Exploring The Healthcare Price Tag: Research On Private Hospitals

Exploring the Healthcare
Price Tag
Research on Private Hospitals
Actuarial & Insurance Solutions

Ashleigh Theophanides
12 June 2008
HASA NHRPL 2009
2008 Deloitte Touche Tohmatsu
Agenda
Overview of analysis
Private hospital building composition
Nurse staffing
Length of stay wards and theatres
Occupancy wards and theatres
Generalised Linear Modelling
HASA NHRPL 2009
Assets
Methodology Overview
Expenses
Occupancy
Overhead expenses
Staffing nursing and administrative
Working capital
Medical equipment
Surgical ward
ICU
Major theatre
Land and building
HASA NHRPL 2009
Methodology Overview
Ward
U1
M1
Theatre
U2
M2
Equipment
U3
M3
Revenue
Operating expenses
Working capital
Assets
Medical equipment
Surgical
ICU
Target
Profit
Theatre
ROI
Land and building
HASA NHRPL 2009
Distribution of hospitals by number of beds

Sample: 83% of private multi-disciplinary hospital beds
HASA NHRPL 2009
Distribution of beds and space per bed (m2)
45
35%
40
30%
35
25%
30
25
20%
20
15%
15
10%
10
Space per bed (m2)
HASA NHRPL 2009
Maternity
High Care
Neonatal
ICU
0%
Day
0
Paediatric
5%
Medical
Surgical
Space per bed (m2)
Average hospital composition
Percentage of beds
Distribution of theatres
Distribution of theatres
45%
Percent of hospitals
40%
35%
30%
25%
20%
15%
10%
5%
13+
9 - 12
5-8
<4
0%
Number of theatres
HASA NHRPL 2009
Staffing - nursing
Analysis of nursing staffing by nursing category:
Registered Nurse (RN)
Enrolled Nurse (EN)
Enrolled Nursing Assistant (ENA)
Other nursing categories
Unit manager (RN 1 per ward)
Care workers (not nurse but used to supplement care)
Permanent vs. agency staff
Nursing salaries by type of ward and impact of overtime
Nursing model
Acuity number of nursing hours required per patient
Skill mix ratios distribution of acuity by nurse type
HASA NHRPL 2009
Nursing ratios Actual

Total staff ratios by ward type and nurse category
100%
12%
90%
Percenatge
80%
42%
33%
46%
40%
70%
40%
32%
15%
22%
17%
23%
25%
23%
25%
71%
30%
75%
15%
10%
31%
36%
Paediatric General
32%
44%
Medical, Neurological
20%
14%
64%
60%
50%
17%
10%
64%
50%
21%
Registered Nurse
HASA NHRPL 2009
Enrolled Nurse
Maternity
High Care
Neonatal ICU/HCU
Ward Type
ICU & Specialised ICU
Day
Psychiatric
Surgical
0%
Enrolled Nurse Assistant
Nursing staff per bed

Number of nurses per bed
Ward Type
Surgical
10
Total Staff Nurses per Bed

Enrolled
Registered
Enrolled
Nurse
Nurse
Nurse
Assistant
0.232
0.204
0.249
Unit
Manager
Care Worker
Total
0.032
0.135
0.853
Psychiatric
0.237
0.126
0.125
0.040
0.108
0.636
Medical, Neurological
0.218
0.190
0.248
0.028
0.174
0.859
Paediatric General
0.283
0.223
0.271
0.046
0.167
0.990
Day
0.143
0.123
0.561
0.029
0.051
0.906
1.822
0.523
0.214
0.082
0.223
2.864
Neonatal ICU/HCU
1.115
0.257
0.126
0.065
0.086
1.649
High Care
0.983
0.382
0.114
0.056
0.154
1.689
Maternity
0.565
0.213
0.298
0.049
0.155
1.280
HASA NHRPL 2009
Looking forward nursing graduates

