EVALUATING THE USE OF HOSPITAL BED CAPACITY IN MEDICAL ORGANIZATIONS
https://doi.org/10.17749/2070-4909.2017.10.4.037-043
Abstract
Since recently, a number of normative legal acts aimed at increasing the salaries of medical professionals in the Russian Federation have been implemented. As these decisions are not supported by increasing the financial bases of medical organizations, those institutions may develop the accounts payable status. Under these conditions, the efficient usage of hospital beds may bring a financial relief to these medical institutions. The present study addresses the assessment of bed usage and suggests a well-rationalized set of methods to evaluate and characterize the bed usage efficiency. The main indicators of this efficiency are: the number of beds, the bed turnover, the number of hospitalized patients, the average length of hospital stay per patient per year, and the average bed occupancy per year. In this study, we analyze the available data on the hospital bed usage taken from the annual statistical information published by the Ministry of Health of the Russian Federation. Using the method of chain substitutions we have found ways to improve the quality of medical services and reduce economic losses in medical organizations. Our results recommend implementing periodical analysis of the hospital bed usage both in general and in specialized clinics. The results also suggest mobilizing more reserves to increase the performance of hospital bed usage, mainly by increasing the bed occupancy in specialized round-the-clock hospitals. It is recommended to conduct a comparative analysis of the planned vs factual bed usage, to restructure the hospital setting with a possible change in the number of specialized beds, to optimize the routing of patients when providing primary medical care, as well as routing the patients when providing emergency service including emergency specialized medical care.
Keywords
About the Authors
I. A. ZheleznyakovaRussian Federation
Zheleznyakova Inna Alexandrovna – Deputy Director- General of the Federal Public Institution.
Khokhlovsky per., 10-5, Moscow, 109028, phone: +7 (495) 783-19-05 (188)
L. A. Kovaleva
Russian Federation
Kovaleva Lyubov Alexandrovna – Chief expert at the Dpt. of methodical support of the payment policy for medical care at the Federal Public Institution.
Khokhlovsky per., 10-5, Moscow, 109028, phone: +7 (495) 783-19-05 (188)
T. A. Khelisupali
Russian Federation
Khelisupali Teona Alexandrovna – Leading specialist at the Dpt. of methodical support of standardization at the Federal Public Institution.
Khokhlovsky per., 10-5, Moscow, 109028, phone: +7 (495) 783-19-05
M. A. Voinov
Russian Federation
Voinov Mikhail Andreevich – Chief specialist at the Medical Standardization Department of the Federal Public Institution.
Khokhlovsky per., 10-5, Moscow, 109028, phone: +7 (495) 783-19-05V. V. Omel’yanovskii
Russian Federation
Omelyanovskiy Vitaliy Vladimirovich – MD, Professor, Director of the Center for Technology Assessment in Health Care of the Institute of Applied Economic Research of RANEPA, Head of the Health Care Finance Center of the Research Financial Institute of the MF RF.
Nastasiinskii per., 3-2, Moscow, 127006. Phone: +7(499)9569528References
1. Decree of the Government of the Russian Federation of December 28, 2012 No. 2599-r “Plan of measures (“Road map”) Changes in social sectors aimed at improving the effectiveness of public health services” (as amended by the Government of the Russian Federation on 31.10.2013 N 2021-r, as of 30/04/2014 N 721-r, of 28.08.2015 N 1670-r, of 18.05.2016 N 948-r, of 19.07.2017 N 1533-r) [Rasporyazhenie Pravitel’stva RF ot 28 dekabrya 2012 g. N 2599-r «Plan meropriyatii («Dorozhnaya karta») «Izmeneniya v otraslyakh sotsial’noi sfery, napravlennye na povyshenie effektivnosti zdravookhraneniya»» (v red. rasporyazhenii Pravitel’stva RF ot 31.10.2013 N 2021-r, ot 30.04.2014 N 721-r, ot 28.08.2015 N 1670-r, ot 18.05.2016 N 948-r, ot 19.07.2017 N 1533-r) (in Russian)].
2. Novikov A. M., Novikov D. A. Methodology [Metodologiya (in Russian)]. Moscow. 2007.
3. The Great Soviet Encyclopedia. 3rd ed. M., 1968-1979; Soviet Encyclopedic Dictionary [Bol’shaya sovetskaya entsiklopediya. 3-e izd. M., 1968-1979; Sovetskii entsiklopedicheskii slovar’ (in Russian)]. Moscow. 2002.
4. Letter of the Ministry of Health of the USSR of 08.04.1974 N 02-14 / 19 “On the direction” of the Methodological recommendations on increasing the efficiency and analysis of the use of hospital bed capacity of hospitals and treatment facilities (together with “Methodological Recommendations ...”, approved by the Ministry of Health of the USSR 05.04 .1974)” [Pis’mo Minzdrava SSSR ot 08.04.1974 N 02-14/19 «O napravlenii “Metodicheskikh rekomendatsii po povysheniyu effektivnosti i analizu ispol’zovaniya koechnogo fonda statsionarov lechebno-profilakticheskikh uchrezhdenii (vmeste s “Metodicheskimi rekomendatsiyami...”, utv. Minzdravom SSSR 05.04.1974)» (in Russian)].
5. Yashina N. G., Grishunina I. A., Yashin K. S. Methodology for assessing the effectiveness of budgetary resources management in the health sector. Economic analysis. Theory and practice. 2015; 21 (415): 15-24.
