Signature
T = 365 * o / L_bar
| Inputs | Definition | Unit |
|---|---|---|
o | Average bed occupancy, occupied bed-days divided by available bed-days | proportion, for example 0.85 |
L_bar | Average length of stay, occupied bed-days divided by discharges, on the same counts as o | days, above zero |
T | Annual bed turnover rate | patients per bed per year |
|---|
Function
Bed turnover rate and turnover interval function
Maps the discharges, available beds and occupied bed-days of a period to the two measures reported as bed turnover: the turnover rate, the number of patients each bed served, and the turnover interval, the average time a bed stands empty between one patient and the next. It also expresses both through bed occupancy and average length of stay, and spreads the annual cost of a staffed bed over the patients it served. The records follow the notation of the Bed Turnover article. The throughput identity linking annual discharges to beds, occupancy and average length of stay is held on the Average Length of Stay page (HE-FM-ALOS-002) and is referenced here, not repeated.
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Implementations
Excel
Annual bed turnover rate from occupancy and stay in one cell
Excel multiplies 365 by the named occupancy cell, entered as a proportion, and divides by the named average length of stay cell.
=365*Occupancy/ALOS
Assumptions
Occupancy, stay and turnover rate from the same counts
The relation holds exactly only when o, L_bar and T come from the same discharge, bed-day and bed counts, as when average length of stay is bed-days divided by discharges on the same data as occupancy. Series that compute stay or occupancy on other bases do not satisfy it.
A 365-day year for the annual bed turnover rate
The constant 365 converts occupancy into occupied bed-days per bed per year. For a leap year or another period, 365 is replaced by the number of days in the period, and T is then the rate for that period.
Worked examples
Annual bed turnover rate at 85% occupancy and a 5-day stay
At the illustrative baseline, 85% occupancy and an average stay of 5.0 days give a turnover rate of 62.05 patients per bed, the same as discharges divided by beds.
o = 0.85; L_bar = 5; T = 62.05
Route A bed turnover rate with stays cut to 4.25 days
In route A, the average stay falls by 15% to 4.25 days and extra demand keeps occupancy at 85%, so the turnover rate rises to 73 and discharges from the 400 beds rise to 29,200.
o = 0.85; L_bar = 4.25; T = 73
Common errors
Bed turnover rate from averaged occupancy and stay
Averaging hospital-level ratios does not reproduce the ratio of group totals. Applying the formula to Aloh and colleagues' mean occupancy of 42.14% and mean stay of 8.15 days gives about 18.9 patients per bed, against their reported mean turnover of 21.27, because each mean is an average across hospital-years. Pooled figures come from summed discharges, bed-days and beds.
Occupancy entered as a percentage in the bed turnover rate
Entering occupancy as 85 instead of 0.85 multiplies the result by 100, giving 6,205 patients per bed a year at a 5-day stay instead of 62.05.
Sources
Occupancy, stay and turnover definitions that combine into the turnover relation
Aloh HE, Onwujekwe OE, Aloh OG, Nweke CJ. Is bed turnover rate a good metric for hospital scale efficiency? A measure of resource utilization rate for hospitals in Southeast Nigeria. Cost Effectiveness and Resource Allocation. 2020;18:21. Methods: bed occupancy rate is occupied bed-days over active bed-days, average length of stay is occupied bed-days over discharges and bed turnover rate is discharges in one year over active beds; the relation follows from combining the three. Table 2 gives the hospital-year means used in the common error.
Pabón Lasso chart relating occupancy, turnover and stay
Mehrtak M, Yusefzadeh H, Jaafaripooyan E. Pabon Lasso and Data Envelopment Analysis: a complementary approach to hospital performance measurement. Global Journal of Health Science. 2014;6(4):107-116. Section 1.1: occupancy on the horizontal axis, turnover on the vertical axis, and a line from zero through each point showing average length of stay.
Canonical Identity
Stable URI · Machine-readable · Resolvable · CC BY 4.0