Reassessment of health insurance in patient hospital services in Alexandria Part I Bed supply, hospital utilization and bed requirement

The present study was carried out with the aims of exploring the effect of changes in bed supply on hospital utilization and operational efficiency, and for reassessment of required beds for the insured population in Alexandria. The results show that the overall bed population ratio as well as the bed population ratio for the different clinical sections are progressively declining year after year. This is mainly due to the continuous increase in the insured population without a corresponding increase in beds. This shortage in available beds resulted in marked decline in all the three indices of hospital utilization [admission rate, days of care rate and average length of stay] for both the overall and individual sections. Moreover, as a response to this shortage, operational efficiency as measured by occupancy rate and turnover period improved in the early years [up to 1975/76]. This improvement was not maintained in later years and on the contrary a deterioration was observed. A possible cause for this deterioration could be the over-concern of hospital staff and administration for bed shortage. It could be also explained by lack of coordination between and within the two hospitals providing the services. The results of the study also indicate that the bed population balance is negative, both in total and for almost all the clinical sections. An estimated ratio of 2 beds/1000 population is recommended, which is far higher than that currently available [1.31/1000] and for lower than that specified by the National Health Insurance ACT [4/1000]

Reassessment of health insurance in patient hospital services in Alexandria: Part II, effect of consolidation

The occupancy rate was shown by many authors to be higher in large hospitals [or units] than in small ones. This was explained by the fact that the larger the served population is, the higher the demand will be and hence the fluctuations in the demand will be relatively low. The delivery of services for the insured population in Alexandria is conducted through two independent hospitals. Further more, each hospital is divided into several independent sections. It was mentioned in part I of this study that this could be the reason for the low operational efficiency observed. Based on the previously mentioned situation, this study was conducted to explore the possible effect on consolidation of services. As an example to these effects, the general surgery section was chosen. The results of the study indicate that if consolidation of each of the three general surgery units in each of the two hospitals could be done,36 beds can be saved. This will result in total saving of 198,000 LE of the annual operating expences. Moreover, if consolidation can be further extended to cover all the 6 units of the two hospitals a total of 51 beds can be saved and consequently saving of about 280,000 LE annually can be achieved