Nursing output from South African Institutions 1998 vs. 2007
RN output dropped from 35% to 13% over the period
Output of nurses from all South African institutions - 1998
Registered
Nurses
35%
Enrolled Nurse
Assistants
31%
Enrolled Nurses
34%
Output of nurses from all South African institutions - 2007
Enrolled Nurse
Assistants
49%
Registered
Nurses
13%
Enrolled Nurses
38%
Source: South African Nursing Council

11
HASA NHRPL 2009
Staffing nursing
Number of nurses per 100 000 population in SA
Increase in lower levels of nurses EN and ENA
Number of nurses per 100.000 population
South Africa: Nurses per 100,000 population

250
216.02
216.91
200
150
124.50
118.56
100
84.81
77.72
50
0
RN
EN
ENA
Type of nurse
1998
2007

12
HASA NHRPL 2009
Staffing nursing
Ageing of the nursing population in SA
Age distribution : Registered Nurses 2007
60 -69
11%
> 69
2%
Not reported
1%
<30
3%
30 - 39
22%
50 - 59
26%
40 - 49
35%
13
HASA NHRPL 2009
Staffing - nursing
Correlations between number of nursing staff and length of stay per tariff
Provides indication of the efficiency of nursing staff allocations to patients based
on the number of bed days
A higher correlation (close to 1) indicates high level of efficiency
Overall correlation: 89.2%
Tariff / Ward
Surgical
Medical and neurological
Paediatric
Day
High care
Neonatal
Maternity
Overall wards
Theatres
14
HASA NHRPL 2009
Correlation
89.9%
78.9%
77.6%
58.7%
81.8%
65.4%
82.8%
77.0%
89.2%
80.0%
Average length of stay Weekday versus weekend

Overall LOS during 2007 is 3.19 days (2006: 3.17 days)
Average LoS - Weekday vs Weekend
4.50
4.00
3.50
4.09
3.07
2.00
1.50
4.10
2.50
3.04
AVG LOS
3.00
1.00
0.50
Weekday
Weekend
2006
15
HASA NHRPL 2009
2007
Average length of stay Weekday versus weekend

Weekday- 2007
Day Cases
38%
AVG LOS =
4.43 days
stay for more

than a day
62%
Weekend - 2007
Day Cases
20%
stay for more

than a day
80%
16
HASA NHRPL 2009
Average length of stay Per day of the week

Average LoS per weekday - LoS for cases that stay longer than 1 day compared with
overall LoS
6.00
5.00
3.00
4.97
5.00
4.93
4.91
4.66
4.60
4.36
4.36
4.34
4.33
4.37
4.34
4.47
2.00
4.42
AVG LOS
4.00
1.00
2006 longer than a day
17
HASA NHRPL 2009
2007 longer than a day
Sunday
Saturday
Friday
Thursday
Wednesday
Tuesday
Monday
2006 ALL
2007 ALL
Average length of stay Gender
18
HASA NHRPL 2009
Average length of stay tariff code

Description
Surgical
Thoracic & Neurosurgical
Psychiatric
Medical
Paediatric
Day
Isolation
Private
Specialised ICU
ICU
Neonatal ICU
High care
Neonatal high care A
Neonatal high care B
Neonatal
19
HASA NHRPL 2009
2006 - frequency 2007 - frequency

27.4%
27.1%
0.9%
0.9%
1.1%
1.1%
22.6%
22.8%
7.7%
7.7%
24.6%
24.4%
0.1%
0.2%
0.6%
0.6%
0.4%
0.4%
3.4%
3.4%
0.3%
0.3%
7.1%
7.3%
0.4%
0.5%
0.6%
0.6%
0.6%
0.6%
Occupancy 2006 and 2007

Occupancy on Available Beds - 2006 vs 2007
68%
67%
65%
67%
64%
61%
60%
64%
62%
65%
63%
62%
Occupancy %
66%
59%
2006
2007
All
20
HASA NHRPL 2009
Excl April & December
Occupancy weekday versus weekend

