To strengthen the Maharashtra health system public health department, Government of Maharashtra is implementing a project titled "Maharashtra Health Systems development (MHSDP)". The central goal of this project is Cure of the Patient with care, custody as a supportive goals and education and research as extended goals. There are 136 project facility hospitals under MHSDP, such as Community hospitals, Sub district hospitals and District hospitals.

One are of the Institute’s research activity has been on measurement of public hospital performance and patient satisfaction surveys. Institutes common goal is to make public hospitals more efficient and responsive. As people more aware of the hospital performance analysis they become more sensitive to accept required remedial actions for further improvement. In this context, MHSDP has commissioned IHS as a consultant to Validate hospital data and analyze hospital performance periodically. The methodology for this study as follows

1. MHSDP 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.
2. Performance is measured along two broad dimensions:
   1. Hospital activity indicators analysis, and
   2. Service mix indicators.
3. Hospital activity indicators like turnover rate (TR) and bed occupancy (BO) are used to do a combined utilization and productivity (CUP) analysis. Service mix analysis is done for various indicators viz major surgery rate, delivery rate, laboratory rate etc.,.
4. Internal consistency of data is analyzed using a set of consistency indicators and by expert appreciation of the figures. Potential cases of data inaccuracy are identified for further inquiry.
5. A sub set 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.
6. Based on this analysis, IHS faculty identifies some of the hospitals with poor Performance indicators and then visit those hospitals to collate the hospital data.
7. IHS faculty meets MHSDP executives personally to discuss and highlight findings and to plan future course of action.