Hospital utilization pattern in a hepatogastroenterology department of a research institute hospital, from 2004 to 2013.

BACKGROUND: The Theodor Bilharz Research Institute (TBRI) Hospital is a research and referral center for gastroenterology and hepatology. The Hepatogastroenterology (HGE) Department in TBRI Hospital is a center for endoscopy and sonography. The department also has a hepatology ICU. As a part of hospital performance improvement, medical records that satisfy the needs and demands of the healthcare team, setting a practical framework to improve the quality of medical care in TBRI Hospital, were generated.

OBJECTIVE: The aim of the study was to assess the performance of the HGE Department in TBRI Hospital during the 10-year period from 2004 to 2013.

MATERIALS AND METHODS: This is a retrospective observational study. Data were sourced from the electronic database of patient records in the form of automated summary discharge forms and from annual reports from the year 2004 until the year 2013, which are available in the Medical Record Unit in TBRI Hospital. HGE Department data include utilization of outpatient and emergency services and inpatient and ICU services. Hospital admission rates and readmission rates (RARs) were also used. Other utilization indices such as ultrasonography and endoscopy and hospital bed utilization indices such as average length of hospital stay (ALOS), bed occupancy rate (BOR), bed turnover rate, and mortality rate (MR) were also included.

RESULTS: Outpatient cases almost doubled from 2004 to 2013 (from 6209 to14241). Inpatient cases increased by 40.5% (from 2003 to 2829). On average, the emergency admissions and ICU admissions formed about one-fourth of total admissions. RAR decreased over the 10 years (from 14.2 to 0.6). ALOS also decreased (from 9.4 to 6.1). BOR increased from 2004 to 2012 only (from 54.3 to 86.3). Bed turnover rate ranged from 21.1 to 28.5, but in 2012 it increased to 47.7 as a result of the increased BOR that year. MR decreased from 8.9 in 2004 to 0.3 in 2013. Ultrasonography increased from 3384 to 3973. Over the 10 years, the number of endoscopies increased about two-fold (from 2677 to 5100) and endoscopic ligation increased more than 10-fold.

CONCLUSION AND RECOMMENDATIONS: There is an improvement in the hospital performance indicators represented in the form of increased outpatient services, decreased RAR, decreased ALOS, decreased MR, and increased utilization of endoscopies. It is recommended to implement a strategy based on the present findings for continual improvement for competency even in the future.