Preliminary Construction Of Evaluation Model On Bed Utilization Efficiency In General Hospitals

Hospitals’ bed utilization is a major indicator to reflect the work efficiency andresources utilization in the hospital, correctly analyzing bed work efficiency has apositive meaning to maximize the utilization rate of beds and promote a bettermanagement and resource distribution for hospital. Therefore, to construct the urbancomprehensive hospital beds utilization efficiency evaluation model and then givescientific and reasonable evaluation for the existing urban comprehensive hospital bedresource, can provide guidance and basis to the effective utilization and improvementof the comprehensive hospital bed resource, also provide the reference to theformulating regional health planning, rational configuration and utilization of themedical resource.PurposeThis research is on the basis of DRGs concept in the European and Americancountries, combining with China’s actual condition, taking the general hospital bedsutilization efficiency evaluation model as the research object. And on the basis oncomparing and analyzing the advantages and disadvantages of current beds utilizationevaluation model, this research uses the frontier statistics and evaluation method,finally constructs general hospitals’ bed utilization efficiency evaluation model basedon disease with Chinese characteristics and provides the basis to scientific andeffective bed utilization and evaluation.MethodThis research uses literature research method to consult domestic and foreign literatures and policy material about medical institutions bed utilization efficiencyevaluation; Taking Beijing area as sample survey, this paper uses secondary datacollection method to collect genera situation and the first page of hospital patientsmedical records and other information and data related with bed utilization;Combined with DGRs concept, this research uses information theory to calculate casemix index; Using the statistical analysis methods such as cluster analysis, correlationanalysis, the coefficient of variation, combining the expert opinion, screening bedsevaluation index; According to the evaluation need to choose DEA model, thencontract general hospitals’ bed utilization efficiency evaluation model based ondisease.Result and analysis1. Theory analysis on the general hospitals’ bed utilization efficiency evaluationmodel.In China, the main indicators in bed utilization are the number of beds,utilization of beds and average day in hospital, using normalization method, RSRmethod, beds utilization model and analytic hierarchy process to evaluate bedutilization; Oversea researches use more complex and mature model, mainly usingsimulation model, bed capacity model, data envelopment model and so on. In additionto common beds indicators, they also involve the patient’s condition, diagnosticsrelated index, which index involved the condition of difference individual patients.2. Calculation of case mix index on beds utilization evaluation model.This research uses complete hospital patients medical records of17generalhospitals in Beijing in2010, including a total of509955data records. According tothe amount of data and expert advice, based on the DRGs idea and ICD types, thisresearch divides the data into78groups, then based on the information theory,calculates each hospital case mix index.3. Evaluation indexes selection of the general hospitals’ bed utilization efficiencyevaluation modelBased on the detailed2010data from17general hospitals in Beijing, combined with statistic methods such as the cluster analysis, reducing the dimension of theindexes and categorizing them, analysis and select indexes on the evaluation modelbeds. Finally the input indexes are: the total hospitalization expenditures, the numberof doctor, the number of practical beds, standardized number of employee per bed; theoutput indexes are: cure rate, the number of discharge patient, the actual occupied beddays per year, the standardized average length of stay.4. Construction of general hospitals’ bed utilization efficiency evaluation modelBased on the literature analysis and expert advice, combined with the actualneeds of evaluation, the result of DEA model selection is the CCR model and BCCmodel, using the case mix index calculation result and selected indexes, construct thepreliminary general hospitals’ bed utilization efficiency evaluation model.Discussion and SuggestionsDiscussionThe use of combination index can reduce the data dimension, make a largenumber of information into a single index, and then adjust the evaluation indexeswhich are involved in the severity of disease among patients, as a result making theevaluation more accurate; In the index selecting, given priority to statistical method,again with professional background and evaluation demand, so the selecting indexesare more comprehensive and scientific; In the DEA model selection, combined CCRmodel and BCC model, the result is more comprehensive and significance.SuggestionsWhen measuring the index case mix, it’s better to choose the suitable selectinggroup method according to the size of the data, and strictly control the quality of thedata; In the index selection, to have a good understanding of the emphasis of theevaluation, combined with the frontier statistical method, and make the selectionprocess more objective; In a follow-up study, suggest adding case study, make theevaluation system to expand constantly.