A district hospital in India on an average has 24 beds per one lakh population, with Bihar recording the lowest average of six beds and Puducherry the highest of 222 beds , according to a study by NITI Aayog.
In the Study “Best Practices in the Performance of District Hospitals released on September 30, Nito Ayog said that district hospitals in the country had a range of one to 408 beds per one lakh population.
It said that 217 district hospitals had at least 22 beds for every one lakh population. Less populated districts had good infrastructure -related KPIs, while the more populated districts in the states of Uttar Pradesh and Maharashtra got higher scores in KPIs such as bed occupancy rates and number of surgeries per surgeon.
The assessment looked at a wide array of health indicators ranging from beds, doctors, nurses, paramedics, diagnostic and health care facilities to the rate of Caesarean section surgeries and bed occupancy, amongst others. the HMIS data of district hospitals for the financial year 2017–18 was taken as baseline
SUPPORT SERVICES
Based on IPHS (2012), the assessment framework identified 14 support services that a district hospital is expected to maintain. The report said that a district hospital in India has 11 support services on an average. A total of 89 district hospitals had provision of all the 14 support services. With regard to availability of core health care services, 101 district hospitals had provision of all 14 core health care services. On average, a district hospital in India has 10 core health care services.
On diagnostic testing services, 21 district hospitals had provision of all 14 diagnostic testing services; 14 of which are large hospitals (those having more than 300 beds). On average, a district hospital in the country has nine diagnostic testing services, while large district hospitals have an average of 11 services, Niti Aayog said.
BED OCCUPANCY
The average bed occupancy rate in district hospitals in India is 57 per cent. IPHS guidelines for district hospitals (2012) recommend at least 80 per cent bed occupancy. The report said that 263 district hospitals had a bed occupancy rate of more than 80 per cent, of which 54 per cent were small hospitals (those with 200 or less beds), 19 per cent mid-sized hospitals (those with 201–300 beds) and 27 per cent large hospitals (those with more than 300 beds).
ACTION POINTS FOR STAKEHOLDERS
Suggestions to the Ministry of Health and Family Welfare:
- Strengthen HMIS system
- Increase regular trainings on digitisation
Suggestions for States/UTs:
- Increase resources to improve quality at district hospital
- Maintain uniformity and continuity in data entry
- Health system strengthening
- Increase accountability
Suggestions for district hospitals:
- Improve maintenance of records
- Encourage maximum participation
- Increase both in-person and digital trainings
- Encourage digitization
- Align raw data with HMIS elements
