Hospital Statisticas Healthcare statistics #Mortality Rate #NDR #bed occupancy #ALOS

Healthcare statistics #Mortality Rate #NDR #bed occupancy #ALOS

1. Brief Introduction of
Hospital Statistics

Ravinder Singh
Medical Records Supervisor
B.A. (Delhi University), DMRT,ADMRTT
Medanta-The Medicity Guru gram Haryana

2. Objective

Time-30 Minute
•Brief Introduction of hospital statistics.
•Common Statistics Prepared By MRD.
•Definition of some important hospital terms
related to Hospital Statistics.
•Formulas and Calculation.
• Presentation of Statistical Data.

3. Hospital Statistics
Introduction- In Many hospitals, which do not have
a separate department of statistics & IT the medical
record department prepares all statistical reports.
These involve statistics relating to census, bed
occupancy, admissions, discharges, outpatient visits
by service etc. The medical record staff in most
hospitals computes rates and ratios relating to
clinical data also. The administration use this
valuable information available from the statistical
reports for all management functions like planning,
organizing, controlling and actuating.

4. Hospital Statistics
Common Statistical data collected and calculated by MRD
are:-
Number of admissions - total hospital and by service / Unit wise .
OPD Attendance/Visit – Total hospital , Service wise , Unit wise , New & Old ,Average etc.
Number of discharges- (live and expired) - total hospital and by service .
Number of deaths – total hospital and by service .
Number of surgical procedures –Major/ Minor, Specialty wise etc.
Number of deliveries (obstetric patients) –Normal , Caesarian etc.
Emergency – Visit/ Admitted.
Number of LAMA- Reason for LAMA
Number of MLC / Outside MLC
Daycare Admission-SPECIALITY WISE
Diagnosis and Operations ( ICD-10)
ALOS- Specialty ,Unit , Bed category wise
Number of Live & Still Birth etc.
Number of Investigations- Laboratory ,Radiology & others- OPD & IPD/speciality wise

5. Hospital Statistics
Hospital utilization
• Daily census
• Average daily census
• Average length of stay of inpatients
• Percentage of occupancy of hospital beds
• Bed turnover interval
• Bed turnover rate
Death rate
•Hospital death rate
•Net death rate
•Postoperative death rate
•Maternal death rate
•Neonatal death rate etc..

6. Definition of some important hospital
terms
•One of the major functions of a Medical record department
is to provide health information.
•For uniform reporting, knowledge about the meaning and
definition of the different hospital terms is essential.
Otherwise there will not be any uniformity in the
information given by different reporting agencies or
departments or individuals, and statistics will not have
much relevance.
•Definitions of some important hospital terms are in next
slides are taken from the Uniform Hospital Definitions
(American Hospital Association) and/or Glossary of
Hospital Terms (American Medical Record Association)

7. COMMON HOSPITAL DEFINITIONS
Hospital Census -The hospital inpatient census is the number of
inpatients occupying beds in the hospital at a given time.
Hospital Inpatient -A hospital inpatient is a patient who is given lodging
in a hospital while receiving care from a physician, Dentist or allied
services in the hospital.
Hospital New-born Inpatient -hospital inpatient that was born in the
hospital at the beginning of his current inpatient hospitalization.
Inpatient Admission -An inpatient admission is the formal acceptance
by a hospital of a patient who is to receive care from a physician,
dentist or allied services while lodged in the hospital.
Inpatient Discharge -An inpatient discharge is the termination of the
granting of lodging and the formal release of any inpatient by the
hospital.
 

8. COMMON HOSPITAL DEFINITIONS
Hospital Live Birth -The hospital live birth is the complete expulsion or extraction from its
mother, in a hospital facility, of a product of conception, irrespective of the duration of
pregnancy, which, after such separation breathes or shows any other evidence of life, such
as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary
muscles, whether or not the umbilical cord had been cut or the placenta is attached; each
product of such a birth is considered live born.
Transfer -A change in inpatient care unit, medical staff unit, or responsible physician, of an
inpatient during hospitalization.
Discharge Transfer -The disposition of an inpatient to another health care institution at the
time of discharge.

9. COMMON HOSPITAL DEFINITIONS
Low birth weight- Weight less then 2500
gm at birth.
Average Daily Census – The average daily
census is the average number of
inpatients maintained in the hospital
each day for a given period of time.
 

10. Formulas and Calculation
 
Daily Inpatient Census
Inpatient census is calculated as follows: The patients remaining in the
hospital at the census-taking time for a specific day, plus the admissions for
the following day, minus discharges (including deaths) for that day, equal
the patients remaining at the next census- time.
The inpatient service day measures the services received by one inpatient in
one 24 hour period, and the 24 hour period is the time between the census-
taking hours on two successive days.
Census is usually taken at midnight because that is the time of least
activity. Children are counted with the adults for census purposes, but
newborns are not.

11. Daily Inpatient Census

Eg.: 1. The number of adult and child patients on June 30th was 450. On July 1
st

21 adult and child patients were admitted, and 18 were discharged (including deaths).
What was the midnight census on July 1
st
?


