia, 60% (4 vs. 10) followed by C.difficile infection, 50% (16 vs 32 infections) observed, HAI-related mortality was not observed pre-/post intervention Conclusion Visits from family and friends eases some of the isolation experienced, in our experience strict adherence to policies coordinated by health-care professionals with cooperation from families help keep balance between the emotional well-being of the patient and risk associated with such visits. Further, analysis of HAIs during neutropenic vs. non-neutropenic stage of the patient, in addition to transplant-related outcomes is warranted.

Turning over the Beds – How Optimizing Pre-Discharge Patient Teaching Reduced Discharge Delays in the Inpatient Hospital at Dana-Farber Cancer Institute and Brigham and Women's Hospital

<h3>Introduction</h3> With rapidly increasing demand at academic medical centers, inpatient resource allocation is a critical focus. Patients receiving autologous stem cell transplant (ASCT) often face complicated discharges, requiring lengthy day of discharge teaching sessions from nurses and dietitians that may cause delays in discharge time. We queried if streamlining the complex discharge process by scheduling teaching appointments in advance would reduce unnecessary delays in discharge. <h3>Methods</h3> An interdisciplinary committee reviewed existing workflows with relevant stakeholders. Process improvement methodologies, including value-stream mapping, were utilized to reduce variation and delays. New teaching workflows ("discharge pilot") were implemented using a model line approach to iteratively test operations on 1 inpatient pod and were later rolled out on 4 (of 10) pods. After IRB review, patients were allocated to receive the discharge pilot based upon admission to one of these pods. Discharge time was compiled to assess impact. <h3>Discharge teaching before</h3> Typically, discharge teaching was completed on the day of discharge as clinicians waited for caregivers to arrive, contributing to delays; teaching took 2 hours. Information given in teach sessions varied greatly between clinicians. Beyond poor utilization of staff, patients and caregivers reported they could not retain critical information as they were prepared for discharge. <h3>Discharge Teaching Workflow Redesign</h3> Teach content delivery was standardized using templated guidelines for home and medication preparation. A provider checklist (Fig 1) was created specifying when to complete discharge readiness tasks. Specialized posters were hung in patient rooms for provider documentation and to engage patients and caregivers on their care journey (Fig 2). Nurses distributed caregiver requirements prior to the teaching appointment and caregivers were notified of required attendance. Teaching appointments were scheduled 2-3 days prior to discharge. <h3>Resulting change in discharge timing</h3> Between Jan. – Sep. 2019, 58.8% of patients receiving pilot (advance) discharge teachings (n = 68) discharged before 2pm (range 10:27a – 7:01p). During this same time, only 39.7% of patients receiving no discharge intervention (n = 68) discharged before 2pm (range 11:29a – 11:30p) (p = 0.0257) (Fig 3). <h3>Conclusion</h3> Scheduling discharge teaching for patients and their caregivers in advance increased discharges from the hospital before 2pm, significant for operational improvement. This optimized staff resource utilization and allowed for more efficient bed turnover. Other factors like central line removal and transfusion timing should be examined. We are now examining satisfaction and anxiety during discharge when advance teaching is performed. Further research should assess precaution adherence for this intervention.

Assessment of performance in teaching hospitals: Using multicriteria decision-making techniques.

BACKGROUND:It is essential to evaluate the performance of hospitals in the health system. Hospitals need a performance evaluation system to develop and compete in order to measure the efficiency and effectiveness of their programs, processes, and human resources. This study aimed to evaluate the performance of teaching hospitals using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method and hierarchical analysis.MATERIALS AND METHODS:This was a cross-sectional and descriptive study conducted in 2019 in all teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences. The required data were collected using a standard checklist. The collected data were analyzed using the analytic hierarchy process (AHP) and TOPSIS. In the first phase, annual indicators of hospital evaluation were collected. Following the AHP, key performance indicators (KPIs) were selected and prioritized in hospitals.RESULTS:The questionnaires were provided to 15 experts to weigh KPIs, and the most important indicators were selected. The results of hierarchical analysis showed that three main indicators in evaluating the performance of hospitals were bed turnover rate, emergency clients, and length of stay.CONCLUSIONS:One of the problems in evaluating hospitals is the use of key indicators that alone measure the quantity or quality of their performance. Multicriteria decision-making can be used to determine key indicators first, and then by combining these indicators into a multicriteria decision-making model, a better assessment of the role and performance of hospitals can be provided.

Effective Antibiotic Stewardship Program: Controlling Antibiotic Resistance and Optimizing Drug Use in Ahmadi Hospital

An Antimicrobial Stewardship Program (ASP) is established to promote cost effective and safe use of antimicrobial agents. Basically, this approach directs the management of antimicrobials in terms of selection of appropriate drugs, determination of administration routes and standardization of both medication dosage and treatment duration. The program involves, but is not limited to, Hospital Staff Education, Pharmacodynamics Dose Optimization, Computer-Assisted Decision Support Programs, Pharmacist-Driven Intravenous to Oral Switch Programs, Pharmacy Dosing Programs and Antibiotic Cycling. A study was conducted to determine effectiveness of the ASP in significantly improving patient outcomes (e.g. decrease morbidity and mortality from infection). This was undertaken by collecting restrospective data on patient length of hospital stay, bed turnover rate and antibiotic consumption over a period of 2 years since the ASP was initiated. Periodic data were then compared and interpreted based on its clinical, quality and financial implications in order to measure effectiveness of the program implementation.

