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Acta Médica Costarricense
On-line version ISSN 0001-6002Print version ISSN 0001-6012
Abstract
MORERA-SALAS, Melvin. Management of bed occupancy and length of stay of public hospitals in Costa Rica. Acta méd. costarric [online]. 2014, vol.56, n.3, pp.109-114. ISSN 0001-6002.
Objective: To determine if the variability in occupancy levels is a product of poor planning of bed occupancy with respect to demand or of mismanagement in length of stay. Methods: Data is from 2011 and was provided by the Social Security Institution (Caja Costarricense de Seguro Social). By using scatter graphs, we compared the Hospital Efficiency Index, which measures efficiency in management of length of stay, with bed occupancy rate, which measures efficiency in management of beds, to determine if variability in occupancy rates results from poor planning of bed occupancy with respect to demand or from mismanagement of hospital stays. Results: Poor internal distribution of the beds was found in 58% of hospitals, causing high occupancy in some departments and suboptimal occupancy in others. In 83% of hospitals there is more than one department with longer stays than the ones expected in the cases they attend. Conclusion: Most hospitals have an inadequate internal distribution of beds, a situation that could be solved by assigning the number of beds based on the expected demand for each specialty. There is a high number of hospitals with inappropriate lengths of stay when compared to the cases they attend. This requires a more detailed analysis of length of stay management in the main Diagnosis Related Groups and the development of protocols to standardize service delivery in Diagnosis Related Groups and the development with greater variability in average length of stay.
Keywords : Health Management; Management Indicators; Bed Occupancy; Length of Stay.