The Census on June 30
th

-
450

Plus

Admissions on July 1
st

+
21

Minus

Discharges on July 1
st

-
18

The Census on July 1
st

-
453

When you calculate the inpatient service days or daily inpatient census, the number of
patients who were both admitted and discharged on the days should also be added to this
number because they are not included in either of the midnight census calculations.
Otherwise the services received by them will not be accounted for.

12. The Average Daily Inpatient Census
The formula to calculate this is:

Total Inpatient Days for a period
Total number of days in the period

E.g.: In June XYZ Hospital rendered 3500 inpatient service days to adults and
children. June has 30 days. So according to the formula the average daily IP

Census for June is: -

3500/30 =116.67 or 117

The average daily IP census for newborns is usually calculated separately.
The formula to calculate it is:

Total Newborn IP service days for a period
Total number of days in the period

13. LENGTH OF STAY
The length of stay for one inpatient is the number of calendar days from his admission to discharge.

To compute the length of stay the date of admission is subtracted from the date of discharge if both the dates are
in the same month. This way, only either the admission or the discharge day is counted.

If a patient is admitted on August 17 and discharged on August 27th the length of stay is (27- 17) = 10.

If a patient is admitted on August 17th, and discharged on September 10th, the length of stay is calculated as
follows:






Aug 31 – Aug 17

=

14

September days

=

10

Length of stay


=

24

14. The Average Length of Stay (Average duration of hospitalization)
The average length of stay is the “average length of hospitalization of inpatients
discharged during the period under consideration”

The formula for computing the average length of stay is:

Total length of stay (discharge days)
Total Discharges

E.g.: XYZ hospital discharged 1350 patients (including deaths - excluding
newborns) in May. Their combined length of stay was 15645 days. According
to the formula the
-average length of stay is

15645 = 11.59 or 11.6
1350

15. INPATIENT BED OCCUPANCY
The bed occupancy of a hospital reflects how well a hospital is doing
so it is a very important aspect of hospital management information
system. Bed occupancy simply means the number of beds occupied.
The formula to compute bed occupancy ratio is:-
Total inpatient service days for a period X 100
Total inpatient bed count X number of days in the period

E.g.: XYZ Hospital has a bed complement or inpatient bed count of 175.
During the month of June the hospital rendered 4350 inpatient service
day .Bed Occupancy is-.
According to the formula given above, the bed occupancy is

4350 X 100 = 82.86 %
175 X 30

16. DEATH RATE - (MORTALITY RATE)
Different kinds of death rates such as gross death
rate, net death rate, anesthetic death rate,
postoperative death rate etc. are compiled by
the medical record department. Deaths are
included with discharges because like
discharges they are also a termination of
inpatient hospitalization.

17. Hospital Death Rate or (Gross Death Rate)
Definition: - The hospital death rate or gross death rate is the proportion of
inpatient hospitalizations which end in death, and is usually expressed as a
percentage.

Formula: - (to compute gross death rate)

Number of deaths of inpatients X 100
Number of discharges (including deaths) in the same period

E.g.: XYZ Hospital had a total no of 18 deaths in June 2017. A total no of
450 patients were discharged (including deaths) in June.

What is the Gross Death Rate?

Gross Death Rate = 18 X 100 = 4%
450

18. Net Death Rate (Institutional Death Rate)
Net Death Rate (Institutional Death Rate)
While computing the net death rate deaths which occur within 48 hours of admission are not
counted.
Definition: - The net death rate or institutional death rate is the ratio of the total number of deaths
occurring in the hospital. 48 hours or more after admission for a period to the total number of
discharges including deaths which occur 48 hours after the admission for the same period.

Formula: -

Net Death
Rate
= Deaths (including N.B.s) minus those
under 48 hrs.for a period X100
Total No. of discharges and deaths
(including
newborns) - deaths under 48 hours

E.g.: In ABC Hospital there were 18 deaths in July and 3 of the deaths occurred within
48 hours of admission. The total discharges including all the deaths were 423.
Find the net death rate.

Net Death Rate = (18 - 3) X 100 = 15/420 X 100 = 3.6% (3.57 %)
423 - 3

19. Hospital Maternal Death Rate (Maternal Mortality Rate)
The ratio of maternal (obstetric) deaths for a period to the total number of obstetrical patients
discharged (including deaths).

Formula:-

Total number of direct maternal deaths for a period X 100
Total number of maternal discharges for the period

E.g.: During October 14, CMC had 2 maternal deaths and discharged 206 maternal
patients (the number discharged included the death). According to the formula
the maternal death rate is

2 X 100 = 0. 97 %
206

Note: - Hospitals usually count only those patients whose death is a result of an obstetric
complication as maternal death.

