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Admissions The number of admissions is defined as the number of inpatient admissions. A given person could be admitted more than once during the year. The number of admissions multiplied by the average length of stay produces the total number of patient days. Average Daily Census (ADC) The average daily census provides the mean number of beds occupied during the year. The average daily census multiplied by 365 gives the total number of patient days per year. The average daily census divided by the bed capacity and multiplied by 100 gives the occupancy rate. Average Length of Stay (ALOS) The average length of stay is the average number of days patients remain in the facility per hospital stay. ALOS is computed by dividing the total patient days by the number of admissions. Length of stay can be thought of as an indicator of either efficiency or seriousness of patient's illness. Where facilities are able to discharge patients in a shorter time, they might be thought of as being more efficient. However, in some instance where patients remain out of a hospital until their condition is more serious or where outpatient care is encouraged for less serious conditions, patients admitted may be required to stay longer. In addition, in the event that
long term care patients are occupying acute beds because they cannot find
long term accommodations, this may tend to increase the acute length of
stay--confusing the interpretation. It would be best if, when computing
length of stay, wait listed long term care patients could be omitted from
the acute inpatient care data. This has not been done in these data.
Inpatient Days (I/P Days) The number of patient days in a given service. Total patient days is the sum of all inpatient days for all services. Occupancy Rates (OCCUP %) Occupancy rates can be computed by dividing the ADC by the number of licensed beds and multiplying by 100. This provides an idea of the proportion of bed capacity occupied on the average day. As with ADC, this will fluctuate from day to day and by type of bed and place. If a hospital's occupancy rate is too high, it may not have adequate capacity to accept new patients. Also, some extra beds are always needed in order to allow for maintenance, renovation, etc. Usually, high occupancy in long term care beds is more acceptable, i.e., above 95%, since there is less daily fluctuation in daily census. In acute care, particularly where patients are admitted on a non-scheduled basis, e.g., OB, CCU, etc., the optimal occupancy can be lower in order to permit unforeseen admissions. For other types of acute beds, an occupancy of about 80-85% is acceptable because admissions can be scheduled if bed capacity is fully utilized on a given day. In some instances, occupancy may run over 100% because of an overflow situation. This might occur if there are, for example, too many of a given type of patient who must be temporarily assigned to another bed type. Where occupancy rates are very high, this is an indication of an inadequate supply of that type of bed on a given island; where they are low, it is an indication of either an adequate supply or surplus of that type of bed on that island. Although a facility's occupancy
rate for licensed beds may run below 100% occupancy, that facility could
run at or near 100% occupancy in terms of the number of staffed beds which
were regularly maintained or set up and staffed ready for use. Differences
in the licensed and staffed beds occupancy rates may be due to temporary
closure of wards or rooms because of facility renovations, labor shortages
and strikes.
SHPDA Approved Bed Capacity The SHPDA approved bed capacity is the Certificate of Need (CERT) approved and authorized bed capacity. |