a) Planning Areas
Planning areas are the same as those for medical-surgical and
pediatric care.
b) Age
Groups
1) For maternity care, female ages
15-44.
2) For gynecological care
within obstetrics units, female ages 15 and over.
c) Facility Utilization Rates
Facilities that provide an obstetrics service should operate
those beds at or above an annual minimum occupancy rate of:
1) 60% for facilities with a bed capacity of
1-10 beds;
2) 75% for facilities
with a bed capacity of 11-25 beds;
3) 78% for facilities with a bed capacity of
26 or more beds.
d) Bed
Capacity
Obstetrics bed capacity is the total number of obstetrics
beds for a facility as determined by HFSRB pursuant to this Part.
e) Need Determination
The following methodology is utilized to determine the
projected number of obstetrics beds needed in a planning area:
1) Multiply the projected year's female 15-44
population (the projected year is five years from the base year) by the current
fertility rate of the health planning area to obtain projected
births;
2) Multiply the projected
number of births by a hospitalization factor of .99 (99%) to determine number
of projected births occurring in hospitals;
3) Multiply projected births occurring in
hospitals by length of stay factor of 2.5 days to obtain projected maternity
patient days;
4) Divide the
gynecology utilization (of the base year) within obstetrics units by the
current female 15+ population to obtain a gynecology patients use
rate;
5) Multiply the use rate of
gynecology patients by the projected female 15+ population to obtain projected
gynecology patient days;
6) Divide
the projected maternity patient days by 365 to obtain a maternity average daily
census;
7) Divide the projected
gynecology patient days by 365 to obtain a gynecology average daily
census;
8) Divide the gynecology
patient days by .9 (90%) to determine obstetric beds needed for gynecology
patients;
9) Divide the maternity
average daily census by .60 (60% occupancy factor) if the ADC is below 10; by
.75 (75% occupancy factor) if the ADC is 10 through 25; and by .78 (78%
occupancy factor) if the ADC is 26 and over, to obtain obstetrics beds needed
for maternity patients;
10) Add the
maternity bed need (step 9) with the gynecology need (step 8) to determine
total unadjusted obstetrics bed need.
11) Determine the number of patients entering
the planning area from outside and the number of area residents leaving the
planning area for obstetrics service;
12) Multiply the total number of patients
entering the area and those leaving the area by 2.5 to determine a patient day
estimate for in-migration and out-migration;
13) Multiply the patient totals for area
in-migration and out-migration by a .85 (85%) adjustment factor;
14) Subtract the resulting in-migration
adjusted patient day total from the out-migration adjusted patient day total to
determine the net in or out patient day migration estimate;
STATE BOARD NOTE: Patient migration adjustment is for a one
year period and the base year shall be the date of the latest available patient
origin data.
15) Divide the
net in or out patient day estimate by 365 to determine the average daily census
for migration;
16) Add to net
in-migration areas the average daily census for migration to the unadjusted bed
need to determine the migration adjusted obstetrics bed need; in net
out-migration areas subtract the average daily census for migration to
determine adjusted obstetrics bed need;
17) Subtract the number of existing beds in
the planning area from the projected planning area bed need to determine the
projected number of surplus (excess) beds or the projected bed deficit or
additional beds needed in the area.