Occupancy based on available beds - Weekend vs Weekday
90%
80%
60%
77%
76%
40%
76%
50%
74%
35%
34%
20%
35%
30%
35%
Occupancy %
70%
10%
0%
Weekday
Weekend
2006
21
HASA NHRPL 2009
Weekday Excl April & Dec Weekend Excl April & Dec
2007
Length of stay - Theatres

Theatre length of stay (minutes)
Distribution of
Category
times
Average time
Major theatre
94%
60.5
Minor theatre
6%
21.4
Total
100%
54.5
Average time in major theatre - 2006 vs 2007
70.00
50.00
30.00
60.40
40.00
60.68
Avg Time in mins
60.00
2006
2007
20.00
10.00
0.00
Average time
22
HASA NHRPL 2009
Length of stay Theatres by age

Average theatre time by age
90
80
Average time in theatre (minutes)
70
60
50
40
30
20
10
0
0
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
106
Age
Major
23
HASA NHRPL 2009

Correlation between theatre time and age
High variability in the older ages and among neonates
Gender
Males
Females
Overall
24
HASA NHRPL 2009
Ages
Correlation
All ages
Ages < 70
Ages > 2
All ages
Ages < 70
Ages > 2
All ages
Ages < 70
Ages > 2
77%
96%
76%
76%
97%
75%
72%
98%
71%
Length of stay Theatres by day of week

Major Theatre Minutes - 2006
Week day
Average time
Average age
Distribution
Monday
61.2
41.6
18.2%
Tuesday
61.1
41.8
20.1%
Wednesday
61.0
41.5
19.4%
Thursday
59.8
41.0
20.1%
Friday
57.3
38.8
16.5%
Saturday
Sunday
67.9
37.1
3.9%
71.4
37.2
1.8%
Total
60.7
40.8
100.0%
Major Theatre Minutes - 2007

Week day
25
Average time
Average age
Distribution
Monday
61.3
42.1
18.2%
Tuesday
61.4
41.9
19.8%
Wednesday
60.6
41.6
19.7%
Thursday
59.3
40.9
20.2%
Friday
56.6
39.0
16.5%
Saturday
Sunday
67.5
37.3
3.7%
70.7
37.1
1.9%
Total
60.4
40.9
100%
HASA NHRPL 2009
Length of stay Theatres by month of year

Distribution of cases by month of year
Distribution of cases in major theatre per month - 2006 vs 2007
10.0%
9.0%
Avg time in mins
8.0%
7.0%
6.0%
5.0%
4.0%
8.2%
8.7%
9.2%
9.1%
8.7%
8.8%
8.8%
7.5%
8.9%
7.8%
8.8%
3.0%
5.6%
2.0%
1.0%
2006
26
HASA NHRPL 2009
December
November
October
September
August
July
June
May
April
March
February
January
0.0%
2007
27
HASA NHRPL 2009
No RVU
33.0 +
31.5 - 33.0
30.0 - 31.5
28.5 - 30.0
27.0 - 28.5
25.5 - 27.0
24.0 - 25.5
22.5 - 24.0
21.0 - 22.5
19.5 - 21.0
18.0 - 19.5
16.5 - 18.0
15.0 - 16.5
13.5 - 15.0
12.0 - 13.5
10.5 - 12.0
09.0 - 10.5
07.5 - 09.0
06.0 - 07.5
04.5 - 06.0
03.0 - 04.5
01.5 - 03.0
00.0 - 01.5
Average theatre time (minutes)
Length of stay Impact of RVUs

Averrage theatre time by RVU
180.00
160.00
140.00
120.00
100.00
80.00
60.00
40.00
20.00
0.00
Relative Value Units (RVU)

Average theatre time by age
90
80
Average time in theatre (minutes)
70
60
50
40
30
20
10
0
0
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
106
Age
Major
28
HASA NHRPL 2009
Generalised Linear Modelling - Introduction

