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Lack of patients? a hypothesis for understanding discrepancies between hospital resources and productivity

Bratlid, Dag
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/300627
Date
2006
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  • Institutt for klinisk og molekylær medisin [2126]
  • Publikasjoner fra CRIStin - NTNU [21936]
Original version
BMC Health Services Research 2006, 6(42)   10.1186/1472-6963-6-42
Abstract
Background: Despite a substantial increase in hospital resources, increased hospital admissions

and out-patient visits, long waiting lists have been a significant problem in Norwegian health care.

A detailed analysis of the development in resource allocation and productivity at St. Olavs

University Hospital in central Norway was therefore undertaken.

Methods: Resource allocation and patient volume was analysed during the period 1995 to 2001.

Data were analysed both for emergency and elective admissions as well as outpatient visits specified

into new referrals and follow-up consultations.

Results: Full time employee equivalents for doctors and nurses increased by 36.6% and 25.9%,

respectively, and all employees by 28.1%. However, admitted patients, outpatient consultations and

surgical procedures only increased by 10%, 15% and 8.3%, respectively. Thus, the productivity for

each hospital employee, defined as operations pr. surgeon, outpatient consultations pr. doctor etc.

was significantly reduced. A striking finding was that although the number of outpatient

consultations increased, the number of new referrals actually went down and the whole increase

in activity at the outpatient clinics could be explained by a substantial increase in follow-up

consultations. This trend was more evident in the surgical departments, where some departments

actually showed a reduction in total outpatient consultations.

Conclusion: In view of the slow increase in hospital activity in spite of a significant increase in

resources, it can be speculated that patient volume might be a limiting factor for hospital activity.

The health market (patient population) might not be big enough in relation to the investments in

increased production capacity (equipment and manpower).
Publisher
BioMed Central
Journal
BMC Health Services Research

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