20. Hospital Neonatal Death Rate (Infant newborn mortality rate)
The ratio of deaths of infants born in the hospital (newborn inpatient deaths) to the total
number of newborn discharges for a period. (Foetal Deaths are not included)

Formula:-

Total number of newborn deaths for a period X 100
Total number of newborn infant discharges for the period

E.g.: During June, GTB hospital had 3 newborn deaths and discharged 323 newborn
infants including death. According to the formula the newborn death rate is:

3 X 100 = 0.93 %
323

21. Caesarean Section Rate
Caesarean Section Rate is the ratio of Caesarean sections performed to deliveries.
Delivery has been defined as the act of giving birth to either a living child or a dead
foetus.

Formula: -

Total_ number of Caesarean sections performed in a Period X 100
Total number of deliveries in the period

E.g.: In ABC Hospital there were 150 deliveries in August. Of this 3 were by
Caesarean section. Find the Caesarean section rate for August.

According to the formula, the Caesarean Section Rate is

3 X 100 = 2%
150

22. Bed Turnover Rate
Mean number of patients "passing through" each bed during a period.
-Indicates the use made of available beds.
Formula-
Number of discharges (separations) in the period
Available beds
Example
During the month of June there were 736 discharges (including deaths) from
a hospital with 210 beds. The turnover rate for June was:
736
210 =3.50 or 3.5

23. Bed Turnover Interval
Average period in days that an available bed remains empty between the discharge
of one inpatient and the admission of the next.
-Indicates the time that available beds are free.
-Indicates a shortage of beds when negative, and under-use of the hospital or an
inefficient admission system, if positive.
-Formula
Available beds x days in the period - patient days for the period
Number of discharges, including deaths, in the period
Example
A hospital with 210 available beds in June rendered 4,780 patient days and had
736 discharged/died patients. The turnover interval rate using the above formula
is:
210 x 30 - 4780 = 1520
736 736 = 2.06 or 2.1 days

24. Presentation of Statistical Data
Reporting of results is an important part of any statistical study, and the presentation of
data is of great importance.

Tabulation or classification is a process by which data is systematically organized and
recorded to enable analysis and interpretation.

Tables: - A properly constructed and adequately labeled table is very useful in the
presentation of data.

Discharge diagnosis from Medical Ward in June -15 (Communicable diseases)


Diagnosis Male Female Total
Gastroenteritis 50 15 65
Enteric Fever 14 15 29
Malaria 6 8 14

25. Presentation of Statistical Data
Graphs and diagrams
a. Bar diagrams: A bar diagram is commonly used to provide a visual comparison of
figures in a time series.
Diagnosis Male Female Total
Gastroenteritis 50 15 65
Enteric Fever 14 15 29
Malaria 6 8 14



0
10
20
30
40
50
60
70
Male
Female
Total

26. Presentation of Statistical Data
Line graph: A line graph is preferred when the emphasis is on the trend of the
time series over a period.
Diagnosis Male Female Total
Gastroenteritis 50 15 65
Enteric Fever 14 15 29
Malaria 6 8 14





0
20
40
60
80
100
120
Male Female Total
Malaria
Enteric Fever
Gastroenteritis

27. Presentation of Statistical Data
Pie diagrams: A pie diagram may be chosen when component parts of the
figure relating to each category have to be shown.
Diagnosis Male Female Total
Gastroenteritis 50 15 65
Enteric Fever 14 15 29
Malaria 6 8 14



Male
Gastroenteritis
Enteric Fever
Malaria

28. Presentation of Statistical Data
SPECIALITIES WISE ADMISSIONSJAN FEB MAR APR MAY JUN JUL AUG SEP OCTNOV
Anaesthesia 0 0 1 1 0 1 0 1 0 0 0
Bariatrics 17 18 21 25 56 36 42 42 45 34 51
Breast Services 28 24 40 32 37 26 43 52 41 33 35
CTVS 363 323 389 429 408 365 394 412 367 309 393
Cardiology 817 825 815 829 784 823 871 829 878 709 829
Critical care 13 16 22 12 15 19 16 17 14 12 11
Dermatology 0 0 0 1 0 0 1 1 1 1 0
E.N.T. 105 93 112 112 107 112 96 106 96 98 108
Endocrinology 11 12 11 13 17 13 29 12 15 29 20
GI Surgery 192 184 189 225 212 244 191 191 191 161 201
Gastroenterolog 360 366 489 441 473 447 460 500 497 422 485
Gen Surg &MIS 5 1 3 3 0 0 0 0 0 0 1
Head & Neck Onco 49 32 49 51 57 42 61 53 61 54 50
Internal Med 100 84 123 111 121 104 153 172 156 165 155
Intervn Radio 0 0 1 1 3 1 3 6 3 5 7
Liver transplant 119 115 121 147 158 135 155 123 138 116 112
Medical Onco 1047 1005 1042 1050 1129 1183 1211 1145 1233 1171 1133
Nephrology 129 119 135 199 163 172 179 201 167 180 163
Neurology 177 175 186 187 175 161 181 197 169 137 186
Neurosurgery 166 160 211 248 197 206 203 199 184 177 200
Obs &Gynae 54 56 84 55 73 72 66 76 54 39 58
Ophthalmology 26 32 38 39 2 0 0 0 1 0 0

29. Brief Introduction of Hospital Statistics