GLM is a form of regression, which takes account of the effect of several different
factors at once.
It assumes an underlying structure for the relationship between the variable we
are trying to model (e.g. average claims experience) - the response or
dependant variable- and the factors that affect it (e.g. age, gender, number of
chronic conditions etc).
Formula 1:
Response variable = k x ffactor 1 x ffactor 2 x x ffactor n + e
Where k is a constant and ffactor n is a parameter which depends on the level of
factor i (so if factor i is age, then ffactor i might be something like 0.8 if age < 35,
1.00 if 35 age< 50 and 1.25 otherwise).
The factor e allows for statistical variability and is called the error term. In the
modelling, various statistical distributions are fitted to the error term with the aim
of minimising such variability.
29
HASA NHRPL 2009
Generalised Linear Modelling Results All Wards

Intercept
Estimate
2.013
Lower CI (5%)
2.003
Upper CI (95%)
2.023
Risk factor
estimate
1.836
0.823
0.745
0.834
0.831
0.887
0.950
1.000
1.043
1.066
1.061
1.040
1.022
1.031
1.057
1.112
1.174
1.230
1.362
Risk factor
Lower CI estimate
1.825
0.818
0.740
0.827
0.826
0.881
0.945
1.000
1.038
1.061
1.055
1.034
1.016
1.025
1.051
1.105
1.167
1.221
1.350
Risk factor
Upper CI estimate
1.846
0.828
0.751
0.842
0.837
0.892
0.955
1.000
1.048
1.072
1.066
1.046
1.028
1.037
1.063
1.118
1.182
1.239
1.373
1.029
1.024
1.035
Age Results
Age band
A: Under 1
B: 01-04
C: 05-09
D: 10-14
E: 15-19
F: 20-24
G: 25-29
H: 30-34
I: 35-39
J: 40-44
K: 45-49
L: 50-54
M: 55-59
N: 60-64
O: 65-69
P: 70-74
Q: 75-79
R: 80-84
S: 85+
Patient distribution
3.7%
6.5%
3.5%
2.5%
4.1%
5.5%
7.8%
9.7%
9.0%
7.6%
7.2%
6.5%
6.1%
5.3%
4.6%
3.8%
3.0%
1.9%
1.3%
Exposure weighted factor
30
HASA NHRPL 2009

Procedures Results
No of Proceduires
A: 0
B: 1
C: 2
D: 3
E: 4
F: 5
G: 6
H: 7
J: 8
K: 9
L: 10
M: 10+
32.5%
33.6%
17.5%
7.9%
4.0%
2.0%
1.0%
0.6%
0.3%
0.2%
0.1%
0.2%
Risk factor
estimate
1.340
1.000
1.042
1.199
1.381
1.592
1.845
2.088
2.448
2.351
3.124
4.582
Risk factor
Lower CI estimate
1.336
1.000
1.039
1.194
1.373
1.582
1.831
2.069
2.420
2.321
3.073
4.542
Risk factor
Upper CI estimate
1.344
1.000
1.046
1.204
1.388
1.602
1.860
2.108
2.476
2.382
3.177
4.623
1.193
1.190
1.197
Risk factor
estimate
0.602
1.000
1.305
1.626
1.932
2.319
2.663
3.095
3.543
3.924
3.543
5.258
Risk factor
Lower CI estimate
0.567
1.000
1.301
1.621
1.925
2.307
2.646
3.069
3.507
3.874
3.488
5.205
Risk factor
Upper CI estimate
0.638
1.000
1.308
1.631
1.940
2.331
2.681
3.121
3.580
3.974
3.599
5.311
1.300
1.297
1.303
ICD10 Results
No of ICD10
A: 0
B: 1
C: 2
D: 3
E: 4
F: 5
G: 6
H: 7
J: 8
K: 9
L: 10
M: 10+
0.1%
50.1%
26.7%
12.5%
5.5%
2.5%
1.2%
0.6%
0.3%
0.2%
0.1%
0.2%
31
HASA NHRPL 2009

