There are about 150 First referral hospital in AP such as Community hospitals, Area hospitals and District hospital, which are administered by Andhra Pradesh Viadya Vidhana Parishad (APVVP).

IHS has been commissioned by the parishad to undertake a performance analysis of these hospitals on monthly basis. The methodology for the study is;

APVVP statistics section makes data available to IHS around last week of the month following the study month. IHS analyses the data for its consistency and then computes various performance indicators. The performance indicators are then used to identify outlier hospitals and potential sources of poor performance.

i. Hospital activity indicators analysis, and

ii. Service mix indicators.

Hospital activity indicators like turnover rate (TR) and bed occupancy (BO) are used to do a combined utilisation and productivity (CUP) analysis. Service mix analysis is done for various indicators viz major surgery rate, delivery rate, laboratory rate etc.,

Internal consistency of data is analysed using a set of consistency indicators and by expert appreciation of the figures. Potential cases of data inaccuracy are identified for further inquiry.

A sub set 10 % of hospitals are identified each month for field visit. Criteria for identification of hospitals for qualitative study is arrived at after studying the results of quantitative analysis of performance for the corresponding month. Most commonly followed criteria are given below.

1. Outlier status.
2. Potentiality for inaccuracy in data gathering and compilation.
3. Inconsistency between level of hospital activity and service mix indicators.

Based on this analysis, IHS faculty identifies some of the hospitals with poor Performance indicators and then visit those hospitals and do data collation, case sheet review, general observations also.

IHS faculty meet APVVP executives to personally discuss and highlight findings and to plan future course of action.