Assessment of clinical and paraclinical departments of military hospitals based on the Pabon Lasso Model.

INTRODUCTION:Today, it is important to use different indices to measure the performance of hospitals. This study aimed to investigate and evaluate the performance indicators of military hospitals and measurement of performance by using the Pabon Lasso model.METHODS:This was an applied and descriptive-analytical study that was conducted among five military hospitals affiliated to the Army of the Islamic Republic of Iran by using data from 2017 to 2018. Raw data related to performance indicators such as bed occupancy ratio (BOR), average length of stay (ALoS), and bed turnover rate (BTR) were collected by referring to the hospital medical record unit. After comparing performance indicators with the standards of the Ministry of Health, the Pabon Lasso model was used to measure hospitals' performance.RESULTS:In general, the average BOR and bed turnover interval rate are higher than that of the national standard in all hospitals and are in favorable status. However, the average length of stay in all hospitals was in unfavorable status. Furthermore, one and two hospitals were located in zone 3 in Pabon Lasso graph in the years 2017 and 2018, respectively. Overall, there was no change in the performance of the hospitals in the study time periods.CONCLUSION:In general, except for the average length of stay indicator, hospitals had a favorable performance level. Therefore, planning to improve performance indicators should be at the top of the programs.

The experience of development of partnership between science and health care institutions in resolving issues of circulatory system diseases

In Russia, the process of clustering institutions at the regional level is evolved. The analysis of scientific publications revealed only several examples of efficiently functioning medical clusters. As a rule, the publications present problems or projects and perspectives of development of medical clusters. At that, no information is available concerning organizational mechanisms integration of institutions. Purpose of the study is to evaluate the results of partnership between institutions of science and practice in resolving strategic health problems related to diseases of blood circulatory system. Materials and methods. The study applied such methods as monographic approach, data derivation, statistical technique, logical and system analysis. Results. The partnership between scientific and educational institutions and practical health care organizations was analyzed on the example of the system of medical care of circulatory system diseases organized in the Kemerovo region. The effective functioning of such a partnership is based on seven integration principles. Thus, the number of treated patients increased by 7.1% from 2011 to 2018. At the same time, the number of beds decreased by 9.2%. As a result, bed turnover increased by 18.1% over this period. The work of X-ray surgery service almost doubled the rate of percutaneous coronary interventions in case of acute coronary syndrome (from 22.0% in 2011 to 42.7% in 2018). The main organizational basics of successful cooperation of institutions are succession and interdependency in work of physians and departments, joint environments of quality management, knowledge management and personnel training, shared management of research and medical activity, common production and information environment, corporate culture and traditions.

Physicians and management of emergency hospitals: professional power threatened?

Kanban is a technical arrangement for the organization of hospital care focused on the management of beds and clinical care, aimed at the quality and comprehensiveness of care and greater hospital bed turnover, and thus a reduction in length-of-stay and hospital costs. The system's most striking and innovative feature is constant, updated patient follow-up, shared by the professional team in systematic meetings. Characterize the probable impacts from the arrangement's adoption on physicians' professional power (autonomy and authority). Qualitative study in a municipal urgency-emergency hospital using the following data production techniques: ethnography of the hospital's routine, with observation and records in field diaries, and shared seminars with researchers and teams. Physicians value multi-professional work for qualifying their practice, as an ancillary and complementary line. Kanban tends to be controlled by "hybrids" (physicians who accumulate management and clinical functions) that express synergies between "clinical management" and "hospital bed management". Thus, in this arrangement interferences in physicians' work are not exercised from outside, and physicians' clinical decisions still condition the work of the other professional groups. Physicians do not see their authority and autonomy threatened by Kanban, given the linkage between management authority and professional authority. Still, aspects related to hybridization and internal stratification of the medical profession need to be better addressed in the debate on health professionals' power.

ANALYSIS OF STRUCTURE AND FUNCTIONING OF HOSPITAL BEDS OF EMERGENCY DEPARTMENT IN THE RUSSIAN FEDERATION

29 emergency departments (ED) with hospital beds were functioning in 2018 in the Russian Federation (RF). Within the period 2014–2018 the bed capacity has been increased from 415 to 737, which portion is increased from 0,036% to 0,071% (in 2018 the portion of daily bed was 27,3%, the portion of the bed of short stay department was 72,7%). The number of discharged patients has been increased from 94545 to 306757. Therewith the portion of patients referred from ED to specialized units has been decreased from 19,0% to 11,1%. The average annual bed occupancy rate is 276,6 and 274,1. The bed turnover has been increased from 262,6 to 447,2. The lethal index is decreased from 0,18% to 0,13%. Bed population ratio keeps at the low level (5.0 bed per 1 million people which is rated as 4,5% from recommended values). Additional introduction of hospital departments of emergency medicine in 56 federal subjects of the RF al­lows quicker to achieve the goals of the National Project «Health care».