Weekday Results
Weekday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
19.0%
18.6%
17.7%
17.8%
15.1%
6.3%
5.5%
Risk factor
estimate
1.000
0.954
0.943
0.933
0.967
1.091
1.123
Risk factor
Lower CI estimate
1.000
0.951
0.940
0.930
0.963
1.086
1.118
Risk factor
Upper CI estimate
1.000
0.957
0.947
0.937
0.970
1.095
1.128
0.977
0.974
0.980
Risk factor
estimate
1.023
1.000
Risk factor
Lower CI estimate
1.021
1.000
Risk factor
Upper CI estimate
1.025
1.000
1.011
1.010
1.012
Risk factor
estimate
1.000
1.011
Risk factor
Lower CI estimate
1.000
1.009
Risk factor
Upper CI estimate
1.000
1.013
1.005
1.004
1.006
Risk factor
estimate
1.000
1.085
Risk factor
Lower CI estimate
1.000
1.079
Risk factor
Upper CI estimate
1.000
1.090
1.005
1.005
1.006
Year results
Year
2006
2007
49.2%
50.8%
Gender results
Gender
Female
Male
56.5%
43.5%
Maternity Results
Maternity indicators
No
Yes
93.7%
6.3%
32
HASA NHRPL 2009
Ward Factors
No of ICD10
No of Proceduires
Age band
Year
Gender
Weekday
33
HASA NHRPL 2009
Exposure weighted
factor
1.300
1.193
1.029
1.011
1.005
1.005
0.977
Generalised Linear Modelling Results Theatres

Intercept
Estimate
27.296
Lower CI (5%)
27.168
Upper CI (95%)
27.425
Risk factor
estimate
0.938
0.882
0.925
0.982
0.970
0.971
0.988
1.000
1.007
1.009
1.018
1.021
1.028
1.022
1.007
0.983
0.950
0.911
0.899
Risk factor
Lower CI estimate
0.929
0.877
0.920
0.976
0.965
0.967
0.984
1.000
1.003
1.005
1.014
1.017
1.024
1.017
1.002
0.978
0.945
0.904
0.890
Risk factor
Upper CI estimate
0.948
0.887
0.931
0.988
0.975
0.976
0.992
1.000
1.011
1.013
1.022
1.025
1.032
1.026
1.011
0.988
0.956
0.917
0.907
0.990
0.986
0.994
Age Results
Age band
A: Under 1
B: 01-04
C: 05-09
D: 10-14
E: 15-19
F: 20-24
G: 25-29
H: 30-34
I: 35-39
J: 40-44
K: 45-49
L: 50-54
M: 55-59
N: 60-64
O: 65-69
P: 70-74
Q: 75-79
R: 80-84
S: 85+
1.0%
4.9%
3.6%
2.6%
4.4%
5.8%
8.2%
10.4%
9.9%
8.3%
7.7%
7.0%
6.6%
5.8%
4.9%
3.8%
2.8%
1.6%
0.8%
34
HASA NHRPL 2009

