The Impact of Health Transformation Plan on Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Interval in a Deprived Region of Iran: An Interrupted Time Series

Abstract

Background: The health transformation plan (HTP) in Iran started in May 2013 with 3 financial support approaches for people, creating justice in access to health services and improving the quality of services in hospitals in 2 health and treatment sectors. In the first phase, this program was divided into 8 separate packages in the treatment section, reducing the amount of payment for hospitalized patients, supporting the longevity of doctors in disadvantaged areas, the presence of resident specialist doctors in hospitals, improving the quality of visiting services in hospitals, improving the quality of hoteling in hospitals, and financial support of incurable, special and low-income patients. It refers to promoting natural childbirth and launching an air emergency service. Objectives: This study aims to investigate the effect of HTP on bed occupancy rate, average length of stay, and bed rotation distance in one of the most deprived areas. Methods: This study was a semi-experimental and retrospective descriptive-analytical study before and after the health system transformation plan based on the information collected from March 2012 to March 2019 in all Sistan and Baluchistan province hospitals. The data of indicators of monthly bed occupancy rate, average length of stay, and bed rotation interval in 83 months in the years before and after the implementation of the transformation plan were collected from the Vice-Chancellor of Treatment of Universities or the statistical units of hospitals and compared. The data were analyzed by Stata software using the interrupted time series (ITS) model, and split regression analysis was used to evaluate the short-term and long-term effects of HTP on the studied indicators. Results: This study showed that the bed occupancy rate increased, and the average length of stay and bed turnover interval decreased immediately after HTP in Sistan and Baluchistan province hospitals. Also, the reform had a long effect on these indicators. Conclusions: Possibly due to underdeveloped hospitalization services in the past, the bed occupancy rate increased, and the average length of stay and bed turnover interval decreased in the hospitals after this province's major health system reform.