DATA STORY : The Performance Of District Hospitals Report

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It is released by NITI Aayog. It is first ever performance assessment of district hospitals undertaken across the country. The framework classifies hospitals in three categories: Small Hospitals (less than or equal to 200 beds), Mid-sized Hospitals (between 201–300 beds) and Large Hospitals (more than 300 beds).

Assessment Indicators:

• Number of functional hospital beds per 1,00,000 population
• Ratio of doctors, nursing staffs and paramedical staff in position to Indian Public Health Standards (IPHS) norm;
• Proportion of support services available
• Proportion of core health care services available
• Proportion of diagnostic services available
• Bed occupancy rate
• C-section rate
• Surgical productivity index
• OPD per doctor
• Blood bank replacement rate

Key Findings:

• Beds per Population: On an average, a district hospital had 24 beds for 1, 00,000 people.

For the assessment, it was set that a hospital should have 22 beds for that many people (IPHS 2012 guidelines).

The World Health Organization (WHO) recommends five hospital beds for every 1,000 people.

1. 1. Doctor-to-Bed Ratio: Only 27% of the total 707 districts assessed met the doctor-to-bed ratio of 29 doctors per 100 beds in a hospital.
   2. 88 hospitals out of 707 had the required ratio of staff nurses.

• Ratio of Paramedical Staff: Only 399 hospitals were found to have a ratio of paramedical staff in position as IPHS norms laid down (100 paramedical staff for 500-bed hospital).
• Support Services: On an average, every district hospital in India had 11 support services, compared to the required 14.
• Diagnostic Testing Services: Only 21 hospitals fulfilled the criteria of having all diagnostic testing services available.
• Bed Occupancy: 182 hospitals out of the 707 had bed occupancy of 90% or more.

Suggestive Measures:

• Affordability: Provide effective, affordable health care services (curative including specialist services, preventive, and promotive) for a defined population.
• Accessibility: At least one district hospital for every district providing advanced secondary care. Extensive coverage; Service coverage encompassing both urban (district headquarter town) and the rural population in the district.
• Broad scope: Provide wide-ranging technical and administrative support and education and training for primary health care.
• Substantial infrastructure: The district hospital, having beds ranging from 100 to 1200, provides out and inpatient critical services including surgical interventions such as cesarean sections; care for sick new-borns, infants, and children; management of NCDs and infectious diseases; and blood storage facility on a 24-hour basis.
• Contribution to society: District hospitals have a lot to contribute towards meeting the country’s global and national goals and targets, including the SDGs, and thus improving health outcomes.