Procedures Results
No of Procedures
A: 0
B: 1
C: 2
D: 3
E: 4
F: 5
G: 6
H: 7
J: 8
K: 9
L: 10
M: 10+
7.1%
45.0%
25.7%
11.1%
5.3%
2.6%
1.3%
0.7%
0.4%
0.2%
0.2%
0.3%
Risk factor
estimate
0.427
1.000
1.149
1.288
1.408
1.530
1.697
1.837
1.935
2.070
1.953
2.636
Risk factor
Lower CI estimate
0.414
1.000
1.146
1.284
1.403
1.523
1.687
1.824
1.917
2.047
1.929
2.615
Risk factor
Upper CI estimate
0.439
1.000
1.151
1.291
1.413
1.537
1.707
1.850
1.953
2.093
1.977
2.658
1.093
1.091
1.096
Risk factor
estimate
1.026
1.000
1.059
1.085
1.138
1.187
1.206
1.261
1.304
1.320
1.189
1.406
Risk factor
Lower CI estimate
0.988
1.000
1.056
1.082
1.133
1.181
1.198
1.249
1.288
1.300
1.170
1.389
Risk factor
Upper CI estimate
1.067
1.000
1.061
1.088
1.142
1.193
1.215
1.273
1.320
1.340
1.207
1.422
1.040
1.038
1.041
ICD10 Results
No of ICD10
A: 0
B: 1
C: 2
D: 3
E: 4
F: 5
G: 6
H: 7
J: 8
K: 9
L: 10
M: 10+
0.1%
54.9%
25.0%
11.4%
4.6%
2.0%
0.9%
0.5%
0.3%
0.2%
0.1%
0.2%
35
HASA NHRPL 2009

Weekday Results
Weekday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
19.0%
20.0%
19.3%
19.4%
16.1%
3.7%
2.6%
Risk factor
estimate
1.010
1.000
1.007
0.995
0.988
1.072
1.113
Risk factor
Lower CI estimate
1.008
1.000
1.005
0.992
0.985
1.067
1.107
Risk factor
Upper CI estimate
1.013
1.000
1.010
0.997
0.991
1.077
1.118
1.006
1.004
1.008
Risk factor
estimate
1.007
1.000
Risk factor
Lower CI estimate
1.005
1.000
Risk factor
Upper CI estimate
1.008
1.000
1.003
1.002
1.004
Risk factor
estimate
1.000
1.052
Risk factor
Lower CI estimate
1.000
1.050
Risk factor
Upper CI estimate
1.000
1.054
1.022
1.021
1.023
Risk factor
estimate
1.000
0.629
Risk factor
Lower CI estimate
1.000
0.626
Risk factor
Upper CI estimate
1.000
0.633
0.974
0.974
0.974
Year results
Year
2006
2007
49.5%
50.5%
Gender results
Gender
Female
Male
57.2%
42.8%
Maternity Results
No
Yes
93.0%
7.0%
36
HASA NHRPL 2009

RVU band Results
RVU band
0
000 - 001.5
001.5 - 003
003 - 004.5
004.5 - 006
006 - 007.5
007.5 - 009
009 - 010.5
010.5 - 012
012 - 013.5
013.5 - 015
015 - 016.5
016.5 - 018
018 - 019.5
019.5 - 021
021 - 022.5
022.5 - 024
024 - 025.5
025.5 - 027
027 - 028.5
028.5 - 030
030 - 031.5
031.5 - 032
033+
BLANK_CPT
NO MATCH
3.2%
0.6%
5.9%
4.6%
4.9%
4.9%
13.4%
5.5%
3.9%
3.7%
3.4%
3.9%
4.8%
5.2%
1.9%
2.9%
1.3%
8.0%
0.8%
1.2%
1.2%
0.7%
0.6%
4.6%
6.8%
1.8%
37
HASA NHRPL 2009
Risk factor
estimate
1.657
1.677
1.007
1.021
1.195
1.147
1.000
1.188
1.493
1.574
1.459
1.477
1.868
1.766
2.371
2.145
2.342
2.639
2.708
3.024
3.061
3.182
3.367
4.052
4.562
1.682
Risk factor
Lower CI estimate
1.647
1.660
1.001
1.014
1.188
1.140
1.000
1.181
1.484
1.565
1.451
1.469
1.859
1.758
2.357
2.133
2.325
2.626
2.686
3.004
3.041
3.158
3.340
4.035
4.431
1.669
Risk factor
Upper CI estimate
1.666
1.695
1.013
1.027
1.202
1.153
1.000
1.194
1.501
1.583
1.468
1.485
1.877
1.775
2.385
2.157
2.358
2.653
2.729
3.044
3.081
3.207
3.395
4.069
4.697
1.694
1.907
1.890
1.924
Summary of GLM factors
38
HASA NHRPL 2009
Ward Factors
No of ICD10
No of Proceduires
Age band
Year
Gender
Weekday
Exposure weighted
factor
1.300
1.193
1.029
1.011
1.005
1.005
0.977
Theatre Factors
RVU band
No of Procedures
No of ICD10
Gender
Weekday
Year
Age band
Exposure weighted
factor
1.907
1.093
1.040
1.022
1.006
1.003
0.990
0.974
Ward and Theatre GLM factors by Age