6. Orlov A. E. Fundamental’nye issledovaniya (in Russian). 2015; 7-2: 424-7.
7. Vakhrushina M. A. Mezhdunarodnyi bukhgalterskii uchet (in Russian). 2015; 43 (385): 2-17.
8. Decree of the Government of the Russian Federation of December 12, 2016 N 1403 “On the Program of State Guarantees of Free Medical Assistance to Citizens for 2017 and for the Planning Period 2018 and 2019” [Postanovlenie Pravitel’stva RF ot 19.12.2016 N 1403 «O Programme gosudarstvennykh garantii besplatnogo okazaniya grazhdanam meditsinskoi pomoshchi na 2017 god i na planovyi period 2018 i 2019 godov» (in Russian)].
9. Statistical information of the Ministry of Health for 2014, 2015, 2016: “Resources and activities of healthcare organizations” Health facilities (number and provision of population with beds of various specialties)” [Statisticheskaya informatsiya Ministerstva zdravookhraneniya za 2014, 2015, 2016 gg.: «Resursy i deyatel’nost’ meditsinskikh organizatsii zdravookhraneniya «Koechnyi fond (chislo i obespechennost’ naseleniya koikami razlichnykh spetsial’nostei)» (in Russian)].
10. Statistical information of the Ministry of Health for 2014, 2015, 2016: “Resources and activities of medical health organizations” Nursing fund (average employment and average length of stay in bed in a year)” [Statisticheskaya informatsiya Ministerstva zdravookhraneniya za 2014, 2015, 2016 gg.: «Resursy i deyatel’nost’ meditsinskikh organizatsii zdravookhraneniya «Koechnyi fond (srednyaya zanyatost’ i srednyaya dlitel’nost’ prebyvaniya na koike v godu)» (in Russian)].
11. Statistical information of the Ministry of Health for 2014, 2015, 2016: “Resources and activities of health care organizations” Nursing fund (bed turnover and lethality)” [Statisticheskaya informatsiya Ministerstva zdravookhraneniya za 2014, 2015, 2016 gg.: «Resursy i deyatel’nost’ meditsinskikh organizatsii zdravookhraneniya «Koechnyi fond (oborot koiki i letal’nost’)» (in Russian)].
12. Letter of the Ministry of Health of the Russian Federation of March 18, 2014 N 16-0 / 10 / 2-1796 “Methodology for calculating the need for medical personnel of the subjects of the Russian Federation” [Pis’mo Minzdrava RF ot 18 marta 2014 g. N 16-0/10/2-1796 «Metodika rascheta potrebnosti vo vrachebnykh kadrakh sub”ektov Rossiiskoi Federatsii» (in Russian)].
13. Letter of December 21, 2015 N 11-9 / 10 / 2-7796 “On the formation and economic justification of the Territorial Program of State Guarantees of Free Medical Assistance to Citizens for 2016 and for the Planning Period of 2017 and 2018” [Pis’mo ot 21 dekabrya 2015 g. N 11-9/10/2-7796 «O formirovanii i ekonomicheskom obosnovanii Territorial’noi programmy gosudarstvennykh garantii besplatnogo okazaniya grazhdanam meditsinskoi pomoshchi na 2016 i na planovyi period 2017 i 2018 godov» (in Russian)].
14. Letter of November 8, 2013 N 11-9 / 10 / 2-8309 “On the formation and economic justification of the Territorial Program of State Guarantees of Free Medical Assistance to Citizens for 2014 and for the Planning Period of 2015 and 2016” [Pis’mo ot 8 noyabrya 2013 g. N 11-9/10/2-8309 «O formirovanii i ekonomicheskom obosnovanii Territorial’noi programmy gosudarstvennykh garantii besplatnogo okazaniya grazhdanam meditsinskoi pomoshchi na 2014 i na planovyi period 2015 i 2016 godov» (in Russian)].
15. Letter of 12 December 2014 No. 11-9 / 10 / 2-9388 8309 “On the formation and economic justification of the Territorial Program of State Guarantees of Free Medical Assistance to Citizens for 2015 and for the Planning Period 2016 and 2017” [Pis’mo ot 12 dekabrya 2014 g. N 11-9/10/2-9388 8309 «O formirovanii i ekonomicheskom obosnovanii Territorial’noi programmy gosudarstvennykh garantii besplatnogo okazaniya grazhdanam meditsinskoi pomoshchi na 2015 i na planovyi period 2016 i 2017 godov» (in Russian)].
16. Statistical materials published annually by the Ministry of Health of the Russian Federation: “The incidence of the entire population of Russia” [Ezhegodno publikuemye Minzdravom RF statisticheskie materialy: «Zabolevaemost’ vsego naseleniya Rossii» (in Russian)] (www.rosminzdrav.ru).
17. Order of the Ministry of Health and Social Development of Russia from 17.05.2012 N 555n (as amended on 12/16/2014) “On approval of the nomenclature of the hospital bed profile for medical aid profiles” (Registered in the Ministry of Justice of Russia 04.06.2012 N 24440) [Prikaz Minzdravsotsrazvitiya Rossii ot 17.05.2012 N 555n (red. ot 16.12.2014) «Ob utverzhdenii nomenklatury koechnogo fonda po profilyam meditsinskoi pomoshchi» (Zaregistrirovano v Minyuste Rossii 04.06.2012 N 24440) (in Russian)].
Review
For citations:
Zheleznyakova I.A., Kovaleva L.A., Khelisupali T.A., Voinov M.A., Omel’yanovskii V.V. EVALUATING THE USE OF HOSPITAL BED CAPACITY IN MEDICAL ORGANIZATIONS. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2017;10(4):37-43. (In Russ.) https://doi.org/10.17749/2070-4909.2017.10.4.037-043
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.