A recent NITI Aayog report reveals that each surgeon in the district hospitals of Jammu and Kashmir performs 240 surgeries every year, while each doctor in OPD attends to 23 patients every day, on an average, bringing the Union Territory among the better performers across the country.
The study titled ‘Best practices in the performance of District Hospitals in India’, the first-ever performance assessment of district hospitals with respect to infrastructure and service outputs, was released by NITI Aayog on Thursday.
Over 700 district hospitals across the country have been assessed for some pre-determined key performance indicators. The validation exercise, based on monitoring framework developed in 2017, was initiated in December 2018 and concluded in 2019, that is, prior to COVID19 pandemic which overwhelmed the public health infrastructure.
Beginning with first KPI, which is, ‘Number of functional beds’ – regularly maintained and staffed and immediately available for the care of admitted patients, J&K is reported to have only 17 average number of beds in a district hospital for every 1 lakh population.
The IPHS guidelines, 2012 requires DH to ensure at least 22 beds for this size of population.
For the second KPI, which is, ‘Ratio of doctors, staff nurses, and paramedical staff in proportion to IPHS norms’, 19 DH’s were assessed in J&K. 11 were found to meet the IPHS norms for the positioned strength of doctors, 0 for staff nurses and 16 for paramedical staff.
The third KPI assessed DH’s for Availability of 14 identified ‘support services’ – HIS implemented in OPD; HIS implemented in IPD; HIS implemented in pharmacy; HIS implemented–complete HIS; Sterilization and Disinfection; Fully equipped blood bank, Waste management including biomedical waste; Medico-legal/postmortem Service; Hospital Transport Ambulance (Basic Life Support/ Advanced Life Support); Dietary services for patient; Electric supply (power generation and stabilization); Drugs and pharmacy; Water supply; and Refrigeration. Here, J&K is reported to have 11 average number of support services in a DH.
Likewise, J&K has 11 ‘core health care services’ in its DH’s out of the identified 14 – General Medicine; General Surgery; Obstetrics & Gynecology; Pediatrics including Neonatology (as required for level II SNCU); Emergency (accident & other emergency) (Casualty 24X7 basis); Critical Care (ICU); Anesthesia; Ophthalmology; ENT; Dermatology and Venereology (Skin & VD) RTI / STI; Orthopedics; Dental care; Public Health Management; Radiology.
Out of the 14 identified diagnostic testing services – Urine Analysis; Stool Analysis; PAP smear; Sputum; Haematology; Microbiology; Serology; Biochemistry; Cardiac Investigations; Ophthalmology; ENT; Radiology; Endoscopy; and Physiology (Pulmonary function test), which form the Fifth KPI, J&K, on an average has 9 services available in its DH’s.
The sixth KPI has been mentioned as Bed occupancy rate, which reflects effective utilization of available beds in a hospital. While IPHS 2012 recommends a bed occupancy rate of at least 80%, J&K was shown to have an average bed occupancy rate of 48.01%.
Further, J&K performs C-section deliveries, which are absolutely critical to save lives, at an average rate of 35.76%, ranking the UT at 10th place in India for this KPI.
Moreover, with atleast 240 surgeries per surgeon in DH in a year, when on an average, 194 surgeries per surgeon are performed in a year in a DH in India, J&K stands at 13th rank in ‘Surgical productivity index’.
The report also reveals that a doctor in J&K’s DH, attended to 23 OPD patients in a day, which reflects how adequate is the number of doctors in the UT to attend to expected patient load so as to give adequate time and quality treatment to patients, which is the basic right of every patient.
Lastly, while assessing the ability of the hospitals to provide as well as manage the supply of blood from low-risk donors under the KPI ‘Blood bank replacement rate’, J&K was found to be poor performer as it asks patient’s attendant to give blood units for getting blood from the blood bank of its DH’s. Here, the UT scored 49, which is much higher than the national average of 35.
The full report can be accessed here.
Also: Read my article at The News Now
In J&K’s DHs, 240 surgeries, 8400 OPD patients, per doctor, per year
Published in The News Now on 6th October, 2021
waliaharry 