The modern state of specialized psychiatric service for the population of the Moscow region

Aim. To perform the analysis of psychiatric service of the Moscow region and to determine the basic targerts to improve the availability of psychiatric service for the population of the Moscow region. Methods. The study included the methods of retrospective statistical observation based on the data from the official statistical forms of annual reports (forms №14, №30, №36) of psychiatric institutions of the Moscow region in 2013-2017. Results. The Moscow region is a territory of sustainable social economic development. In terms of fertility it takes the 1st place among the subjects of the Central Federal district, and 27th place in the Russian Federation. Specialized psychiatric care for the population of the Moscow region is provided in neuropsychiatric dispensaries, hospitals, day hospitals of psychiatric clinics, based on three principles: a differentiated approach to assist different patient cohorts, stepwise and continuity of care at different stages. Despite the restructuring of the psychiatric service and the widespread reduction of the number of beds in the Russian Federation, bed capacity of psychiatric hospitals in the Moscow Region remains at the same level, although there has been a negative dynamics in the work of the hospital bed from 354.3 days in 2013 to 329 in 2017. At the same time, the efficiency of day hospitals has increased: the length of stay of patients in the day hospital has decreased from 51 in 2013 to 39 days in 2017, the day bed turnover rate has increased from 5.5 to 5.9. In five years, the number of patients discharged from day hospitals has increased: 2 200 in 2013 and 2 521 in 2017. In the outpatient service there is a steady decrease in the number of dispensary patients (decreased from 71 413 to 69 364 in 5 years), and vice versa, the number of patients provided with counseling and treatment increased from 79 023 to 93 697. The number of diseases-related visits to a psychiatrist is decreasing. In 2013, 781 243 disease-caused and home visits occured, in 2017 - 496 540. Conclusion. The results of the conducted study indicate both positive tendencies and negative sides of psychiatric service for the population of the Moscow region, which should be taken into account when planning reorganization and optimization of functioning of psychiatric service in the modern conditions: increased number of day beds, establishing medical rehabilitation departments, reduction of inefficient hospital beds.

EVALUATION OF BED UTILIZATION PERFORMANCE OF HOSPITAL DEPARTMENTS IN TURKEY WITH GREY RELATED ANALYSIS

The aim of this study was to analyze the bed utilization performance of hospital departments in Turkey with grey relational method. Grey relational analysis was used to determine the bed utilization performance levels of surgery and internal clinics in Turkey. In this study, hospital performance indicators are used as variables; bed occupancy rate, bed turnover rate and average length of stay. Research data were obtained from the Statistical Report of Public Hospitals Unions. Data were analyzed using MS Excel, SPSS 18 software. In this study, b ed occupancy rate (%), average length of stay (day) and bed turnover rate performance indicators of clinics were found to be 67.3; 5.6 and 63.4, respectively. According to the grey relational analysis, the section with the most desirable characteristics represents the sections with the highest scores. The highest grey relational grade score was found to be obstetrics and gynecology (0.904) and the lowest score dermatology (0.474) departments . In multidimensional analysis, it was evaluated in two categories as efficient and inefficient in evaluating the bed use performance of departments. Hospitals are the most resource-consuming element of a health care system. The hospital's bed utilization performance has a positive impact on the hospital's financial success. A significant portion of the cost of operating in hospitals is due to unnecessary patient hospitalization. In order to reduce hospital costs, patient beds need to be used optimally. Hence, hospital managers should regularly audit bed utilization.

EVALUATION OF BED UTILIZATION PERFORMANCE OF HOSPITAL DEPARTMENTS IN TURKEY WITH GREY RELATED ANALYSIS

The aim of this study was to analyze the bed utilization performance of hospital departments in Turkey with grey relational method. Grey relational analysis was used to determine the bed utılization performance levels of surgery and internal clinics in Turkey. In this study, hospital performance indicators are used as variables; bed occupancy rate, bed turnover rate and average length of stay. Research data were obtained from the Statistical Report of Public Hospitals Unions. Data were analyzed using MS Excel, SPSS 18 software. In this study, bed occupancy rate (%), average length of stay (day) and bed turnover rate performance indicators of clinics were found to be 67.3; 5.6 and 63.4, respectively. According to the grey relational analysis, the section with the most desirable characteristics represents the sections with the highest scores. The highest grey relational grade score was found to be obstetrics and gynecology (0.904) and the lowest score dermatology (0.474) departments. In multidimensional analysis, it was evaluated in two categories as efficient and inefficient in evaluating the bed use performance of departments. Hospitals are the most resource-consuming element of a health care system. The hospital's bed utilization performance has a positive impact on the hospital's financial success. A significant portion of the cost of operating in hospitals is due to unnecessary patient hospitalization. In order to reduce hospital costs, patient beds need to be used optimally. Hence, hospital managers should regularly audit bed utilization.