Best Practices in the Performance of District Hospital Report_00.1
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Best Practices in the Performance of District Hospital Report

 

Relevance

  • GS 2: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

 

Context

  • Recently, NITI Aayog has released a report titled, ‘Best Practices in the Performance of District Hospital’ where it has accessed the performance the district hospitals across the country.
  • This report is the first-ever performance assessment of district hospitals undertaken across the country.
  • A few months ago, NITI Aayog released a report on Not-for-Profit Hospital Model Study.

 

Best Practices in the Performance of District Hospital Report_50.1

 

Key findings

  • Average number of functional beds in a district hospital per 1 lakh population
    • On an average, a district hospital in India has 24 beds per 1 lakh population.
    • The number of functional beds in a district hospital ranges from 1 to 409 beds per 1 lakh population.
    • Puducherry had the highest average beds in the country with a district hospital in the UT having an average of 222 beds per 1 lakh population, while Bihar had the lowest average of 6 beds per 1 lakh population.
  • Ratio of doctors
    • Doctors prescribed by IPHS (Indian Public Health Standards).
Beds Doctors
100 29
200 34
300 50
400 58
500 68

 

  • Overall, 189 of 707 district hospitals were found to meet the doctor to bed ratio as per IPHS norms.
  • Uttar Pradesh had the highest proportion (12.7%) of doctors in position at district hospitals meeting IPHS norms, followed by Karnataka. However, looking at the percentage of hospitals in each State/UT that meet the IPHS norm, only Chandigarh, Dadra and Nagar Haveli, and Goa had all district hospitals fulfilling IPHS norms for positioned doctors.
  • Availability of core health services
    • A total 101 out of 707 hospitals fulfilled the criteria of having all 14 functional specialties belonging to States/UTs
    • . Tamil Nadu had the highest proportion (16.8%; 17/101) of hospitals with all functional specialties, followed by Karnataka (13.9%; 14/101)
  • Availability of diagnostic testing services
    • Only 21 hospitals belonging to States/UTs fulfilled the criteria of having all diagnostic testing services available.
    • Karnataka had the highest proportion (28.6%) of hospitals with all support services, followed by Telangana (19%).
  • Bed Occupancy ratio
    • Bed occupancy rate = (Total number of inpatient bed days added for a year × 100) / (Total Functional Beds × 365)
    • The bed occupancy rate in many hospitals (n=123) were found to exceed 100% occupancy rate because the government hospitals cannot deny admission to patients.
    • Of 707 hospitals, a total of 182 hospitals had bed occupancy rate of 90% or higher.
    • Uttar Pradesh (14.8%) had the highest proportion of hospitals with bed occupancy rate greater than or equal to 90%, followed by Madhya Pradesh (10.9%),

 

Shoonya Campaign

 

Suggestions

  • To the Ministry of Health and Family Welfare
    • Strengthen HMIS system
    • Increase regular trainings on digitisation
  • For the states/UTs
    • Increase resources to improve quality at district hospital
    • Maintain uniformity and continuity in data entry
    • Strengthen the health system
    • Increase accountability
  • For district hospitals
    • Improve maintenance of records
    • Encourage maximum participation
    • Increase both in-person and digital trainings

 

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