Risk factor estimates by age
2.000
Risk factor estimate
1.800
1.600
1.400
1.200
1.000
0.800
0.600
0.400
0.200
Theatre
39
HASA NHRPL 2009
S: 85+
R: 80-84
Q: 75-79
P: 70-74
O: 65-69
N: 60-64
M: 55-59
L: 50-54
K: 45-49
J: 40-44
I: 35-39
H: 30-34
G: 25-29
F: 20-24
E: 15-19
D: 10-14
C: 05-09
B: 01-04
A: Under 1
0.000
Ward
Ward and Theatre GLM factors by Weekday

Risk factor estimates by day of week
1.200
1.000
0.800
0.600
0.400
0.200
Theatre
40
HASA NHRPL 2009
Sunday
Saturday
Friday
Thursday
Wednesday
Tuesday
Monday
0.000
Ward
41
HASA NHRPL 2009
033+
031.5 - 033
030 - 031.5
028.5 - 030
027 - 028.5
025.5 - 027
024 - 025.5
022.5 - 024
021 - 022.5
019.5 - 021
018 - 019.5
016.5 - 018
015 - 016.5
013.5 - 015
012 - 013.5
010.5 - 012
009 - 010.5
007.5 - 009
006 - 007.5
004.5 - 006
003 - 004.5
001.5 - 003
000 - 001.5
Risk factors estimate
Theatre GLM factors by RVU

GLM factors by RVU
4.500
4.000
3.500
3.000
2.500
2.000
1.500
1.000
0.500
0.000
RVU band
Consolidated
Analysis of change in Occupancy

Increase in occupancy from 62.09% to 64.52% between 2006 and 2007
Reason for the increase in occupancy?
Utilisation
1.91%
Length of stay
0.52%
Driven by changes in disease

profiles among those with 2 or
more ICD10s
42
HASA NHRPL 2009
43
HASA NHRPL 2009
Member of
2008
Deloitte
Touche
Tohmatsu
Deloitte
Touche
Tohmatsu

Exploring The Healthcare Price Tag: Research On Private Hospitals

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Exploring the Healthcare

Actuarial & Insurance Solutions

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Land and building

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Land and building

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Distribution of hospitals by number of beds

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Distribution of beds and space per bed (m2)

Space per bed (m2)

HASA NHRPL 2009

Space per bed (m2)

Average hospital composition

2008 Deloitte Touche Tohmatsu

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Nursing ratios Actual

HASA NHRPL 2009

ICU & Specialised ICU

Enrolled Nurse Assistant

2008 Deloitte Touche Tohmatsu

Nursing staff per bed

Total Staff Nurses per Bed

ICU & Specialised ICU

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Looking forward nursing graduates

Output of nurses from all South African institutions - 2007

Source: South African Nursing Council

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

South Africa: Nurses per 100,000 population

Source: South African Nursing Council

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Source: South African Nursing Council

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

HASA NHRPL 2009

Average length of stay Weekday versus weekend

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Average length of stay Weekday versus weekend

stay for more

stay for more

HASA NHRPL 2009

2008 Deloitte Touche Tohmatsu

Average length of stay Per day of the week

2006 longer than a day

HASA NHRPL 2009

2007 longer than a day

2008 Deloitte Touche Tohmatsu

Average length of stay Gender