RESUMO
Background: Hospital costs are the largest component of health expenditure and they have therefore been a key focus in the drive for increased efficiency in the health sector.1With the simultaneous menace of ever increasing price rise and population explosion there is dearth of the existing meagre resources and thereby it becomes necessary to allocate and utilise the available resources to the fullest with provisions for minimum wastage. The objective of this study is to find out the pattern of diseases with their ICD-10 codes and the hospital performance indicators in patients admitted at the surgery ward of North Bengal Medical College during the study period.Methods: A descriptive epidemiological study with cross-sectional design was done by complete enumeration of all patients admitted in surgery ward of North Bengal Medical College and Hospital in Darjeeling district of West Bengal from July 2016 to September 2016.Results: A total of 2227 patients were admitted during the study period with intra-cerebral haemorrhage (I61) being the most common cause of admission followed by abdominal injury (S36) and burn (T29). The bed occupancy rate was 144.21%, bed turn-over rate 14.26 and average length 9.1. Scatter plot indicates hospital utilisation at Region IV as per Pabon Lasso Model of Hospital Utilisation.Conclusions: A high bed occupancy rate and low bed turn-over rate indicates scarcity of hospital beds, preponderance of severe and chronic cases and unnecessary stay in hospital.
RESUMO
Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya. Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique. Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis. Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures.