Best practices in the performance of District Hospitals

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BEST PRACTICES IN THE PERFORMANCE OF
DISTRICT HOSPITALS Copyright@ NITI Aayog, 2021
NITI Aayog
Government of India,
Sansad Marg, New Delhi–110001, India
Report and Cover Design by YAAP
Suggested Citation
Rakesh Sarwal, Shoyabahmed Kalal, Vaishnavi Iyer (2021).
Best Practices in the Performance of District Hospitals. NITI Aayog.
ISBN: 978-81-953811-0-4
DOI: 10.31219/osf.io/y79bg
Available at: https://www.niti.gov.in/verticals/health-and-family-
welfare
Disclaimer
Every care has been taken to provide accurate information along
with references thereof. Only validated data submitted by competent
authorities at the district and state levels have been used in the
assessment. However, NITI Aayog shall not be liable for any loss or
damage whatsoever, including incidental or consequential loss or
damage, arising out of, or in connection with any use of or reliance
on the information in this document. Message from the Chief Executive Officer
iii
A healthy population is a productive one, a happier one. The Government of India is committed
to this vision, as reflected in the National Health Policy 2017 and several other pathbreaking
initiatives such as the Ayushman Bharat Yojana.
This report is the first-ever performance assessment of district hospitals undertaken across the
country. It marks a major shift in the health care delivery system towards data-driven governance
and takes us even closer to communities and people availing health services. The entire objective
of the exercise is to pave the way for a more informed understanding of health care services
available in different regions and flag gaps, if any.
The Government has made significant progress in improving the health care system in India. It
has initiated major reforms to improve citizens’ access to quality and affordable health care at
a much greater pace. This assessment exercise also is a step in that direction.
Understanding the performance of district hospitals vis-à-vis a uniform set of indicators will
be useful for both the district and state officials involved in decision making and improving
service delivery.
I hope that the observations and recommendations presented in this report will help in guiding
the decision-makers at the state- and district-levels in taking informed and evidence-based
decisions and accelerate the transformation of the public health system in India.
Amitabh Kant
Chief Executive Officer
NITI Aayog
Government of India
New Delhi, India
Message from the
Chief Executive
Officer Kulithalai Government Hospital, Karur, Tamil Nadu Foreword
v
The progress in the health sector in India in terms of improved service delivery and outcome
in the last decade has been commendable. District hospitals have a pivotal role in creating
healthier communities, providing a wide spectrum of health care services that caters to all
individuals of the population. Despite their crucial role in providing advanced secondary care,
there are unfortunately gaps, be it shortage of human resources, capacities, utilization and service
uptake, quality issues, operational challenges, or sometimes just a lack of motivation amongst
hospital staff. To make “health for all” a reality and to ensure that every citizen has access to
safe and reliable health services, these gaps must be closed. The district hospital performance
assessment exercise undertaken by NITI Aayog is an important step in that direction.
NITI Aayog, in collaboration with the Ministry of Health and Family Welfare, World Health
Organization, and key stakeholders, has developed the first-ever comprehensive assessment
of the performance of district hospitals in India. The exercise captures the infrastructure and
service outputs of district hospitals, giving us useful data to understand their performance and
help pave the way towards better health outcomes.
Based on the monitoring framework developed in 2017, the validation exercise was initiated in
December 2018 and concluded in 2019 across 731 district hospitals in the country. This exercise
has now culminated in what is a large-scale baseline assessment of district hospitals across
the country covering 707 (97%) district hospitals. The Health Management Information System
(HMIS) data for the year 2017-18 has been used as baseline for this exercise.
This country-wide assessment of district hospitals on a pre-determined set of key performance
indicators will serve as a valuable resource that can help hospitals perform better as they
learn from one another. It will also encourage a sense of healthy competition and provide an
opportunity to showcase progress. In addition, it would bring about greater accountability for
quality health care facilities in district hospitals.
It is worth noting that this was the first time any large scale national onsite survey of hospital data
was done at the facility level. The exercise apart from making the abovementioned framework
of NITI Aayog more meaningful would also reveal comprehensive insights on HMIS and the
overall status of record maintenance and data reporting at the district hospital level. It will
Foreword Foreword
vi
create awareness among district hospitals regarding the HMIS and the importance of proper
record keeping.
The uniqueness of this report lies in how it has collected and used data around key parameters
of infrastructure and services that are available in the district hospitals. The findings from this
study may be used to deliver better health services. By celebrating data and assigning it priority,
the exercise has helped increase reliance on information technology for greater digitization and
optimization of data management. Finally, the initiative provides us with an essential tool to
track progress on crucial health care indicators on a regular basis.
We hope that this performance assessment will spur a movement that can demand better
health service delivery and strengthen the country’s health systems, minimizing disparities
and irregularities that exist in the quality of services offered across the board. Inevitably, this
would create a learning environment where hospitals can draw lessons from one another, share
best practices, and work collaboratively. A roadmap of action would likely emerge for district
hospitals in their quest for upgrading and improving service delivery. The goal of any national
health programme is to constantly strive for improved health outcomes for the populations
they serve. We hope this effort by NITI Aayog and the Ministry of Health and Family Welfare
is a step in that direction.
Dr Vinod K Paul
Member, NITI Aayog Acknowledgments
vii
This report on the best practices in the performance of district hospitals in India has been the
result of extensive consultations and collaboration with numerous stakeholders. NITI Aayog
would like to thank the Union Ministry of Health and Family Welfare and all officers in the
Department of Health and Family Welfare who supported and contributed significantly to
making this performance assessment exercise robust and well represented.
NITI Aayog is extremely grateful to the State Governments and Union Territories for their support
and assistance throughout the process of this exercise, right from finalizing the indicators up to
collating best practices of well performing district hospitals in the area of their excellence. We
also thank all district-level health officials for extending their support, coordinating with us, and
providing us with helpful information without which the project could not have been completed.
The selection of indicators and the report preparation have benefitted from technical support
provided by the World Health Organization India Country Office. I appreciate the contribution of
Dr Roderico Ofrin, WHO Representative to India; Ms Payden, Deputy WHO Representative
to India; Dr Hilde De Graeve, Team Lead, Health Systems; Dr Ved Prakash Yadav, National
Professional Officer, Health Information System; and Dr Sonali Rawal, National Professional
Officer, Patient Safety and Quality of Care.
I appreciate the support of the NABH team led by Mr. Adil Zainulbhai, Chairman, QCI; Dr Ravi
P. Singh, Secretary General, QCI; Dr Atul Mohan Kochhar, CEO, NABH; Dr Harish Nadkarni,
ex-CEO, NABH; Dr Kashipa Harit, Deputy Director and Project Head, NABH; and
Mr Arsh Hashmi, Project Associate, QCI.
The project was designed and conceptualised under the guidance of Dr Rajiv Kumar,
Vice Chairperson, NITI Aayog; Dr Vinod K Paul, Member, NITI Aayog; Mr Amitabh Kant, CEO,
NITI Aayog, and Mr Alok Kumar, former Adviser, Health and Family Welfare, NITI Aayog. The
Acknowledgments Acknowledgments
viii
report writing was done by a team of Shri Shoyabahmed Kalal, Deputy Secretary, NITI Aayog;
Vaishnavi Iyer, Young Professional, NITI Aayog; supported by Dr Bhanu Duggal, Professor &
HOD, Department of Cardiology, AIIMS, Rishikesh; Dr Kashipa Harit, NABH; Arsh Hashmi, QCI;
and Jyoti Khatter, Senior Research Officer, NITI Aayog. The NITI team also included budding
professionals namely Shreya Chaturvedi, Gaurika Saxena, Ashima Singh, and Shreya Jain, Interns,
who assisted in the compilation of the report.

Dr Rakesh Sarwal
Additional Secretary
NITI Aayog
Government of India
New Delhi, India Table of Contents
ix
Table of Contents
Message from the Chief Executive Officer iii
Foreword v
Acknowledgments vii
List of Abbreviations xiii
Executive Summary xvii
1. Introduction to District Hospitals: The Centrepiece of the Health Care Delivery
System..............................................................................................................................................1
1.1 Public health care in India 2
1.2 Towards improved health outcomes — SDGs and Ayushman Bharat 3
1.3 Role and importance of district hospitals 4
1.4 Role of a robust Health Management Information System (HMIS) 6
1.5 Global practices in hospital performance assessments 7
2. Rationale and Approach for the Performance Assessment of District Hospitals............9
2.1 Project background 10
2.2 Objectives of the project 10
2.3 Measures used in the assessment 11
2.4 Categorization of hospitals for analysis 11
2.5 Process for conducting assessment 12
2.6 Key results of data validation 13
2.7 Computation of KPI scores 14
3. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)........17
3.1 Number of functional beds per 100,000 population 20
3.2 Ratio of doctors, staff nurses, and paramedical staff in proportion to IPHS norms 25 Table of Contents
x
3.3 Availability of support services 34
3.4 Availability of core health care services 38
3.5 Availability of diagnostic testing services 42
3.6 Bed occupancy rate 47
3.7 C-section rate 53
3.8 Surgical productivity index 58
3.9 OPD per doctor 63
3.10 Blood bank replacement rate 68
4. Challenges and Limitations.......................................................................................................72
4.1 Issues and challenges during the data collection and validation exercise 73
4.2 Concerns with regard to KPIs and their associated HMIS data components 73
4.3 Limitations of the scoring process  74
5. Learnings and Way Forward.....................................................................................................75
5.1 Key learnings and observations from the district hospital performance assessment 76
5.2 Action points for stakeholders concerned 76
Annexures.............................................................................................................................................81
Annexure 1: Health Management Information System 82
Annexure 2: Summary of Health Systems Studied 83
Annexure 3: Definitions of Key Performance Indicators (KPIs) for the District Hospital
Performance Assessment 88
Annexure 4: State/UT-wise top scoring district hospital for each Key Performance
Indicator (KPI) 95
Annexure 5: Graphs illustrating the State/UT-wise average raw score of each KPI for
each hospital category (small, mid-sized, and large) 103
Annexure 6: List of district hospitals having all requisite services (support services, core
health care services, diagnostic testing services) 117
Table 6A: List of district hospitals having all identified support services (N=14) 117
Table 6B: List of district hospitals having all identified core health care
services (N=14) 120
Table 6C: List of district hospitals having all identified diagnostic
testing services (N=14) 123
Annexure 7: KPI-wise raw scores for district hospitals 125
Table 7A - KPIs 1-5 126
Table 7B - KPIs 6-10 160
Table 7C - District and District Hospital Codes 191 Table of Contents
xi
LIST OF TABLES
Table 1: Distribution of hospital services accessed in India 3
Table 2: List of Key Performance Indicators (KPIs) to assess district hospitals 11
Table 3: Categorization of district hospitals 12
Table 4: Top performing district hospitals in the country for the KPI “Number of
functional beds per 100,000 population” 22
Table 5: Total medical and paramedical manpower requirements as per IPHS 25
Table 6: Count and percentage of district hospitals in each State/UT meeting IPHS
norms for medical and paramedical staff 26
Table 7: Top performing district hospitals in the country for the KPI “Ratio of doctors,
nurses and paramedical staff in position to IPHS norms” 29
Table 8: Top performing district hospitals in the country that have all the identified
support services (N=14) 36
Table 9: Top performing district hospitals in the country that have all the identified
core health care services (N=14) 40
Table 10: Top performing district hospitals in the country that have all or most of the
identified diagnostic testing services (N=14) 44
Table 11: Top performing district hospitals in the country that have a bed occupancy
rate up to 100% 50
Table 12: District hospitals in India with the highest C-section rate 55
Table 13: Top performing district hospitals in the country for the KPI “surgical
productivity index” 60
Table 14: Top performing district hospitals in the country for the KPI “OPD per doctor” 65
Table 15: Top performing district hospitals in the country that have a blood bank
replacement rate of 0% 69
LIST OF FIGURES
Figure 1: India’s three-tiered public health system 2
Figure 2a: State/UT-wise percentage of match between NABH onsite validated data and
corresponding HMIS values 14
Figure 2b: Indicator-wise percentage of match between NABH onsite validated data and
corresponding HMIS values 15
Figure 3a: Distribution of hospitals by size 18
Figure 3b: Distribution of district hospitals by state/UT 19
Figure 3.1.1: State/UT-wise average number of beds in a district hospital for every
1 lakh population 21
Figure 3.1.2: Percentage of district hospitals in each State/UT that have at least 22 beds
per 1 lakh population 22 Table of Contents
xii
Figure 3.2.1: Percentage of district hospitals in each State/UT that meet the doctors to
bed ratio as per IPHS norm 28
Figure 3.2.2: State/UT-wise average ratio of doctors across hospitals in position to the
IPHS norms 30
Figure 3.2.3: State/UT-wise average ratio of nurses across hospitals in position to the
IPHS norms 31
Figure 3.2.4: State/UT-wise average ratio of paramedical staff across hospitals in position
to the IPHS norms 31
Figure 3.3.1: State/UT-wise distribution of the number of hospitals (n=89) with availability
of all support services 35
Figure 3.3.2: Average number of support services in a district hospital by State/UT 36
Figure 3.4.1: State/UT-wise distribution of number of hospitals (n=101) with all 14 functional
core health care services 39
Figure 3.4.2: State/UT-wise average number of available core health care services in a
district hospital 40
Figure 3.5.1: State/UT-wise distribution of number of district hospitals (n=21) with all
14 functional diagnostic testing services available 43
Figure 3.5.2: State/UT-wise average number of available diagnostic testing services in a
district hospital 44
Figure 3.6.1: Average bed occupancy rate (%) of a district hospital by State/UT 48
Figure 3.6.2: State/UT-wise number of district hospitals (n=182) with bed occupancy rate
of 90% or higher 49
Figure 3.6.3: Percentage of district hospitals in each State/UT that have a bed occupancy
rate of at least 80 per cent 49
Figure 3.7.1: Average percentage of C-section deliveries in a district hospital by State/UT 54
Figure 3.7.2: Number of district hospitals by State/UT having C-section rate less than 35% 54
Figure 3.8.1: State/UT-wise distribution of number of district hospitals (n=177) in the upper
quartile for surgical productivity index 59
Figure 3.8.2: Average number of surgeries per surgeon performed in a year in a district
hospital by State/UT 59
Figure 3.9.1: State/UT-wise distribution of number of district hospitals (n=177) having doctors
attending to 34 or more OPD patients per day 64
Figure 3.9.2: Average number of OPD patients per doctor in a day in a district hospital by
State/UT 64
Figure 3.10: Average number of blood units issued on replacement in a year in a district
hospital by State/UT 69 List of Abbreviations
xiii
ABARK Ayushman Bharat – Arogya Karnataka
ANM Auxiliary Nurse Midwife
AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha And Homeopathy
BDS Bachelor Of Dental Surgery
BY Base Year
CBC Complete Blood Count
CCU Cardiac Care Unit
CEO Chief Executive Officer
CHC Community Health Centre
CMO Chief Medical Officer
CRSCivil Registration System
CRVS Civil Registration And Vital Statistics
C-section Caesarean Section
CSSD Central Sterile Supply Department
DH District Hospital
DPT Diphtheria, Pertussis And Tetanus
DVDMS Drugs And Vaccines Distribution Management System
EAG Empowered Action Group
ENT Ear-Nose-Throat
FLV First-Level Verification
FRU First Referral Unit
HDU High Dependency Unit
HIS Hospital Information System
List of Abbreviations List of Abbreviations
xiv
HIV Human Immunodeficiency Virus
HMIS Health Management Information System
HRMIS Human Resources Management Information System
HWC Health And Wellness Centre
ICU Intensive Care Unit
IDSP Integrated Disease Surveillance Programme
IECInformation, Education And Communication
IMR Infant Mortality Rate
INR Indian Rupees
IPDInpatient Department
IPHS Indian Public Health System
ISO International Organization For Standardization
IT Information Technology
IVA Independent Validation Agency
KFT Kidney Function Test
KPI Key Performance Indicator
LBW Low Birth Weight
LFT Liver Function Test
LDR Labour And Delivery Room
MBBS Bachelor Of Medicine And A Bachelor Of Surgery
MCH Maternal And Child Health
MCI Medical Council Of India
MIS Management Information System
MMR Maternal Mortality Ratio
MO Medical Officer
MoH&FW Ministry Of Health And Family Welfare
NA Not Applicable
NABH National Accreditation Board For Hospitals And Healthcare Providers
NACO National Aids Control Organization
NCD Non-Communicable Disease
NE North-Eastern
NFHS National Family Health Survey
NHM National Health Mission
NHP National Health Policy
NHSRC National Health Systems Resource Centre
NITI Aayog National Institution For Transforming India List of Abbreviations
xv
NMR Neonatal Mortality Rate
NQAS National Quality Assurance Standards
OPV Oral Polio Vaccine
OPD Outpatient Department
ORGI Office Of The Registrar General And Census Commissioner Of India
OT Operation Theatre
PAP Papanicolaou
P FORM IDSP Reporting Format For Presumptive Surveillance
PHC Primary Health Centre
PLHIV People Living With Hiv
PIPs Programme Implementation Plans
PGI Post-Graduate Institute
RRC-NE Regional Resource Centre For North-Eastern States
RNTCP Revised National Tuberculosis Control Programme
RU Reporting Unit
SC Sub-Centre
SDG Sustainable Development Goals
SDH Sub-District Hospital
SRB Sex Ratio At Birth
SRS Sample Registration System
SN Staff Nurse
SNO State Nodal Officer
SNCU Special Newborn Care Unit
TA Technical Assistance
TB Tuberculosis
TFR Total Fertility Rate
U5MR Under-Five Mortality Rate
UT Union Territory
UHC Universal Health Coverage Dindigul Government Hospital, Dindigul, Tamil Nadu Executive Summary
xvii
Executive Summary
India has made significant progress in improving its health outcomes over the last two decades.
Many key indicators, however, continue to show considerable scope for improvement. Considering
the needs of health care in the country, the Government of India has made ambitious global
and national commitments to further improve health outcomes. To honour these commitments,
it is important to measure and evaluate the performance of the public health infrastructure.
District hospitals are a valuable resource providing secondary level of health care, which includes
comprehensive preventive, promotive and curative services. Currently, there are more than 800
district hospitals across the country providing crucial services to the population. In view of a
large fund allocation for district hospitals under the National Health Mission (NHM), as well as
their critical role in health care provision, there is a need to set up a comprehensive system
to assess their performance holistically. Therefore, NITI Aayog took up to create a framework
for tracking the performance of these government hospitals, based on key parameters that
illuminate the health of our hospitals.
NITI Aayog conducted a detailed study on the domestic and international health systems, in
consultations with the World Health Organization, Ministry of Health and Family Welfare, and
other stakeholders, in order to determine the domains and specific indicators that are required
to be included in this holistic assessment of hospitals. This is the first-ever pan-India assessment
at the district level that draws upon physical validation of the data from the Health Management
Information System (HMIS) to benchmark the district hospitals on a diverse mix of input and
output indicators. The assessment looked at a wide array of health indicators ranging from
beds, doctors, nurses, paramedics, diagnostic and health care facilities to the rate of Caesarean
section surgeries and bed occupancy, amongst others. Of the ten Key Performance Indicators
(KPIs) used in this exercise, five portray the level of infrastructure these district level hospitals
have, and the remaining indicate the output these hospitals are generating.
A total of 707 district hospitals, including medical colleges from some States, as shared by
the Ministry of Health and Family Welfare, Government of India, across 36 States and Union
Territories were part of the assessment conducted in 2018–19. For this assessment, the HMIS data
of district hospitals for the financial year 2017–18 was taken as baseline, which was validated Executive Summary
xviii
against the physical records maintained by the hospitals. The validation exercise was conducted
by the National Accreditation Board for Hospitals and Healthcare Providers (NABH). It involved
onsite review of medical records of all district hospitals — the registers from where data was
collated and entered in the HMIS portal were reviewed for the purpose of the audit. The validation
exercise revealed that on average, there was a 75% match between the data in the physical
records and that entered on HMIS. The most common reasons for a mismatch between the
two data points included difference in the understanding of definitions of various indicators,
lack of continuity in data capture and data entry in HMIS, and ambiguous indicator definition.
Key Findings
The regional variance across states in the country was evidently visible in the top performing
hospitals across indicators. District hospitals from almost every state and union territory have
fared well in one or the other indicator. For the KPI “No. of functional hospital beds per 100,000
population” it is seen that on an average a district hospital in India has 24 beds per 1 lakh
population. The Indian Public Health Standards (IPHS) 2012 guidelines recommend district
hospitals to maintain at least 22 beds per 1 lakh population (based on district population average
of 2001 Census). District hospitals in India have a range of 1 to 408 beds per 1 lakh population.
217 district hospitals were found to have at least 22 beds for every 1 lakh population. Less
populated districts have been seen to fare well in infrastructure-related KPIs, while the more
populated districts in the states of Uttar Pradesh, Maharashtra, etc. have obtained higher scores
in KPIs such as bed occupancy rates and number of surgeries per surgeon.
Hospital support services, such as a hospital information system, blood bank, waste management,
complement clinical services indirectly contribute to better health outcomes. Based on IPHS
(2012), the assessment framework identified 14 support services that a district hospital is
expected to maintain. It was found that a district hospital in India has 11 support services on
an average. A total of 89 district hospitals were found to have provision of all the 14 support
services. With regard to availability of core health care services, 101 district hospitals were
found to have provision of all 14 core health care services. On average, a district hospital in
India has 10 core health care services. As for availability of diagnostic testing services, 21 district
hospitals were found to have provision of all 14 diagnostic testing services; 14 of which are large
hospitals (those having more than 300 beds). On average, a district hospital in the country
has 9 diagnostic testing services, while large district hospitals have an average of 11 services.
One of the means of determining the efficiency of a district hospital is its bed occupancy rate.
The average bed occupancy rate in district hospitals in India is 57%. IPHS guidelines for district
hospitals (2012) recommend at least 80% bed occupancy. 263 district hospitals were found to
have a bed occupancy rate of more than 80%, of which 54% were small hospitals (those with
200 or less beds), 19% were mid-sized hospitals (those with 201–300 beds), and 27% were
large hospitals (those with more than 300 beds). Of these 263 hospitals, the largest share
(16%) is occupied by district hospitals in Uttar Pradesh, followed by Madhya Pradesh (9%), and
Maharashtra (8%).
District hospitals have been employing unique initiatives in different arenas in order to improve
their service delivery. For instance, Belgaum district hospital, Karnataka has an impressive blood
bank replacement rate of 0% (0 blood units issued on replacement). The hospital team achieved
this by focusing on the importance of counselling and convincing potential donors to become
regular donors, thereby ensuring availability of blood units in the blood bank. Executive Summary
xix
JLNM Hospital in Srinagar was found to have a high C-section rate. They followed a
multidisciplinary approach to effectively improve on existing infrastructure and manpower,
including gynaecologists, medical officers, nursing staff and other support staff who were
available round the clock. Integrating the health infrastructure with sufficient support services,
availability of fully functional blood bank and special newborn care unit (SNCU) helped clinicians
in managing high risk delivery cases in the hospital.
This report shares some of the best practices adopted by the district hospitals that obtained
the highest scores in each of the indicators. It is hoped that states and districts would be able
to learn from one another. An institutional mechanism that helps build capacity and sustain
these practices would be useful.
The need for strengthening the public health information system cannot be emphasized enough.
It involves better data management, regular data validation and periodic inspections, such as this
performance assessment exercise. To ensure quality and timely health information, adequate,
trained and dedicated human resources must be provided. An increase in awareness of the
importance of HMIS portal following this exercise provides an ideal opportunity to strengthen
public health information systems in the country.
The overall objective of this exercise has been to assess the performance of the district hospitals
on pre-determined Key Performance Indicators (KPIs) and repeat it annually to capture the
change. An annual assessment of district hospitals can serve as a valuable resource that can
help them improve their performance. It will also foster a sense of healthy competition and
provide an opportunity to showcase progress. It will further help to objectively assess how
efficiently the resources are being utilized and thus help improve delivery. Importantly, it will
provide greater confidence in the quality of data and serve as a tool to track crucial health
care indicators more efficiently.
Many of the variables included in the exercise, however, are input based indicators that reflect
the health of the hospitals indirectly. As the exercise evolves, more indicators, which directly
represent the health outcomes and reflect the quality of services that are being delivered at
public health facilities, could be included.
This exercise highlights the importance of accurate and quality data reporting and is expected
to lead to improved HMIS data. It is anticipated that this would encourage policymakers and
programme managers using HMIS data to undertake real-time programme evaluation, course
correction and evidence-based policy formulation.
It is hoped that the information will be used by the states and districts to improve their
service delivery and thereby, improve performance on health outcomes. It will also foster
healthy competition and motivate district hospitals and states to take corrective measures,
where needed. Overall, the findings of this first-ever facility-based comprehensive exercise for
measuring performance is expected to prove extremely valuable for more informed policy
formulation and strategic planning for better health outcomes. Executive Summary
xx
Kulithalai Government Hospital, Karur, Tamil Nadu
Introduction to
District Hospitals:
The Centrepiece
of the Health Care
Delivery System
1 Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
2
1.1 PUBLIC HEALTH CARE IN INDIA
India has made significant progress in improving its health outcomes over the last two decades.
Many key indicators, however, continue to show considerable scope for improvement. We now
need to build on the many opportunities to respond to the growing aspirations and needs of
a new India. The National Health Policy 2017 envisages strengthening the health system and
investing in health and the organization of health care services.
1
Policy making in the country’s health sector is shaped by its federal structure and the Central–
State divisions of responsibilities and financing. Public health and sanitation, hospitals and
dispensaries are state subject, which means the primary responsibility of their management and
service delivery lies with the states. However, the Centre also invests in health services through
Centrally Sponsored Schemes such as the National Health Mission (NHM) and Ayushman Bharat.
The Centre plays an important role in vital statistics, medical education, and drugs administration,
among others, which are subjects in the Concurrent List, as also in planning, policy making, and
funding for public health at state and national levels.
ubpl icd e hr ee
ait l
t-
h3

ss
y’
sa
it
ed
mn
I
PRIMARY
HEALTH CARE
TERTIARY
HEALTH CARE
Sub-Centres (SC)
Primary Health Centres (PHC)
District Hospitals
Community Health Centres
(CHC) at block level
Specialists (gynaecologists,
pediatricians, surgeons) posted
at CHC and DH
Medical colleges & advanced
medical research institutes
Specialised Intensive Care Units
Advanced diagnostic support services
Specialised medical personnel
SECONDARY
HEALTH CARE
Health and Wellness Centres (HWC)
Sub-District Hospitals
Figure 1: India’s three-tiered public health system
As shown in Figure 1, the public health care infrastructure in India has been developed as a
three-tier system:
Primary health care provides the first level of contact between the population and
health care providers. It has three types of health care institutions, namely, sub-centre
(SC), primary health centre (PHC) and, more recently, Health and Wellness Centre
(HWC).
1 National Health Policy 2017, Ministry of Health and Family Welfare, Government of India Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
3
Secondary health care refers to a second tier of health system, in which, patients
from primary health care are referred to higher hospitals for treatment. In India, the
institutions for secondary health care include district hospitals, sub-district hospitals,
and community health centres at the block level.
Tertiary health care is the third level of health system that includes specialized
consultative care, provided mostly on referral basis, from primary and secondary
health care. Tertiary care service is usually provided by medical colleges and advanced
medical research institutes.
The NSS reports on the key indicators of social consumption of health in India
2
throw light
on the care-seeking behaviour of the Indian population. Table 1 shows the distribution of
hospital services accessed in the outpatient and inpatient departments with respect to type of
demography (rural/urban) and service provider (public/private). The epidemiological transition
of disease burden and the country’s commitment towards achieving Universal Health Coverage
(UHC) has witnessed rapid growth in the health care sector. This is duly reflected in the roll-out
of the world’s largest social protection scheme, Ayushman Bharat.
3
Table 1: Distribution of hospital services accessed in India
Share of ailments treated in the outpatient
department by sector and demography
 
Share of ailments treated in the inpatient
department by sector and demography
 
Rural Urban
 
RuralUrban
20142017–1820142017–182014 2017–18 2014 2017–18
Public
facilities
28.30%32.50%21.20%26.20%
Public
facilities
42.00% 45.70%32.00%35.30%
Private
facilities
71.70%67.50%78.80%73.80%
Private
facilities
58.00% 54.30%68.00%64.70%
Source: NSS 71
st
and 75
th
rounds, NSSO, Ministry of Statistics and Programme Implementation
Taking into account the needs of health care in the country, the government has made ambitious
global and national commitments to improve health outcomes.
For India to keep its global commitment, we need to measure and evaluate how its existing
public health ecosystem, including district hospitals, is performing.
1.2  TOWARDS IMPROVED HEALTH OUTCOMES — SDGS AND
AYUSHMAN BHARAT
India has made creditable progress over the last two decades on many fronts, including
elimination of polio, maternal and neonatal tetanus and yaws, thereby improving health
outcomes, as also in reducing the disease burden of mothers and children. There has been a
2 NSSO, Key Indicators of Social Consumption in India: Health, NSS 71st (2014) and 75th (2017–18) rounds, Ministry of
Statistics and Programme Implementation
3 Press Information Bureau, Government of India, “Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (AB-
PMJAY) to be launched by Prime Minister Shri Narendra Modi in Ranchi, Jharkhand on September 23, 2018” (https://
pib.gov.in/Pressreleaseshare.aspx?PRID=1546948) Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
4
significant decline in infant mortality between the years 2006 and 2018, from 57 to 32 per 1000
live births. Similarly, the maternal mortality ratio has dropped from 212 deaths per 100 000 live
births in 2007–09 to 113 deaths in 2016–18.
4
As per the National Health Profile 2020, life expectancy in India has significantly increased
from 49.7 years in 1970-75 to 69 years in 2013-17. As a consequence, India today is in the
‘epidemiological transition’ phase, where it faces a dual burden on the disease, namely rising
burden of non-communicable diseases (NCDs) and the already existing burden of communicable
diseases. A holistic approach needs to be in place to address this epidemiological transition.
Two major drivers to improve health care outcomes for the country are the Sustainable
Development Goals (SDGs) and the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana.
While the former reflects the country’s aspirations and commitments, the latter represents the
government’s intent and action.
District hospitals have the potential to become valuable sources of information on how services
are rolled out for other aspects of secondary public health care, including NCDs. To tackle the
growing burden of disease and to provide quality primary, secondary, and tertiary health care,
India launched Ayushman Bharat, a centrally sponsored programme, in 2018, which aims to
provide free access to secondary and tertiary health care services for low-income earners in the
country. Under the programme, both public and private hospitals, including district hospitals are
empanelled to provide services to eligible beneficiaries.
5
This makes it imperative to measure
and understand the current state of health at district hospitals in the country.
1.3 ROLE AND IMPORTANCE OF DISTRICT HOSPITALS
When patients reach any given district hospital, they expect that a doctor in the required
medical specialty would be available at the outpatient department (OPD) to diagnose and
treat their health disorder and prescribe tests and medicines, which can then be obtained at
the pharmacy in the hospital. If the doctor orders diagnostic tests, the patient can get them
done at a laboratory by a technician at that particular point of care. If the doctor recommends
admission, the patient can get a bed at the hospital. If a higher-level medical intervention,
such as surgery, is suggested, the patient can be operated upon within a reasonable period of
time. During the patient’s stay at the hospital, they are cared by the on-duty nurses. After the
surgery, the patient should recover without any infection. The hospital ecosystem is expected
to maintain acceptable levels of hygiene and cleanliness. These are the standard expectations
of any patient visiting a district hospital anywhere in the world.
All these essential components form links of a delicate health care chain that determines the
patient’s experience. Inefficiencies and inadequacies in any of the departments can frustrate
the patient and adversely impact the health outcomes and overall reputation of the hospital.
4 SRS bulletin, Office of Registrar General of India, Ministry of Home Affairs, Government of India
5 https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/ayushman-bharat-private-players-
to-get-a-role-in-running-district-hospitals/articleshow/66266577.cms Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
5
This assessment has considered a wide array of health indicators including number of beds,
doctors, nurses, and paramedical staff, availability of diagnostic and health care specialties,
bed occupancy rate, among others. Indicators were identified on the basis of certain aims
and objectives that needed to be fulfilled by a holistic assessment process. Indicators were
broadly classified under the domains of structure and output, and top and least performing
district hospitals in each indicator were identified.
For patients at the bottom of the economic pyramid, unavailability and inaccessibility of medical
attention and intervention at a public sector hospital could mean that their health issues are
unaddressed. This could affect their productivity and in turn cost them loss of wages, pushing
them into the vicious cycle of poverty and unemployment. This unaddressed illness and sub-
optimal productivity, when faced by a significant size of the population, has the potential to
negatively impact the country’s economy to grow sustainably.
In the three-tier structured level of public health care, the district hospital forms an integral and
vital part of the health care delivery system. It functions as a secondary level of health care,
which provides comprehensive preventive, promotive, and curative health care services to the
people in the district.
A total of 810 district hospitals across India provide critical services to the population.
6
Each district hospital is linked with public hospitals/ health centres such as the community
health centre (CHC), the primary health centre (PHC), and the sub-centre (SC).
As per the Indian Public Health Standards (IPHS), district hospitals are mandated to:
provide comprehensive secondary health care (specialist and referral services) to the
community;
achieve and maintain an acceptable standard of quality of care; and
make services more responsive and sensitive to the needs of the people of the district
and the hospitals/centres from where the cases are referred.
Key elements governing the functioning of district hospitals:
Affordability. Provide effective, affordable health care services (curative including
specialist services, preventive, and promotive) for a defined population.
Accessibility. At least one district hospital for every district providing advanced
secondary care.
Extensive coverage. Service coverage encompassing both urban (district headquarter
town) and the rural population in the district.
Broad scope. Provide wide-ranging technical and administrative support and education
and training for primary health care.
6 As on 31st March 2020, Rural Health Statistics, 2019–20. Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
6
Substantial infrastructure. The district hospital, having beds ranging from 100 to 1200,
provides out and inpatient critical services including surgical interventions such as
caesarean sections; care for sick newborns, infants, and children; management of NCDs
and infectious diseases; and blood storage facility on a 24-hour basis.
Contribution to society. District hospitals have a lot to contribute towards meeting the
country’s global and national goals and targets, including the SDGs, and thus improving
health outcomes.
1.4 ROLE OF A ROBUST HEALTH MANAGEMENT INFORMATION
SYSTEM (HMIS)
To make health services more responsive and sensitive to the needs of the people, there must
be a robust health information system that tracks the progress and on-ground activities in a
systematic manner. In recognizing this, India launched HMIS in 2008 to capture comprehensive
health information on input, output, outcome, and impact indicators from sub-centres, PHCs,
CHCs, and district hospitals. These were fed into standardized formats in a web-based system.
The system was initially launched with the idea of uploading district-wise consolidated figures
but has since evolved to serve as an important source for evidence-informed policy.
HMIS captures facility-wise information on formats framed in close consultation with
programme divisions under the Ministry of Health and Family Welfare (MoH&FW) and other
stakeholders. The data is being utilized in grading health facilities, identification of aspirational
districts, and review of state programme implementation plans (PIPs), among others.
The information generated from HMIS serves as evidence for analysis, which helps shape policy
and strengthens programme interventions. It is a valuable tool that grades health facilities,
identifies aspirational districts, and reviews state PIPs. Further, it is used by the Central/ State
governments to monitor and supervise the different functions that make up the public health
system. These HMIS formats are designed to capture data on a set of indicators that are vital
to track and measure performance of health programmes. A brief summary of the indicators
on which data is collected and the frequency with which the reports are generated can be
seen in Annexure 1.
Uploading facility-wise data on the HMIS web portal:
More than 200,000 health facilities upload the data, out of which 95 per cent are public
health facilities.
On a monthly basis, facility-wise service delivery data is uploaded by these health facilities
On a quarterly basis, training data is collated
On an annual basis, infrastructure related data is collated
Notwithstanding the importance of the HMIS database, there have been observations about the
limitations of the quality and the scope of data that the health information system generates.
One of the concerns expressed is that the health outcome statistics generated through this
system are not representative of the population as all private sector data is not being reported Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
7
in the HMIS portal. Another issue that has been flagged is that despite the hospitals generating
a wealth of information internally, the same does not always get fully reflected in the national
database.
These factors and concerns around on-ground validation of data have led to a need to deepen
the understanding of how public health units fundamentally function and what is the experience
that the patient takes home from these hospitals and clinics. Are the patients able to access
doctors? Get essential drugs? Undergo surgeries when needed? These are some of the questions
that need to be answered. From these realizations, germinated a seed of thought — India must
evaluate the health of its district hospitals, and assess their performance.
Robust estimation of health care indicators and studying their trends over time at the district
level would help strengthen the health information systems and also prove valuable for
informed policy formulation and improved health care delivery.
A robust estimation of different health care indicators and studying their trends and patterns over
time at the district level would be useful to understand intra-state variations. A comprehensive
assessment of these trends in the health care indicators, and their association with policy
targets, would prove valuable to inform and improve health care policy formulation and decision
making at all levels.
1.5  GLOBAL PRACTICES IN HOSPITAL PERFORMANCE
ASSESSMENTS
Performance indicators being a useful mechanism in measuring the quality of service, it has
become a popular means in many arenas to use them in facilitating both improvement and
efficient management. In the health sector too, there are well established systems of comparing
health systems cross-nationally on multiple dimensions. Performance indicators are a dynamic
concept that evolve with time, as it cannot ignore changes and evolution that occur in the health
sector. WHO and global partners have developed a Health Systems Strengthening framework
for a comprehensive assessment of components such as service delivery and health workforce.
7

Within this framework, of a set of indicators are measured — for example, the number of
functional beds with respect to population is an important indicator in measuring the levels of
access to hospital inpatient services, identifying areas with disproportionate number of beds,
and allowing for comparisons within and between countries, regions, sectors, and programs.
Similar to health systems, the hospitals and health care delivery systems of different countries
are also evaluated on certain indicators. For instance, the number of beds available in a hospital
with respect to its population size — WHO recommends that for every 1,000 people there
be at least 5 beds. The Indian Public Health Standards (IPHS) recommends district hospitals
in India to maintain 220 beds per 10 lakh population.
8
In the same manner, other indicators
such as bed occupancy rate, availability of doctors and other medical staff, admission rates,
patient satisfaction, among others, are also recommended and measured. These indicators
reflect the functioning of the health systems but do not represent the performance of health
7 World Health Organization, Strengthening Health Systems to Improve Health Outcomes: WHO’s Framework for
Action, 2007.
8 Indian Public Health Standards (IPHS), Guidelines for District Hospitals, 2012 Introduction to District Hospitals: The Centrepiece of the Health Care Delivery System
8
care institutions (hospitals) per se. While independent studies may measure the performance of
hospitals in a region (e.g., the Times Health All India Multispecialty Hospitals Ranking Survey),
there is no standard framework that helps assess and compare hospital performance on a set
of uniform parameters.
NITI Aayog undertook an in-depth study of domestic and international health systems in order
to develop a holistic framework to assess the overall performance of district hospitals in India
in a uniform manner. The salient features of these systems are included in Annexure 2. The
following chapter highlights the indicators used in the study and the methodology in assessing
district hospitals’ performance.
Rationale and
Approach for
the Performance
Assessment of
District Hospitals
2 Rationale and Approach for the Performance Assessment of District Hospitals
10
2.1 PROJECT BACKGROUND
Public health experts have questioned the limited use of administrative data generated in the
country and, at times, its quality. For instance, the country makes use of the sample registration
system (SRS) and National Family Health Surveys (NFHS) for data on maternal mortality ratio
(MMR), infant mortality rate (IMR), under-5 mortality rates, total fertility rates (TFR), and other
important indicators in the absence of complete Civil Registration and Vital Statistics (CRVS)
system.
Further, key outcome measures like IMR, MMR, etc. through the SRS system are limited to
the state level and do not provide information about district-level variations. However, the
public health care system is organized for service delivery at the district and sub-district level.
Therefore, outcome-based measures of system functioning at the district level are needed to
help programme managers prioritize and tailor their implementation at the local level.
Assessing the performance of district hospitals across the country on a uniform set of key
indicators can serve as a valuable resource that can help identify where the hospitals stand in
terms of their service delivery and what are the gaps contributing to any under-performance.
This will also help study why these gaps exist and how they can be addressed. Undertaking
such an exercise annually will help foster a sense of healthy competition between the individual
district hospitals and provide them an opportunity to showcase progress against relevant
indicators, such as health information systems, stockouts, and functional beds, among others.
This calls for a robust, trustworthy facility-generated data ecosystem and reporting. Large
funding allocations to district hospitals to provide critical secondary care services to the
community, as well as their critical role in health care delivery, calls for a comprehensive system
of assessment of district hospitals.
Having an annual exercise to validate existing data as well as to collect fresh data from the
fundamental unit of the public health care system should allay misgivings about the quality of
routine, administrative data. It would also help policy makers to find an essential tool to track
many crucial health care indicators on a regular basis and assess whether or not the data
reported in the government’s existing health information system is reflecting the correct picture
on the ground.
The Indian Public Health Standards (IPHS) is a set of uniform standards envisaged to improve
the quality of health care delivery in the country. They came into existence in the year 2007
and were last revised in 2012. The guidelines are currently under review and the updated
guidelines are expected to be released by the National Health Systems Resource Centre. They
provide benchmarks for assessing the functional status of hospitals. The MoH&FW is increasingly
nudging hospitals to adopt these standards for providing optimal care to the community.
2.2 OBJECTIVES OF THE PROJECT
To assess the performance of district hospitals vis-à-vis selected Key Performance
Indicators (KPIs)
To disseminate the best practices of well performing district hospitals, so that other
hospitals in the country may follow similar interventions to improve their performance
and thereby improve health outcomes Rationale and Approach for the Performance Assessment of District Hospitals
11
2.3 MEASURES USED IN THE ASSESSMENT
The assessment looked at a wide array of health indicators ranging from beds, doctors, nurses,
paramedics, diagnostic and health care specialties available to bed occupancy rates, caesarean-
section surgeries, and blood bank replacement rate. Annexure 2 gives a summary of the health
systems studied in order to create a suitable framework for assessment. A total of 10 KPIs were
identified to assess the ecosystem and performance of district hospitals in all the States and
Union Territories (UTs). The KPIs were designed by NITI Aayog in consultations with multiple
stakeholders namely, the MoH&FW, the States of Punjab, Maharashtra, Uttar Pradesh, Assam,
and Tamil Nadu, and specialist agencies like World Health Organization and Bill and Melinda
Gates Foundation. After sharing them with all States/UTs for seeking feedback, the KPIs were
then finalised in November 2016 by a working group comprising JS (Policy) MoH&FW, Adviser
(Health) NITI Aayog, Principal Secretary – Health & ME (Punjab), and WHO representative.
The KPIs were identified on the basis of certain aims and objectives that needed to be fulfilled
by a holistic assessment process. They were broadly classified into two categories — structure
and output. Five of these 10 KPIs estimated the level of infrastructure which the district-level
hospitals had, and the remaining indicated the outputs that these hospitals were generating. A
list and description of the indicators is given in Table 2.
Table 2: List of Key Performance Indicators (KPIs) to assess district
hospitals
Domain Category*Key Performance Indicator
Structure
A 1. Number of functional hospital beds per 100,000 population
A
2. a. Ratio of doctors in position to IPHS norm;
b. Ratio of staff nurses in position to IPHS norm;
c. Ratio of paramedical staff in position to IPHS norm
B 3. Proportion of support services available
A 4. Proportion of core health care services available
A 5. Proportion of diagnostic services available
Output
B 6. Bed occupancy rate
B 7. C-section rate
B 8. Surgical productivity index
B 9. OPD per doctor
B 10. Blood bank replacement rate
*Note: Category A indicators are those that are largely under the control of the State, while Category B indicators are
those that are largely under the control of the district hospital Rationale and Approach for the Performance Assessment of District Hospitals
12
2.4 CATEGORIZATION OF HOSPITALS FOR ANALYSIS
For meaningful analysis and comparison, district hospitals were categorized according to their
bed strength, thereby enabling comparison of similar-sized hospitals. Therefore, for the purpose
of the assessment, district hospitals having up to 200 beds were referred to as small hospitals;
those with more than 300 beds were called large hospitals; and those with 201 to 300 beds
were referred to as mid-sized hospitals (Table 3).
Table 3: Categorization of district hospitals
Hospital CategoryCriteria
Small hospital District hospital having up to 200 beds
Mid-sized hospital District hospital having 201 to 300 beds
Large hospital District hospital having more than 300 beds
2.5 PROCESS FOR CONDUCTING ASSESSMENT
Pre-assessment phase. As stated above, NITI Aayog, the Ministry of Health and Family Welfare
(MoH&FW), and World Health Organization (WHO) developed a framework for a comprehensive
assessment of district hospitals with a set of KPIs finalized in consultation with States and UTs
and other key stakeholders. Thereafter, the National Accreditation Board for Hospitals and
Healthcare Providers (NABH), a constituent board of Quality Council of India (QCI), was selected
as the external data validation agency through a competitive bidding process.
The Statistics Division of MoH&FW finalized and shared the HMIS data of all district hospitals
with NITI Aayog for the year 2017-18. NABH in consultation with NITI Aayog, the National
Health Systems Resource Centre (NHSRC) and the Statistics Division from MoH&FW, and Indian
Statistical Institute (ISI) designed a questionnaire based on the numerator and denominator
variables of the KPIs. The questionnaire was field-tested and developed into a mobile application
(survey instrument) for onsite data collection of 57 data items mapped to the KPIs.
Training phase. The NABH assessors (medical professionals from various health institutes in the
country) were trained on the overall project, questionnaire, and methodology of the assessment.
As many as 17 training workshops were conducted across the country and more than 400
assessors trained.
Assessment phase (data collection). The assessors conducted the onsite review of primary
records of district hospitals and validated the observed data with the corresponding HMIS
data for each hospital. The responses were collected through a mobile application (survey
instrument). A backend quality team from the NABH office was mapped to each assessor for
guidance on the day of the assessment. The team monitored the assessment live and flagged
the response/ evidence in case of any discrepancy. To ensure that the data collected was
appropriate, multiple levels of quality check of assessments were undertaken. At the time of
assessment during the period 2018–19, a total of 731 district hospital across 37 States/UTs were
part of the on-ground data collection and validation exercise. Of these, 24 hospitals could not
be assessed due to security issues and difficult terrain. In effect, 707 (97%) district hospitals
were assessed for data validation by the NABH assessors. Rationale and Approach for the Performance Assessment of District Hospitals
13
Post-assessment phase (data validation and analysis). After assessment, the data collected
was cleaned to identify and analyse variation between onsite collected data and HMIS data.
NITI Aayog shared this cleaned data with the respective States/UTs and conducted a video
conference between them and the validation team (NABH and MoH&FW Statistics Division)
to validate the reviewed data. In case the States/UTs disagreed on any of the data points that
were collected and shared by NABH, they were given an opportunity to submit corrected data
with evidence within a stipulated time period. The submitted data was then examined by NABH
and incorporated in the final database, which was used for the evaluation of KPIs.
2.6 KEY RESULTS OF DATA VALIDATION
For the 707 hospitals assessed for data validation, the average percentage of match between
the onsite collected data and its corresponding HMIS entry was 75 per cent. Many reasons were
cited for the 25 per cent average mismatch, some of the most common being difference in
understanding of definitions of various indicators, lack of continuity in data capturing and data
entry in HMIS, ambiguous indicator definition, among others. These are elaborated in detail in
Chapter 4.
Methodology for evaluation of percentage of match in data
The findings of the data validation exercise are based on the match/mismatch found between
the assessor-observed value (onsite validated data) and the corresponding value entered in
the HMIS portal. District hospital-wise response to each validated data for the 56 questions
(HMIS data points) was compared with their corresponding pre-entered HMIS value. Based
on this, a specific percentage of match was calculated for each district hospital. For example,
if a match was found between the onsite validated data and its corresponding HMIS data
entry for 49 out of 56 questions for a particular district hospital, then the percentage of
match for that hospital becomes 88 per cent (=49/56*100).
State/UT-wise average percentage of match (Figure 2a) between the onsite validated data
and its corresponding HMIS values was calculated by taking the average percentage of
match of each district hospital falling under that State/UT.
Indicator-wise percentage of match (Figure 2b) was calculated by taking the percentage
of the total count of match observed for that indicator across the total hospitals assessed
(N=707). For example, the assessor-observed value for the question, ‘Is General Surgery
service available?’ matches with its corresponding HMIS data entry in 576 of the 707 district
hospitals. Hence the percentage of match for the indicator across the district hospitals is
81 per cent (=576/707*100).
Percentage of match: State/UT-wise and indicator-wise
State-wise, Goa showed the maximum percentage of match (87%) while Mizoram showed
the least match (63%) between onsite validated data and pre-entered HMIS values. In the
case of UTs, Dadra and Nagar Haveli showed a 100% match, while Lakshadweep had the least
percentage of match (41%). Most of the district hospitals fell in the range of 65%–85% of match
(see Figure 2a). With regard to indicator-wise percentage of match, the components under the
core health care services showed maximum match, while the human resource component of the Rationale and Approach for the Performance Assessment of District Hospitals
14
indicators showed the least match in all the States/UTs, with number of paramedical staff having
the least percentage of match (see Figure 2b). This may be attributed mainly to difference in
definitions of the medical staff as understood by the hospital vis a vis definition of HMIS.
100
91
87
86
84
83
83
83
81
81
80
79
79
78
78
77
77
77
77
76
76
76
76
74
74
73
73
71
70
68
68
65
64
63
62
42
41
Dadra & Nagar Haveli
Chandigarh
Goa
Punjab
Tamil Nadu
Assam
Meghalaya
West Bengal
Maharashtra
Madhya Pradesh
Andhra Pradesh
Chhattisgarh
Daman & Diu
Tripura
Puducherry
Karnataka
Nagaland
Jharkhand
Haryana
Delhi
Odisha
Telangana
Rajasthan
Bihar
Sikkim
Kerala
Gujarat
Himachal Pradesh
Jammu & Kashmir
Uttarakhand
Uttar Pradesh
Manipur
Arunachal Pradesh
Mizoram
Ladakh
A & N Islands
Lakshadweep
Figure 2a: State/UT-wise percentage of match between NABH onsite validated data and
corresponding HMIS values
2.7 COMPUTATION OF KPI SCORES
While the data validation exercise was crucial in determining the validity of the data entered
in the HMIS portal, this assessment is based on the onsite validated data collected by the
assessors. In order to assess the performance of district hospitals, the formula of each KPI was
defined (see Annexure 3). The raw score for each KPI of each district hospital was calculated
accordingly and then sorted to identify well-performing and least-performing hospitals for each
indicator. Top performing hospitals in each hospital category (small, mid-sized, large) for each
individual KPI were identified so as to learn the best practices they have adopted with respect
to those indicators. The best practices of these top performing district hospitals were sought
from the respective state and/or district-level officials. Rationale and Approach for the Performance Assessment of District Hospitals
15
11
22
27
36
46
50
54
54
55
55
59
61
61
63
64
67
68
70
71
71
71
74
76
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81
83
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90
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96
96
97
Number of paramedicals positioned
Number of staff nurses positioned
Number of doctors positioned
Total number of surgeons positioned
Total number of major surgeries in a year
Total number of OPD patients in a year
Is HIS implemented-IPD?
Total number of inpatient bed days in a year
Total number of blood units issued in a year
Total number of Allopathic-Outpatient…
Is HIS implemented -Complete HIS?
Number of functional beds
Total number of blood units issued on…
Is HIS implemented-Pharmacy?
Is HIS implemented-OPD?
Is Public Health Unit service available?
Is PAP Smear service available?
Total number of deliveries performed in a year
Is Cardiac Investigation service available?
Total number of Ayush-Outpatient attendance
Is Microbiology service available?
Total number of C-section deliveries…
Is General Medicine service available?
Is Physiology (Pulmonary Function Test)…
Is Stool Analysis service available?
Is Critical Care (ICU) service available?
Is Serology service available?
Is General Surgery service available?
Is CSSD service available?
Is Dermatology and Venereology service…
Is Radiology service available? (core)
Is Endoscopy service available?
Is ENT service available? (diagnostic)
Is dietary service available in the hospital?
Is Biochemistry service available?
Is Ophthalmology service available?…
Is Radiology service available? (diagnostic)
Is Pediatrics including Neonatology service…
Is Sputum testing service available?
Is Haematology testing service available?
Is refrigeration service available in the hospital?
Is Water supply service available in the hospital?
Is Hospital Transport Ambulance available?
Is Blood Bank available?
Is Orthopaedics service available?
Is Engineering service available in the hospital?
Is ENT service available? (core)
Is Waste management service available?
Is Ophthalmology service available? (core)
Is Medico-legal/post mortem service available?
Is Emergency service available?
Is Anaesthesia service available?
Is Urine Analysis service available?
Is Obstetrics and Gynaecology service…
Is Dental Care service available?
Is Pharmacy available in the hospital?
Figure 2b: Indicator-wise percentage of match between NABH onsite validated data and
corresponding HMIS values Rationale and Approach for the Performance Assessment of District Hospitals
16
Ernakulam Government Hospital, Ernakulam, Kerala
Assessing District
Hospitals with
respect to the
Key Performance
Indicators (KPIs)
3 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
18
As per the framework, for the purpose of the analysis, hospitals were categorized on the basis
of bed strength (see Table 3). Of the total 707 hospitals assessed, about 62% (438) were small-
sized hospitals. The number of small hospitals was three times the number of large hospitals,
which constituted 21% (149) of the total. Mid-sized hospitals constituted only 17% (120) of the
district hospitals (Figure 3a).
Small (Up to 200 beds)
Mid-sized (200 - 300 beds)
Large (More than 300 beds)
Small (Up to 200 beds)
438
62.0%
Large (201-300 beds)
149
21.1%
Mid-sized (More than 300 
beds)
120
17.0%
Figure 3a: Distribution of hospitals by size
Large states represent a larger share of districts hospitals in the country and smaller states
and UTs have a smaller proportion of district hospitals. It is notable that Uttar Pradesh, with
75 districts has 150 district hospitals which is over 21% of the total district hospitals (Figure
3b). Each district in Uttar Pradesh has separate district hospitals for women and children
and general hospitals. Therefore, each district hospital is split into two distinct hospitals with
separate infrastructure and service delivery and reported as separate facilities in the HMIS portal.
Uttarakhand, with only 2.55% of district hospitals, also has separate hospitals for women and
children and separate general hospitals in each district.
This chapter provides an overview of the performance of district hospitals in India with respect
to each KPI. The importance of each of KPIs included in the assessment is explained, followed by
insights based on the data, and best practices of well-performing district hospitals. Further, the
top performing district hospital in each State/UT in individual KPIs has been listed in Annexure
4. Annexure 5 includes graphs illustrating the State/UT-wise average raw score of each KPI
for each hospital category (small, mid-sized, and large). The KPI-wise raw scores of all district
hospitals that were part of the assessment are given in Annexure 7. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
19
Uttar Pradesh
21.22%
Madhya Pradesh
7.21%
Karnataka
5.66%
Bihar
5.09%
Odisha
4.53%
Tamil Nadu
4.53%
Rajasthan
3.82 %
Assam
3.54%
Maharashtra
3.54%
Jharkhand
3.25%
Punjab
3.11%
Gujarat
2.97%
Kerala
2.97%
West Bengal
2.83%
Chhattisgarh
2.69%
Jammu &
Kashmir
2.69%
Delhi
2.55%2.55%2.55%
Haryana
Uttarakhan d
Andhra
Pradesh
1.98%
Himachal
Pradesh
1.56%
Meghalaya
1.27 %
Mizoram
1.13%
Manipur
0.99%
Arunachal
Pradesh
0.85%
Telangana
0.85%
Tripura
0.85%
Puducherry
- 0.57%
Sikkim
- 0.57%
A & N Islands
- 0.42%
Nagaland
- 0.42%
Daman &
Diu -0.28%
Goa -0.28%
Ladakh - 0.28%
Chandigarh
- 0.14%
Dadra & Nagar Haveli - 0.14%
Lakshadweep
- 0.14%
Figure 3b:
Distribution of district hospitals by State/UT Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
20
3.1 NUMBER OF FUNCTIONAL BEDS PER 100,000 POPULATION
3.1.1 Definition of the KPI
A hospital bed constitutes the primary unit of any hospital infrastructure. The number of
functional hospital beds are of fundamental importance to both the patients and staff. This KPI
lies in the domain of structure and is largely under the control of the state. It refers to hospital
beds which are regularly maintained and staffed and immediately available for the care of
admitted patients. It specifically refers to the number of functional hospital beds in a district,
available for every 1 lakh people in that district. It includes beds available within the hospital
for admissions but excludes floor beds, trolley beds, labour room/operation theatre (OT) tables
and observation beds in emergency/OT/labour room. It is calculated by dividing the number of
functional hospital beds by the population of the district, multiplied by 100,000.
Number of functional beds per
100,000 population
=
Number of functional hospital beds
× 100,000
Population of the district
3.1.2 Significance of the KPI in evaluating a district hospital
One of the important aspects under public health planning is providing the population with
the necessary bed stock. Knowing the number of beds in proportion to the population helps
understand resource availability of the district hospital in comparison to other districts or states.
A shortage of available beds can seriously impact how a hospital functions, as it is the primary
cause of denial of admission, surgery cancellations, and delays in emergency admissions.
Conversely, excess bed capacity may lead to additional costs and stagnant capital. Moreover,
the sub-optimal utilization of resources is not ideal when public health care is facing a resource
crunch. Overall, population is the most important factor to take into account for hospital bed
capacity planning. Hospital capacity planning should consider hospital bed availability alongside
issues related to productivity, and clinical efficiency.
9
This KPI is also useful in identifying resource allocation, such as requirement of staff, support
services, diagnostic testing facilities, etc. For example, in smaller hospitals in less-populated
districts, setting up a diagnostic testing lab for each hospital would not be optimal. In such
a case, two or three district hospitals may be combined to have such services and should be
supported by an efficient logistics system to transport biological samples.
3.1.3 Juxtaposition of the KPI with IPHS guidelines
WHO global standards recommend 5 hospital beds for every 1000 people. The World Bank 2017
data indicates that India has 0.5 beds for every 1000 people, which is inclusive of both public
and private hospitals. This report gives a picture of availability of functional hospital beds in
a district hospital only, which is a small sub-set of health care institutions in the public sector
9 Tian, F., & Pan, J. (2021). Hospital bed supply and inequality as determinants of maternal mortality in China between
2004 and 2016. Int J Equity Health, 20(1), 51. doi: 10.1186/s12939-021-01391-9
Carey, T. A., Wakerman, J., Humphreys, J. S., Buykx, P., & Lindeman, M. (2013). What primary health care services
should residents of rural and remote Australia be able to access? A systematic review of “core” primary health care
services. BMC Health Serv Res, 13, 178. doi: 10.1186/1472-6963-13-178 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
21
that also comprises SCs, PHCs, CHCS, as well as tertiary care institutions. The size of a district
hospital is a function of the hospital bed requirement, which in turn is a function of the size of
the population it serves. IPHS 2012 guidelines recommend a bed occupancy rate of at least 80%
in a district hospital serving a population of 10 lakh, which means the bed requirement in the
district hospital would be 220 beds (based on the assumptions of the annual rate of admission
as 1 per 50 population and average length of stay in a hospital as 5 days).
10
Scaling it down
to the framework used in this study, a district hospital should have at least 22 beds for every 1
lakh population in order to cater to an 80 per cent annual bed occupancy rate.
3.1.4 District hospital performance and associated insights
Figure 3.1.1 shows State/UT-wise average number of functional beds in a district hospital per
1 lakh population. Puducherry had the highest average beds in the country, with a district
hospital in the UT having an average of 222 beds per 1 lakh population, while Bihar had the
lowest average of 6 beds per 1 lakh population. Taking the national average, a district hospital
in India has 24 beds per 1 lakh population (Figure 3.1.1). Annexure 5 includes graphs illustrating
the average number of functional beds per 1 lakh population by State/UT for each of the three
hospital categories — small, mid-sized, and large district hospitals.
Figure 3.1.2. shows the percentage of district hospitals in a State/UT that meet the IPHS
guidelines, 2012 of ensuring at least 22 beds for every 1 lakh population.
150
200
222
104
102
92
78
70
63
59
57
52
49
46
33
32
30
24
24
24
22
22
22
20
20
19
19
19
18
18
18
17
14
13
13
10
9
6
Puducherr y
A & N Islands
Ladakh
Arunachal Pradesh
Daman & Diu
Dadra & Nagar Haveli
Lakshadweep
Sikkim
Mizoram
Delh i
Chandigarh
Meghalaya
Nagaland
Himachal Pradesh
Karnatak a
Goa
Tripura
Manipur
Indi a
Uttarakhand
Kerala
Odisha
Tamil Nadu
Madhya Pradesh
Chhattisgarh
West Bengal
Rajasthan
Gujarat
Punjab
Andhra Prades h
Assam
Jammu & Kashmir
Maharashtr a
Haryana
Uttar Pradesh
Telangana
Jharkhand
Bihar
Figure 3.1.1: State/UT-wise average number of beds in a district hospital for every 1 lakh
population
10 Indian Public Health Standards (IPHS), Guidelines for District Hospitals, 2012
Derivation of the number of beds required in a district with population of 10,00,000:
The total number of admissions per year = 10,00,000 × 1/50 = 20,000
Bed days per year = 20,000 × 5 = 100,000
Total number of beds required when occupancy is 100% = 100000/365 = 275 beds
A bed occupancy of 80% would mean utilisation of 220 beds (i.e., 275 × 80/100   = 220 beds) Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
22
Rajasthan
Gujarat
Ladakh
Maharashtra
Odisha
Bihar
Madhya Pradesh
Uttar Pradesh
Karnataka
Tamilnadu
Assam
Telengana
Andhra Pradesh
Chhattishgarh
Punjab
Jharkhand
West Bengal
Haryana
Uttarakhand
Meghalaya
Kerala
Arunachal Pradesh
Himachal Pradesh
Jammu and Kashmir
Manipur
Mizoram
Nagaland
Tripura
Sikkim
Goa
Delhi
Andaman & Nicobar
Puducherry
Daman and Diu and Dadra and Nagar Haveli
Chandigarh
Lakshadweep
Legend
India_State_Boundary
% of DHs with at least 22 beds per 1 lakh pop#
0.0- 10.7
10.7 - 31.3
31.3 - 46.8
46.8 - 77.8
77.8 - 100.001 75 350 525 70087.5
Miles
Figure 3.1.2: Percentage of district hospitals in each State/UT that have at least 22 beds
per 1 lakh population
The district hospitals that have a higher number of functional beds for every 1 lakh population
in comparison to the rest of the hospitals in the country are indicated in Table 4. The top
performing district hospital in each State/UT for this KPI is listed in Annexure 4.
Table 4: Top performing district hospitals in the country for the KPI
“Number of functional beds per 100,000 population”
Small hospitalsMid-sized hospitalsLarge hospitals
Govt. General Hospital, Mahe,
Puducherry
(409 beds per 1 lakh population)
Leh DH, Leh Ladakh,
Ladakh
(187 beds per 1 lakh population)
Govt. General Hospital, Karaikal,
Puducherry
(252 beds per 1 lakh population)
BJR Hospital, Nicobar,
Andaman and Nicobar Islands
(342 beds per 1 lakh population)
Tomo Riba Institute of Medical
Science & Hospital, Papum
Pare, Arunachal Pradesh
(143 beds per 1 lakh population)
G.B. Pant Hospital,
South Andaman,
Andaman and Nicobar Islands
(199 beds per 1 lakh population)
Govt. General Hospital, Yanam,
Puducherry
(179 beds per 1 lakh population)
Dharwad District Hospital FRU,
Dharwad, Karnataka
(79 beds per 1 lakh population)
DH SDN Hospital, Shahdara,
Delhi
(176 beds per 1 lakh population)
National average: 24 beds per 1 lakh population
Range: 1 to 409 beds per 1 lakh population Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
23
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
The G.B. Pant Hospital in South Andaman, a large district hospital in the UT of Andaman
and Nicobar Islands, has dedicatedly increased the number of hospital beds in line with the
increasing population of the district overtime. Development of infrastructure in existing and
new medical facilities, and addition of new specialties have further increased the number of
functional beds.
Despite being in a less populated district of Nicobar, the BJR
Hospital has perceptively increased hospital beds in the last few
years and assigned them to specific disciplines. This has ensured
optimal performance by the hospital, especially after the COVID-19
pandemic.
—Director of Health Services
Andaman and Nicobar Islands
Tomo Riba Institute of Medical Science & Hospital, Papum Pare, Arunachal Pradesh, which
is the only tertiary care hospital in the state, has gradually expanded existing infrastructure
and manpower requirements to cater to the increasing population. Strengthening of existing
services, regular staff training, adequate fund provision owing to the state government’s political
will have all contributed to increased service utilization and service delivery. The hospital now
provides medical services in all general disciplines and in super-specialty care in Cardiology,
Oncology, Paediatric Surgery, Plastic Surgery, and even in AYUSH.
Leh District Hospital in the UT of Ladakh serves as the main referral hospital for the whole
district, including the neighbouring district Kargil. During summer there is an influx of tourist
and labourers. To accommodate every patient, more beds are being added wherever possible
so that no patient is neglected. For this reason, although this hospital is sanctioned 150 beds,
there are about 270 functional beds. This hospital is the only functional hospital in the district
at present. As such the intervention was necessary.
Three of the four district hospitals the UT of Puducherry are among the top performing hospitals
in the country in this particular KPI. In Government General Hospital, Karaikal, a separate block
for the Obstetrics and Gynaecology Department was sanctioned in 1998, and an eye block
was commenced in August 2004 to fulfil the public demand. During that period number of
bed strength had been sanctioned as 180 beds for Maternity Department and 90 beds for the
Eye Block. Moreover, the hospital caters to the needs of the public not only from the Karaikal
region but also from the neighbouring district of Tamil Nadu. In Yanam district of Puducherry,
the population was gradually increasing and the then 50-bedded hospital was inadequate to
cater to the patient load. Hence the hospital administration sought to increase the number of
beds and submitted proposals to the Directorate of Health. The Health Department sanctioned
a multi-storeyed building with 100 beds, which was completed in 2005. Super specialists from
Kakinada have been engaged on a weekly basis to support the existing services to benefit the
public. Health Melas are conducted to screen various diseases at the field level and then referred Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
24
to multi-specialty clinics in Yanam region. Similar interventions were undertaken in Government
General Hospital, Mahe. Public interest and political will were the key factors in contributing to
increased number of functional beds in the UT of Puducherry.
DH SDN Hospital, Shahdara, Delhi and Dharwad District Hospital FRU, Karnataka employed
similar proactive measures in addressing the demand–supply gap, and increased the bed
strength and manpower in line with state government provisions to cater to its population.
Recommendations for States/UTs
Having a sufficient and balanced number of beds for the population is important as
has been shown by the recent COVID-19 pandemic.
While the IPHS do not recommend allotting specialty-wise beds as it may lead to
suboptimal utilization, the hospital may determine specialty-wise beds depending
upon the number of patients denied admissions from the emergency department for
a particular specialty, as well as days when no elective admissions could be made
for the particular specialty from the outpatient department. Bed strength can be
planned in medium term based on local disease burden and its expected trajectory.
Once a district hospital is converted to a medical college, the number of beds for
each specialty is determined by MCI regulations.
Allotting beds as per specialty and demand would also help avoid multiple admissions
on a single bed (for instance, labour wards can be allotted higher number of beds
than other specialties). This will ensure the dignity of the patient, prevent cross
infection, and ensure hygiene.
An annual audit of the out-patient and emergency footfalls should be done to
recommend the necessary beds for the hospital.
Optimization of hospital beds is necessary not only in economic interests, but also
for efficient patient care, comfort, and outcomes. Opportunities should be explored
for providing a judicious mix of outpatient and inpatient care, improve efficiency and
quality of hospital care, as well as the necessity of forming a reserve of hospital beds
in case of natural calamities, pandemics, or other emergency scenarios, which may
increase the level of hospitalization of citizens in a short period of time. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
25
3.2 RATIO OF DOCTORS, STAFF NURSES, AND PARAMEDICAL
STAFF IN PROPORTION TO IPHS NORMS
3.2.1 Definition of the KPI
The Indian Public Health Standards (IPHS), 2012 lays down certain standards that may be used
as a reference point in health care infrastructure planning. Manpower requirement is determined
by bed strength, as indicated in Table 5.
Table 5: Total medical and paramedical manpower requirements as per IPHS
Cadre 100 Beds 200 Beds 300 Beds 400 Beds 500 Beds
Doctors29 34505868
Staff Nurse45 90135 180 225
Paramedicals 31 426681 100
Total Strength 105 166 251 319 393
Source: Guidelines for District Hospitals, IPHS, 2012
This KPI also lies in the domain of structure and the subject falls under the control of the state
rather than the district hospital. It is calculated by dividing the total number of positioned staff
by the minimum essential manpower required as per IPHS.
Positioned doctors include MBBS, BDS, and AYUSH specialists; for positioned staff nurses, the
post of Auxiliary Nurse Midwife (ANM) is excluded; for paramedical staff, all categories included
in IPHS have been considered.
Ratio of doctors/nurses/ paramedical
staff in position to IPHS norms
=
( )
Total number of positioned staff
Minimum essential manpower required
see Table 5
3.2.2 Significance of the KPI in evaluating a district hospital
Increasing hospital admissions have led to increasing workloads for all grades of medical staff
internationally. The quality of hospital care is influenced by the number of medical staff available.
Studies indicate that hospitals with lower than expected mortality rates had on average 24%
more nurses, as well as 44% more doctors, per bed than those with the highest rates. Policies
are required to achieve proper staffing levels to enhance patient outcomes.
11
Doctors are responsible for covering all the medical wards, surgical patients requiring medical
care, high dependency units and acute medical assessment units. This load is high especially
during the night. It can be difficult to predict how many of these patients will require urgent
11 Merrifield, N. (2015). Higher ratio of nurses per hospital bed linked to fewer patient deaths (available at: https://
www.nursingtimes.net/news/hospital/higher-ratio-of-nurses-per-hospital-bed-linked-to-fewer-patient-
deaths-18-12-2015/)
Sean P. Clarke, Nancy E. Donaldson. (2008). Nurse Staffing and Patient Care Quality and Safety. Patient Safety and
Quality: An Evidence-Based Handbook for Nurses: Vol. 2. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
26
treatment during the night, so it is essential to provide enough doctors to cover both planned
and unplanned care.
Lower number of doctors per bed may make it difficult to treat the complex medical conditions
and the imbalance may negatively affect patient outcomes.
Staff nurses form an important component of any hospital. They are responsible for direct
patient care as well as execute special technical duties in areas like operation theatres, intensive
care units and highly dependent units. Thus, this indicator is useful to measure compliance
with regard to the positioned staff nurses. However, it is important to note that this indicator
excludes the Auxiliary Nurse Midwives (ANM).
Studies have shown that an appropriate size of nurse staff helps to achieve clinical and economic
improvements in patient care, including enhanced patient satisfaction, reduction in medication
errors, incidences of fall, pressure ulcers, health care-associated infections, patient mortality,
hospital readmission and duration of stay, patient care cost, nurses’ fatigue, and burnout.
Paramedics provide an immediate assessment of life threats and initiate care to stabilize the
patient prior to and during transportation to the hospital emergency department. They primarily
work as part of the emergency medical services, most often in ambulances. This indicator is
useful to assess how proactive a given hospital is with regard to emergency care since a greater
number of paramedical staff contribute to reducing response time for any medical emergency
and can, therefore, result in improved outcomes, decreased morbidity and mortality, and better
quality of care for patients.
Almost all the diagnostic procedures are carried out by the paramedical staff and they have
emerged a vital cog in the wheel of the health care delivery system.
3.2.3 District hospital performance and associated insights
Overall, 189 of 707 district hospitals were found to meet the doctor to bed ratio as per IPHS norms
(based on positioned doctors / IPHS norm as per bed category ≥ 1). Only 88 hospitals, however,
were found to have the ratio of staff nurses as per the IPHS norms based on corresponding bed
category. A total of 399 hospitals were found to have ratio of paramedical staff in position as
per the IPHS norms. Table 6 summarizes State/UT-wise number of district hospitals that have
positioned medical and paramedical staff in line with the IPHS norms.
Table 6: Count and percentage of district hospitals in each State/UT
meeting IPHS norms for medical and paramedical staff
State/UT
Total
number
of district
hospitals
assessed
District hospitals that
met IPHS norms for
positioned doctors
District hospitals that
met IPHS norms for
positioned
staff nurses
District hospitals that
met IPHS norms for
positioned paramedical
staff
Total hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitals
Andaman and
Nicobar Islands
3 0 0.00 0 0.00 2 66.67
Andhra Pradesh 14 7 50.00 3 21.43 8 57.14 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
27
State/UT
Total
number
of district
hospitals
assessed
District hospitals that
met IPHS norms for
positioned doctors
District hospitals that
met IPHS norms for
positioned
staff nurses
District hospitals that
met IPHS norms for
positioned paramedical
staff
Total hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitals
Arunachal
Pradesh
6 2 33.33 0 0.00 5 83.33
Assam25 3 12.00 0 0.00 13 52.00
Bihar36 3 8.33 6 16.67 19 52.78
Chandigarh 1 1 100.00 1 100.00 1 100.00
Chhattisgarh 19 3 15.79 1 5.26 11 57.89
Dadra and Nagar
Haveli
1 1 100.00 0 0.00 1 100.00
Daman & Diu 2 0 0.00 0 0.00 0 0.00
Delhi18 16 88.89 11 61.11 16 88.89
Goa2 2 100.00 2 100.00 1 50.00
Gujarat21 1 4.76 1 4.76 3 14.29
Haryana18 16 88.89 7 38.89 11 61.11
Himachal
Pradesh
11 1 9.09 0 0.00 5 45.45
Jammu and
Kashmir
19 11 57.89 0 0.00 16 84.21
Jharkhand 23 1 4.35 1 4.35 14 60.87
Karnataka 40 18 45.00 9 22.50 9 22.50
Kerala21 6 28.57 1 4.76 7 33.33
Ladakh2 1 50.00 0 0.00 2 100.00
Lakshadweep 1 0 0.00 0 0.00 0 0.00
Madhya Pradesh 51 8 15.69 13 25.49 35 68.63
Maharashtra 25 11 44.00 7 28.00 15 60.00
Manipur7 3 42.86 1 14.29 7 100.00
Meghalaya9 1 11.11 1 11.11 2 22.22
Mizoram8 1 12.50 1 12.50 8 100.00
Nagaland3 1 33.33 0 0.00 3 100.00
Odisha32 8 25.00 1 3.13 19 59.38
Puducherry 4 2 50.00 1 25.00 4 100.00
Punjab22 10 45.45 2 9.09 18 81.82
Rajasthan 27 10 37.04 2 7.41 19 70.37
Sikkim4 1 25.00 0 0.00 4 100.00 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
28
State/UT
Total
number
of district
hospitals
assessed
District hospitals that
met IPHS norms for
positioned doctors
District hospitals that
met IPHS norms for
positioned
staff nurses
District hospitals that
met IPHS norms for
positioned paramedical
staff
Total hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitalsTotal hospitalsPercentage of hospitals
Tamil Nadu 32 6 18.75 0 0.00 14 43.75
Telangana6 0 0.00 0 0.00 4 66.67
Tripura6 0 0.00 2 33.33 6 100.00
Uttar Pradesh 150 24 16.00 10 6.67 83 55.33
Uttarakhand 18 0 0.00 0 0.00 7 38.89
West Bengal 20 10 50.00 4 20.00 7 35.00
Total707 189 26.73 88 12.45 399 56.44
Source: Primary data collected by NABH for the district hospital performance assessment
Uttar Pradesh had the highest proportion (12.7%) of doctors in position at district hospitals
meeting IPHS norms, followed by Karnataka (9.5%), Delhi (8.5%), Haryana (8.5%), and Jammu
and Kashmir (5.8%). However, looking at the percentage of hospitals in each State/UT that meet
the IPHS norm, only Chandigarh, Dadra and Nagar Haveli, and Goa had all district hospitals
fulfilling IPHS norms for positioned doctors. Figure 3.2.1 depicts the percentage of district
hospitals in each State/UT that meet the IPHS norm for positioned doctors.
Rajasthan
Gujarat
Ladakh
Maharashtra
Odisha
Bihar
Madhya Pradesh
Uttar Pradesh
Karnataka
Tamilnadu
Assam
Telengana
Andhra Pradesh
Chhattishgarh
Punjab
Jharkhand
West Bengal
Haryana
Uttarakhand
Meghalaya
Kerala
Arunachal Pradesh
Himachal Pradesh
Jammu and Kashmir
Manipur
Mizoram
Nagaland
Tripura
Sikkim
Goa
Delhi
Andaman & Nicobar
Puducherry
Daman and Diu and Dadra and Nagar Haveli
Chandigarh
Lakshadweep
Legend
India_State_Boundary
% of DHs that meet IPHS norm for doctors
0.0 - 4.8
4.8 - 18.7
18.7 - 37.0
37.0 - 57.8
57.8 - 100.001 75 350 525 70087.5
Miles
Figure 3.2.1: Percentage of district hospitals in each State/UT that meet the doctors to
bed ratio as per IPHS norm Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
29
In the case of positioned staff nurses, a total 88 hospitals were found to have ratio of nurses
in position as per IPHS norms (based on positioned nurses / IPHS norm as per bed category
≥ 1). Madhya Pradesh had the highest proportion (14.8%) such hospitals, followed by Delhi
(12.5%), and Uttar Pradesh (11.4%). All district hospitals in Chandigarh and Goa met the IPHS
requirement.
In the case of positioned paramedical staff, a larger number of hospitals have met IPHS
requirements (Table 6).
Table 7 highlights the top hospitals in each category that have the highest ratio of medical and
paramedical staff with respect to the IPHS requirement. The top performing district hospital in
each State/UT for this KPI is listed in Annexure 4.
Table 7: Top performing district hospitals in the country for the KPI “Ratio
of doctors, nurses and paramedical staff in position to IPHS norms”
Small hospitalsMid-sized hospitalsLarge hospitals
Top performing district hospitals in the country for the KPI
“Ratio of doctors in position to IPHS norms”
National average: 0.86 times the requisite staff
Range: 0.10–4.79
Lal Bahadur Shastri Hospital,
East, Delhi
DH has 4.79 times the requisite staff
DH JPC Hospital, North East,
Delhi
DH has 2.34 times the requisite
staff
King George Hospital TH,
Vishakapatnam, Andhra Pradesh
DH has 4.71 times the requisite staff
Babu Jagjeevan Ram Memorial
Hospital Jahgirpuri, North, Delhi
DH has 4.52 times the requisite staff
Balangir, Odisha
DH has 2.26 times the requisite
staff
Victoria Hospital, Bangalore
Urban, Karnataka
DH has 4.19 times the requisite staff
Hedgewar Hospital, Shahdara,
Delhi
DH has 3.76 times the requisite staff
Baripada, Mayurbhanj, Odisha
DH has 2.14 times the requisite
staff
Hubli KIMS District Hospital,
Dharwad, Karnataka
DH has 4.18 times the requisite staff
Top performing district hospitals in the country for the KPI
“Ratio of staff nurses in position to IPHS norms”
National average: 0.60 times the requisite staff
Range: 0.04–2.88
Babu Jagjeevan Ram Memorial
Hospital Jahgirpuri, North, Delhi
DH has 2.51 times the requisite staff
Sanjay Gandhi Memorial
Hospital Mangolpuri, North
West, Delhi
DH has 1.77 times the requisite
staff
Deendayal Upadhyay Hospital,
West, Delhi
DH has 2.88 times the requisite staff
Guru Govind Singh Govt
Hospital, West, Delhi
DH has 2.36 times the requisite staff
Aizawl Civil Hospital, Aizawl
West, Mizoram
DH has 1.32 times the requisite
staff
King George Hospital TH,
Vishakapatnam, Andhra Pradesh
DH has 2.05 times the requisite staff Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
30
Small hospitalsMid-sized hospitalsLarge hospitals
Rao Tula Ram Hospital, South
West, Delhi
DH has 2.11 times the requisite staff
Civil Hospital, Panchkula,
Haryana
DH has 1.14 times the requisite staff
GH Ernakulam, Ernakulam,
Kerala
DH has 1.75 times the requisite staff
Top performing district hospitals in the country for the KPI
“Ratio of paramedical staff in position to IPHS norms”
National average: 1.54 times the requisite staff
Range: 0.03–10.71
Civil Hospital, Rohtak, Haryana
DH has 8.52 times the requisite staff
Aizawl Civil Hospital, Aizawl
West, Mizoram
DH has 5.95 times the requisite
staff
North Goa District Hospital,
North Goa, Goa
DH has 4.39 times the requisite
staff
King George Hospital TH,
Visakhapatnam, Andhra Pradesh
DH has 10.71 times the requisite staff
Churachandpur District Hospital,
Churachandpur, Manipur
DH has 6.69 times the requisite staff
Deendayal Upadhyay Hospital,
West, Delhi
DH has 8.32 times the requisite staff
Combined District Hospital,
Kannauj, Uttar Pradesh
DH has 6.06 times the requisite staff
Shimoga District Hospital,
Shimoga, Karnataka
DH has 6.54 times the requisite staff
The following graphs depict the State/UT-wise average of the ratio of doctors (Figure 3.2.2),
nurses (Figure 3.2.3), and paramedical staff (Figure 3.2.4) in position to the IPHS norms. An
average score of 1 or more denotes that the State/UT has met the IPHS requirement in with
respect to its hospital category (as indicated in Table 5). The green-coloured bar in these graphs
gives the national average of the ratio of medical/paramedical staff.
Ratio of doctors in position to IPHS norms:

2.50
1.42
1.40
1.39
1.38
1.24
1.18
1.17
1.16
0.99
0.98
0.95
0.94
0.94
0.93
0.93
0.88
0.86
0.86
0.81
0.79
0.79
0.78
0.75
0.75
0.72
0.69
0.67
0.66
0.64
0.63
0.63
0.62
0.61
0.56
0.53
0.48
0.48
Delh i
Haryana
Goa
Andhra Prades h
Chandigarh
Karnatak a
Jammu & Kashmir
Dadra & Nagar Haveli
Manipu r
West Bengal
Arunachal Pradesh
Rajasthan
Punjab
Odisha
Maharashtr a
Puducherr y
Ladakh
Kerala
Indi a
Sikki m
Tamil Nadu
Assam
Madhya Pradesh
Meghalaya
Chhattisgarh
Lakshadweep
Nagaland
Telangana
Tripura
Uttar Pradesh
Bihar
Mizora m
Daman & Diu
Jharkhand
Himachal Pradesh
Gujarat
A & N Islands
Uttarakhand
1
Meets
requirement
Figure 3.2.2: State/UT-wise average ratio of doctors across hospitals in position to the
IPHS norms Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
31
Ratio of staff nurses in proportion to IPHS norms:

1.41
1.11
1.07
0.95
0.91
0.88
0.85
0.85
0.84
0.79
0.77
0.75
0.73
0.69
0.68
0.62
0.60
0.60
0.59
0.57
0.57
0.56
0.56
0.54
0.54
0.54
0.53
0.50
0.50
0.48
0.47
0.47
0.47
0.43
0.35
0.32
0.32
0.27
Delhi
Chandigarh
Goa
Puducherry
Maharashtra
Madhya Pradesh
West Bengal
Dadra & Nagar Haveli
Haryana
Tripura
Andhra Pradesh
Punjab
Meghalaya
Rajasthan
Manipur
Karnataka
India
Chhattisgarh
Kerala
Assam
Bihar
Ladakh
Mizoram
Daman & Diu
Telangana
Gujarat
Arunachal Pradesh
Odisha
A & N Islands
Tamil Nadu
Lakshadweep
Sikki m
Nagaland
Uttar Pradesh
Uttarakhand
Himachal Pradesh
Jammu & Kashmir
Jharkhand
1
Meets requirement
Figure 3.2.3: State/UT-wise average ratio of nurses across hospitals in position to the
IPHS norms
Ratio of paramedical staff in proportion to IPHS norms:
4.26
3.81
3.20
3.14
2.90
2.63
2.59
2.56
2.49
2.44
2.33
2.31
2.24
1.92
1.91
1.81
1.78
1.68
1.59
1.55
1.54
1.43
1.38
1.37
1.36
1.33
1.30
1.19
1.17
1.11
1.05
1.03
1.00
0.97
0.83
0.71
0.64
0.40
Dadra & Nagar Haveli
Ladakh
Manipur
Delhi
Puducherry
Goa
Mizoram
Haryana
Tripura
Arunachal Pradesh
Andhra Pradesh
Nagaland
Punjab
Sikki m
Maharashtra
Madhya Pradesh
Chandigarh
A & N Islands
Jammu & Kashmir
Rajasthan
India
Uttar Pradesh
Odisha
Assam
Telangana
Chhattisgarh
Kerala
Bihar
Jharkhand
Himachal Pradesh
West Bengal
Tamil Nadu
Karnataka
Lakshadweep
Uttarakhand
Meghalaya
Gujarat
Daman & Diu
1
Meets
requirement
Figure 3.2.4: State/UT-wise average ratio of paramedical staff across hospitals in position
to the IPHS norms
The State/UT-wise average ratio of doctors, nurses, and paramedical staff in position to their
IPHS norm for each of the 5 bed strength categories can be found in Annexure 5. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
32
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
Victoria Hospital, Bangalore, due to its affiliation with Bangalore Medical College and Research
Institute (BMCRI), has a higher workforce of doctors. In the past years, construction of new
buildings, improvement of existing infrastructure, procurement of new modern equipment and
appointment of faculty on contract basis has played important roles in hospital’s performance
in this indicator.
Hubli KIMS District Hospital located in Dharwad district, Karnataka is well above the IPHS
recommended number of positioned doctors. The administration ensures timely recruitment
of faculty as per the sanctioned posts, awards promotions to doctors in higher cadres, and
creates new posts as per requirement. Further, through a compulsory one-year senior residency
program, Senior Residents after their MD/MS are posted regularly.
In Churachandpur District Hospital, Manipur and Shimoga District Hospital, Karnataka, prompt
monitoring, regular data collection and reporting to the Directorate has resulted in continuous
evaluation, thereby improving performance. Decentralized recruitment of paramedical staff in
a phased manner with preference to local candidates was practiced in Civil Hospitals in the
districts Rohtak and Panchkula of Haryana. They also conducted mass recruitment drives for
the posts of ANMs and staff nurses as part of a single exercise. Providing an enabling work
environment improved employee satisfaction and decreased attrition rate.
In General Hospital Ernakulam, Kerala, human resource support is provided from National
Health Mission and temporary postings through the Hospital Development Society. North Goa
District Hospital and Combined District Hospital, Kannauj, Uttar Pradesh also undertake similar
measures to ensure staff availability to meet the service demand.
King George Hospital, a tertiary care facility in Visakhapatnam, Andhra Pradesh utilizes the
patient footfall and bed strength in addition to the Medical Council of India norms as a tool to
determine and fill the required number of posts for various specialties.
“The ratio of doctors against its IPHS requirement in the district hospitals in Balangir
and Mayurbhanj is higher than most other district hospitals in the country. Here, the
district administration, in close co-ordination with the Government and the co-located
Medical College & Hospital, has provided sufficient doctors for providing Clinical/
Medical Services to the patients. Further, few super-specialisation departments were
also functionalized like Urology, Cardiology, etc. engaging contractual doctors from
corpus funds to provide super-specialization services to the patients.”
—Joint Secretary to Government, Health & Family Welfare Department,
Government of Odisha
The Aizawl Civil Hospital in Mizoram utilizes the Rogi Kalyan Samiti (RKS) and National Health
Mission (NHM) fund for the recruitment of nurses and paramedical staff. Owing to low availability
of health care staff, the hospital specifically recruited and trained technicians who could provide
services on non-working days. This has improved their performance, both in quality and quantity.
Sanjay Gandhi Memorial Hospital, Mongolpuri in Delhi North West and Lal Bahadur Shastri
Hospital in Delhi East ensure that there are frequent recruitments and that vacancies are filled
at regular intervals. Babu Jagjeevan Ram Memorial Hospital Jahgirpuri , Delhi North ensures
retention of staff through regular training and periodic monitoring. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
33
“The requirement for sufficient nursing staff was conveyed from time to time to the
higher authorities, who have vindicated the same. In spite of being located in a far-
flung area, the nursing staff have shown enthusiasm to work in this hospital, owing
to its work ethic and environment.”
—Medical Superintendent, Rao Tula Ram Memorial Hospital, Delhi South West
The staff in Deendayal Upadhyay Hospital, Delhi West is optimally distributed in all wards
to cater to the patient load. Regular monitoring of ward-wise allocations helps in quick
identification of shortfall and necessary action. JPC Hospital in Delhi North East caters to
a population of approximately 15 lakhs. The average OPD attendance is around 3000 and
daily casualty attendance is approximately 800 patients. The requirement of staff is reviewed
periodically, and their services are being utilized effectively as per the patient load of the
hospital. Hedgewar Hospital, Shahdara, Delhi has implemented a residency scheme, having in
place 51 Senior Resident doctors and 40 Junior Resident doctors. The increase in the number
of doctors is still necessary given the patient load, especially in the departments of Obstetrics
and Gynaecology and Accident and Emergency. In Guru Govind Singh Government Hospital,
Delhi West, the bed strength was increased to cater to the patient load, following which the
State sanctioned additional staff for the new services.
Recommendations to States/UTs
A periodic review of the vacancies must be conducted in all district hospitals in
order to ensure timely recruitment of doctors, nurses, and paramedical staff, thereby
contributing to better health outcomes.
States may utilize flexibilities under NHM to engage HR and assume availability of
full contingent of HR as per IPHS norms.
Nurses and paramedical staff should be well trained, and have periodic refresher
training sessions.
Bi-annual trainings for nurses and paramedical staff may be conducted at the nearest
medical college.
Hubli KIMS District Hospital, Dharwad, Karnataka Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
34
3.3 AVAILABILITY OF SUPPORT SERVICES
3.3.1 Definition of the KPI
Support services assist doctors and nurses in carrying out their responsibilities. Given that their
work is broad-based and their responsibilities are crucial in the working of a district hospital, it
is important to measure the coverage of support services while holistically assessing hospital
performance. The KPI includes the proportion of support services available in a hospital out of
the following identified 14 sevices:
i. HIS implemented in OPD
ii. HIS implemented in IPD
iii. HIS implemented in pharmacy
iv. HIS implemented–complete HIS
v. Sterilization and Disinfection
vi. Fully equipped blood bank
vii. Waste management including biomedical waste
viii. Medico-legal/postmortem Service
ix. Hospital Transport Ambulance (Basic Life Support/ Advanced Life Support)
x. Dietary services for patient
xi. Electric supply (power generation and stabilization)
xii. Drugs and pharmacy
xiii. Water supply
xiv. Refrigeration
It is calculated by dividing the number of support services available in the hospital by the total
number of support services. This KPI lies in the domain of Structure. The district hospital has
control over the indicator.
Availability of support services =
Total number of support services available
14
3.3.2 Significance of the KPI in evaluating a district hospital
Hospital support services, though not directly involved with patient care, complement the
clinical services and contribute to enhancing the reliability, hygiene, safety, and comfort of health
care environments, ultimately leading to wider and better health outcomes. Without them, the
day-to-day clinical services in a hospital would be adversely impacted. They have a crucial role
in the mitigation of clinical conditions and delivery of safe care to the patients. The overall
patient satisfaction greatly depends on the quality of hospital supportive services rendered to Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
35
him during his stay. These services usually work at the back end but their contribution in the
overall care of a patient is nowhere less than that of the clinical services. Therefore, identifying
the need for a balanced health workforce with capacity and regular skill training to provide
support services becomes important from the aspect of public health planning.
12
3.3.3 District hospital performance and associated insights
A total of 89 hospitals fulfilled the criteria of having all support services available (based on
available services/ total services score=1) belonging to States/UTs shown in Figure 3.3.1. Tamil
Nadu had the highest proportion (20.2%) of hospitals with all support services, followed by
Rajasthan (11.2%), Uttar Pradesh (10.1%), Karnataka (10.1%), and West Bengal (9%).
18
10
99
8
7
44
33
2222
111111
Figure 3.3.1: State/UT-wise distribution of the number of hospitals (n=89) with availability
of all support services
On an average, every district hospital in India has 11 support services. The State/UT-wise average
number of support services in a district hospital is depicted in Figure 3.3.2. Annexure 5 includes
the hospital category-wise graphs depicting the average number of services in each State/UT.
12 Siganporia, P., Astrakianakis, G., Alamgir, H., Ostry, A., Nicol, A. M., & Koehoorn, M. (2016). Hospital support services
and the impacts of outsourcing on occupational health and safety. Int J Occup Environ Health, 22(4), 274-282. doi:
10.1080/10773525.2016.1227035
Figueroa, R. L., & Vallejos, G. E. (2013). Supporting management of medical equipment for inpatient service in public
hospitals: a case study. Annu Int Conf IEEE Eng Med Biol Soc, 2013, 898-901. doi: 10.1109/EMBC.2013.6609646
Singh, D., Qadri, G., Kotwal, M., Syed, A., & Jan, F. (2009). Quality control in linen and laundry service at a tertiary
care teaching hospital in India. Int J Health Sci (Qassim), 3(1), 33-44.
Ukleja, A., Gilbert, K., Mogensen, K. M., Walker, R., Ward, C. T., Ybarra, J., . . . Enteral Nutrition. (2018). Standards for
Nutrition Support: Adult Hospitalized Patients. Nutr Clin Pract, 33(6), 906-920. doi: 10.1002/ncp.10204
WHO, “Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific”
https://iris.wpro.who.int/bitstream/handle/10665.1/14248/WPR-RC069-09-Hospital-Ann-2018-en.pdf Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
36
1414
13131313
131312
12121212121111
11111111101010101010101010999
9
998
4
3
Dadra & Nagar Haveli
Daman & Diu
Telangana
Tamil Nadu
Goa
Rajasthan
Haryana
West Bengal
Andhra Pradesh
Chandigarh
Madhya Pradesh
Gujarat
Karnataka
Bihar
Chhattisgarh
Himachal Pradesh
India
Maharashtra
Delhi
Jammu & Kashmir
Kerala
Tripura
Odisha
Sikkim
Punjab
Uttar Pradesh
Assam
Meghalaya
Mizora m
Manipur
Puducherry
Jharkhand
Arunachal Pradesh
Ladakh
Uttarakhand
Nagaland
A & N Islands
Lakshadweep
14
Availability of all identified services
Figure 3.3.2: Average number of support services in a district hospital by State/UT
Table 8 lists the top performing district hospitals in the country that have all support services.
13

The top performing district hospital in each State/UT for this KPI is listed in Annexure 4.
Table 8: Top performing district hospitals in the country that have all the
identified support services (N=14)
Small hospitalMid-sized hospitalLarge hospital
Baramula, Jammu and Kashmir Aizawl Civil Hospital, Aizawl
West, Mizoram
Shimoga District Hospital,
Shimoga, Karnataka
Usilampatti, Madurai,
Tamil Nadu
North Goa District Hospital,
North Goa, Goa
GH Ernakulam, Ernakulam,
Kerala
Civil Hospital, Hisar, Haryana Civil Hospital, Panchkula,
Haryana
Dindigul District Hospital,
Dindigul, Tamil Nadu
National average: 11
Range: 3–14
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
The Aizawl Civil Hospital in Mizoram makes use of the RKS fund for procuring of required
consumables and equipment (e.g., fully automatic analyzer) to provide efficient support services.
The hospital took lead in engaging a qualified firm for the annual or comprehensive maintenance
contract (AMC/CMC) of the hospital equipment. Regular skill training of the staff has played a
pivotal role in increasing efficiency of the hospital.
District Hospital Baramulla, Jammu and Kashmir has taken multiple initiatives to improve
their availability of support services. These included outsourcing various support services like
13 As 89 hospitals were found to have all support services, top three hospitals having the highest composite score
(average of the scaled values of all 10 KPIs) within each hospital category among these 89 hospitals were shortlisted.
A list of the 89 district hospitals that have all requisite support services can be found in Annexure 6. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
37
housekeeping, laundry, diet, security, bio medical waste disposal etc., using the mandate for
implementation of Kayakalp initiative. In order to ensure infection control and prevent the
reuse of linen, the hospital has implemented colour coding of bed sheets on specified days.
The e-Aushadhi software facilitates smooth coordination with the pharmacy’s supply chain
management. IEC has been effectively used for proper disposal and segregation of bio-medical
waste. The provision of working and calibrated biomedical instruments in addition to providing
diagnostics in a public–private partnership mode has led to availability of maximum possible
tests in a cost-efficient way. Specific monitoring mechanisms have also been put in place for
proper implementation of all these services.
In Haryana, the Civil Hospitals in Hisar and Panchkula have outsourced these support services
to private service providers selected through tenders. This has greatly resulted in mitigation of
infection and delivery of care to patients, especially during the COVID-19 pandemic.
“We have co-ordinated all available funds, including government
funds, NHM funds, MP-MLA funds, CSR funds, and Hospital
Development Society (HDS) Funds in providing all 14 support
services to the sick and needy. Sponsor meetings were arranged
for accumulating CSR funds and the proposals were reviewed and
approved by the HDS for further implementation.”
—Deputy Director of Health Service,
General Hospital Ernakulam, Kerala
Across the country, similar interventions are undertaken in North Goa District Hospital, Goa;
Shimoga District Hospital, Karnataka; Dindigul and Usilampatti District Hospitals, Tamil Nadu.
Regular monitoring of the services and prompt appointment of specialists, trained nurses, and
paramedical staff. NQAS served as a reference point for implementing and sustaining quality
standards.
Recommendations for district hospitals
aWherever medical colleges are located near a district hospital and have additional
or excess capacity in terms of support services, cross utilisation may be encouraged.
aEach of these services has had a significant role to help abort the ‘chain of transmission’
of COVID-19 infection across various patient care areas in the hospital, while providing
them supportive services
.14

aCentral and State funds may be utilized in the procurement of services.
14 Sodhi, J., Satpathy, S., & Arora, P. (2020). Role of hospital supportive services in COVID-19. International Journal of Infection
Control, 16(3). doi: 10.3396/ijic.v16i3.20499 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
38
3.4 AVAILABILITY OF CORE HEALTH CARE SERVICES
3.4.1 Definition of the KPI
This KPI belongs to the domain of Structure and comes under the control of the State. This
indicator includes the core medical competencies of any given district hospital. Its inclusion
incorporates the breadth of health care services provided.
It is the proportion of 14 recommended specialties from the following list that are functional
against the total number of specialties required:
i. General Medicine
ii. General Surgery
iii. Obstetric & Gynaecology
iv. Paediatrics including Neonatology (as required for level II SNCU)
v. Emergency (accident & other emergency) (Casualty 24X7 basis)
vi. Critical Care (ICU)
vii. Anaesthesia
viii. Ophthalmology
ix. ENT
x. Dermatology and Venereology (Skin & VD) RTI / STI
xi. Orthopedics
xii. Dental care
xiii. Public Health Management
xiv. Radiology
It is calculated by dividing the number of core health care services available in the hospital by
the total number of core health care services the hospital is expected to maintain. This KPI lies
in the domain of Structure. The State has control over the indicator.
Availability of core health care services =
Total number of core
health care services available
14
3.4.2 Significance of the KPI in evaluating a district hospital
Each health care specialty at a hospital has its own role and significance in delivering patient
care. The critical care services focus on resuscitating unstable patients and allowing time for
recovery or the effect of specific therapies to improve outcomes and prevent death. The hospital
care department is mostly dependent upon the emergency services for providing medical
and surgical provisions for the patients in need of immediate care and attention. Emergency
Care in fact serves as the first point of contact for many patients. Especially when there are Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
39
logistical or financial barriers to health care access, people may present for care only when
they are symptomatic with acute illness or injury. As the number of patients visiting ER has
been increasing from day to day, the reliance on ER care is now more comprehensive than ever.
This dependence is mostly because it remains open all round the clock and can never deny
admission to a patient.
15
A hospital providing all specialties gives the patient an opportunity to receive a wider range
of expert inputs under one roof, all of which combine to create a course of treatment that will
offer the best outcome.
16
3.4.3 District hospital performance and associated insights
A total 101 out of 707 hospitals fulfilled the criteria of having all 14 functional specialties belonging
to States/UTs shown in Figure 3.4.1. Tamil Nadu had the highest proportion (16.8%; 17/101) of
hospitals with all functional specialties, followed by Karnataka (13.9%; 14/101), West Bengal (10.9;
11/101%), and Kerala (9.9%; 10/101).
17
14
11
10
9
8
55 5
4
3
2
11111111
Figure 3.4.1: State/UT-wise distribution of number of hospitals (n=101) with all 14 functional
core health care services
15 Schell, C. O., Gerdin Warnberg, M., Hvarfner, A., Hoog, A., Baker, U., Castegren, M., & Baker, T. (2018). The global need
for essential emergency and critical care. Crit Care, 22(1), 284. doi: 10.1186/s13054-018-2219-2
16 Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding:
A systematic review of causes, consequences and solutions. PLoS One, 13(8), e0203316. doi: 10.1371/journal.
pone.0203316 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
40
14
141413
13131313
1313
12121212121111111111
11101010101010
101010
9998
8
7
5
3
Dadra & Nagar Haveli
Goa
Telangana
West Bengal
Tamil Nadu
Rajasthan
Chandigarh
Ladakh
Himachal Pradesh
Andhra Pradesh
Delhi
Punjab
Karnataka
Haryana
Kerala
Madhya Pradesh
Maharashtra
Puducherry
Gujarat
Odisha
Jammu & Kashmir
Bihar
India
Assam
Chhattisgarh
Nagaland
Tripura
Daman & Diu
Mizora m
Sikkim
Meghalaya
Jharkhand
Arunachal Pradesh
Manipur
Uttar Pradesh
Uttarakhand
A & N Islands
Lakshadweep
14
Availability of all identified services
Figure 3.4.2: State/UT-wise average number of available core health care services in a
district hospital
Table 9 lists the top performing district hospitals in the country that have all core health
care services.
17
The top performing district hospital in each State/UT for this KPI is listed in
Annexure 4.
Table 9: Top performing district hospitals in the country that have all the
identified core health care services (N=14)
Small HospitalMid-Sized HospitalLarge Hospital
Kulithalai, Karur,
Tamil Nadu
Aizawl Civil Hospital,
Aizawl West, Mizoram
Shimoga District Hospital,
Shimoga, Karnataka
Government General Hospital,
Mahe, Puducherry
Balangir, Odisha Hubli KIMS District Hospital,
Dharwad, Karnataka
DH Tirur, Malappuram, Kerala Sanjay Gandhi Memorial
Hospital Mangolpuri,
North West, Delhi
GH Ernakulam, Ernakulam,
Kerala
National average: 10 Range: 1–14
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
Aizawl Civil Hospital utilized the facility’s RKS fund for infrastructure development and
engagement of additional manpower which widely augmented the availability of proper intensive
care unit (ICU), newborn intensive care unit (NICU), geriatric care unit, dental services among
others. These initiatives have resulted in higher footfall, efficient use and reduced referrals from
the hospital.
17 As 101 hospitals were found to have all core health care services, top three hospitals having the highest composite score (average
of the scaled values of all 10 KPIs) within each hospital category among these 101 hospitals were shortlisted. A list of these 101
hospitals can be found in Annexure 6. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
41
Balangir District Hospital in Odisha provides various specialized and non-specialized clinical
OPD services along with 24×7 causality and emergency services. The hospital is diligently
providing the 14 identified core healthcare services. The IPD services are also very well manned
with trained staff nurses present round the clock along with the patients. The ancillary services
of the hospital are also very good like the hospital provides mechanized housekeeping services,
smart security services with CCTV cameras, mechanized laundry services, help desk services
(May I Help You), free diet services, proper waste management services, central registration
services, free drug services, free investigation services, free high-end diagnostic services like CT
scan, dialysis, etc. Interventions undertaken by Government General Hospital Mahe, Puducherry
are of a similar nature.
In DH Tirur in Mallapuram district of Kerala the main initiative was infrastructure development,
especially in the women and child hospital wings. With a dedicated team, skilled doctors and
supporting staff and support from local self-government, that is, the District Panchayat, they
were able to secure financial support from the LSGD, MLA and MP. More importantly, the core
health care services were also catered to through support from NRHM.
General Hospital Ernakulam, Kerala and Shimoga District Hospital, Karnataka conduct regular
monitoring and review to ensure availability of services at all times. Hubli KIMS District Hospital
in Dharwad, Karnataka has constituted a quality circle team for each department with regular
internal assessment of the various service provisions as per the guidelines of LaQshya and
NQAS. They execute targeted and time-bound action plans for the gaps in various service
provisions.
Given that Sanjay Gandhi Memorial Hospital in Mangolpuri, North West Delhi caters to a
large population of 25 lakh and has a huge inflow of patients, there is a constant need to
ensure the availability and functionality of these services. These are ensured by improving
infrastructure, manpower, and machinery at the regular intervals. Quality initiatives were taken
up to ensure optimal delivery of services. Obtaining NQAS certification also ensured maintaining
the functionality of all available services and monitoring of same at regular intervals — the same
was observed in DH Kulithalai in Karur, Tamil Nadu.
Recommendations for States/UTs
aDistrict hospitals may be linked to the nearest medical college by employing a hub
and spoke distribution model, which is a cost-effective and time-saving transport
and service distribution mechanism.
18
aPeriodic review and reporting on the quality of services is a good practice to identify
the gaps and take necessary actions.
aService delivery of the essential components under this indicator may be improved
by adhering to the guidelines put forth by NQAS.
18 Elrod, J.K., Fortenberry, J.L. The hub-and-spoke organization design: an avenue for serving patients well. BMC
Health Serv Res 17, 457 (2017). https://doi.org/10.1186/s12913-017-2341-x Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
42
3.5 AVAILABILITY OF DIAGNOSTIC TESTING SERVICES
3.5.1 Definition of the KPI
Diagnostic testing is generally performed to screen for, monitor, and detect diseases. Early
detection and proper treatment depend on establishing a correct diagnosis. This is often aided
by laboratory, radiology, and imaging services. Their inclusion in performance assessment is
particularly important given that they have the potential to change the pre-test probability of
disease into a post-test certainty that is more definitive, hence providing a better information
set of the patient to the doctor. However, this indicator excludes testing done via referral
laboratories. For this KPI, the following 14 diagnostic testing services were identified:
i. Urine Analysis
ii. Stool Analysis
iii. PAP smear
iv. Sputum
v. Haematology
vi. Microbiology
vii. Serology
viii. Biochemistry
ix. Cardiac Investigations
x. Ophthalmology
xi. ENT
xii. Radiology
xiii. Endoscopy
xiv. Physiology (Pulmonary function test)
It is calculated by dividing the number of diagnostic testing services available in the hospital
by the total number of diagnostic testing services the hospital is expected to maintain (i.e. all
14 services). This KPI also lies in the domain of Structure. The State exercises control over it
rather than the district hospital.
Availability of diagnostic testing services =
Total number of diagnostic
testing services available
14
3.5.2 Significance of the KPI in evaluating a district hospital
About 60–70 per cent of medical treatments are based on laboratory diagnostic tests, thus
making it one of the most indispensable segments in the health care industry. Diagnostics may
not completely aid in curing the disease but can go a long way in this direction. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
43
District hospitals are secondary level health care providers in India with basic specialties, though
IPHS has laid down norms with respect to the number of specialties, types of treatments, and
requirement for diagnostic services, most States/UTs in India are not able to adhere to the same
for want of one or more factors. It is observed that in most public hospital laboratories the
diagnostic centres are not adequately equipped with equipment, technology, and manpower.
These lacunae in the system
19
adversely affect the efficiency and operation of the hospital by:
Delaying the treatment procedure and inhibiting the continuity of the treatment
Restricting the treatment capacity of the medical practitioners
Allowing for judgmental errors on the condition of the patients due to absence of
proper diagnostics
Lack of appropriate diagnostic testing service may adversely affect the treatment
outcomes
This also demotivates the medical practitioners as they are not able to extend their services
to their fullest capacity.
The importance of the diagnostic testing services at public health facilities like district hospital
is to ensure availability and access so as to reduce out of pocket expenditure incurred by
patients on diagnostics.
3.5.3 District hospital performance and associated insights
Only 21 hospitals belonging to States/UTs shown in Figure 3.5.1 fulfilled the criteria of having
all diagnostic testing services available (based on available services/ total services score=1).
Karnataka had the highest proportion (28.6%) of hospitals with all support services, followed
by Telangana (19%), Andhra Pradesh (14%), and Gujarat (9.5%).
6
4
3
2
111111
Figure 3.5.1: State/UT-wise distribution of number of district hospitals (n=21) with all 14
functional diagnostic testing services available
19 ICRA Management Consulting Services Ltd, “Prefeasibility Report for Setting up of Diagnostic Centre at District
Hospital Dharwad” 2013 http://abhinavinfo.com/idd_new/assets/pdf/pre_feasibility_studies/70b_DiagnosticLab_
Dharwad.pdf Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
44
1414
13
1212
12111111111110101010101010
9999999888888887
77
66
Dadra & Nagar…
Telangana
Goa
Andhra Prades h
Chandigarh
Ladakh
Tamil Nadu
Delhi
Punjab
Gujarat
Karnatak a
Mizoram
Rajasthan
Haryana
Sikkim
Maharashtr a
Himachal Pradesh
West Bengal
Kerala
Madhya Pradesh
Jammu & Kashmir
Puducherr y
Odisha
India
Assam
Chhattisgarh
Nagaland
Tripura
Daman & Diu
Jharkhand
Lakshadweep
Manipur
Bihar
Meghalaya
Arunachal Pradesh
Uttar Pradesh
A & N Islands
Uttarakhand
14
Availability of all identified services
Figure 3.5.2: State/UT-wise average number of available diagnostic testing services in a
district hospital
Table 10 lists the top performing district hospitals in the country that have all diagnostic
testing services.
20
The top performing district hospital in each State/UT for this KPI is listed in
Annexure 4.
Table 10: Top performing district hospitals in the country that have all or
most of the identified diagnostic testing services (N=14)
Small hospitalMid-sized hospitalLarge hospital
Tandur, Vikarabad,
Telangana
Aizawl Civil Hospital,
Aizawl West, Mizoram
Shimoga District Hospital,
Shimoga, Karnataka
Pt. Madan Mohan Malviya
Hospital, South, Delhi
DH Khammam, Khammam,
Telangana
Hubli KIMS District Hospital,
Dharwad, Karnataka
Baramula DH, Baramula,
Jammu and Kashmir
District Hospital Gadchiroli,
Gadchiroli, Maharashtra
Kilpauk Hospital, Chennai,
Tamil Nadu
National average: 9
Range: 0–14
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
Pandit Madan Mohan Malviya Hospital in South Delhi district, Delhi installed different equipment
such as five-part haematology analyzer, fully automatic biochemistry analyzer, CR System for
300 MA X-ray machine, etc. The procurement process for equipment was streamlined through
Government e-Marketplace (GeM). Microbiology services were strengthened through installation
of Biosafety Cabinet for managing biomedical waste (BMW) generated in the laboratory and a
BMW sterilizer was also installed. At the same time, training and re-training of staff was done
20 As 21 district hospitals were found to have all diagnostic testing services, top three hospitals having the highest composite score
(average of the scaled values of all 10 KPIs) within each hospital category among these 21 hospitals were shortlisted. A list of
these 21 hospitals can be found in Annexure 6. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
45
regularly for ensuring optimal utilization of the equipment. This led to improvement in usage,
regular maintenance of the equipment, and reduction of down time. The turnaround time for the
investigation reduced and the hospital could efficiently manage the increasing load of patients.
New investigations like HbA1C, Serum iron, serum Amylase and serum Ca & Pot were able to
be conducted and overall patient satisfaction improved. 
District Hospitals Kammam (Khamman district) and Tandur (Vikarabad district) have all the
identified diagnostic testing services. While the hospitals do take proactive measures to
ensure the availability and functionality of the required services, the recently launched T-Hubs
(Telangana Diagnostics) initiative of the Government of Telangana has been instrumental in
establishing the requisite services in every district of the state under NHM, which has also led
to a reduction in out-of-pocket expenditure for the patients.
Karnataka Infrastructure Development Department conducted a prefeasibility study for setting
up a diagnostic centre at Dharwad District Hospital.21 Such interventions throw light on the
gaps and requirements to be fulfilled and help addressing the shortfall in an optimal manner.
Hubli KIMS DH and Shimoga DH have taken such adequate measures to ensure the availability
of all services.
DH Baramulla in the UT of Jammu and Kashmir ensured availability through various measures:
implementation of Free Diagnostic Initiative with support from NHM and the pro-active role of
hospital management has ensured uninterrupted supply of test kits, reagents and consumables;
streamlining of Jammu and Kashmir Medical Services Corporation Ltd. (JKMSCL) has improved
the supply chain mechanism and timely procurement of bio-medical equipment, reagents and
consumables; for appropriate calibration and functioning of biomedical equipment, Bio-Medical
Equipment Maintenance and Management program is implemented through PPP mode.
After the empanelling of the hospital under the CMCHIS of Tamil Nadu Government and AB-PMJAY
of the Central Government, Kilpauk Hospital, Chennai was able to perform major diagnostic
procedures and the amount earned was used to improve infrastructure and consumables. Due to
State and Central Government empanelment for insurance schemes, many diagnostic services
(like dynamic MRI, CT scan, digital mammogram, RT PCR for Microbiology, new born OAE (Oto
acoustic emission screening), etc.) are performed free of cost to patients. The hospital used
to face issues primarily in training; for new investigations like RT PCR or mammogram biopsy,
the personnel were asked to undergo immediate training. Lack of availability of consumables
required to perform investigation was tackled by fund raising using the insurance scheme.
Gadchiroli District Hospital, Maharashtra has witnessed significant development. In 1994, the
hospital was a 100-bedded hospital. It had a small laboratory, inadequate equipment, reagents,
kits and vacant posts of Lab Technologists. Medical Officers/ specialists were reluctant to join
due to the inaccessibility of the district. Presently, the hospital has 286 functional beds; vacancies
for medical officers and specialists, pathologists and microbiologists, and trained technicians are
filled through NHM, NCD, IPHS, and State provisions. Laboratories have been strengthened with
procurement and supply of equipment, machines, instruments, kits, lab reagents, etc. Calibration
of instruments and equipment are done regularly to minimise laboratory errors. There are 14
laboratories and 2 mobile pathology units. The State has outsourced laboratory investigations
21 ICRA Management Consulting Services Ltd, “Prefeasibility Report for Setting up of Diagnostic Centre at District
Hospital Dharwad” 2013 http://abhinavinfo.com/idd_new/assets/pdf/pre_feasibility_studies/70b_DiagnosticLab_
Dharwad.pdf Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
46
to HLL Labs for all hospitals in the district, which allowed for free investigations and cashless
treatment of poor villagers and tribals.
Recommendations to States/UTs
Hiring dedicated paramedical staff to maintain service records and handle laboratory
equipment would help in timely identification of shortfall of services.
Often diagnostic facilities have breakdowns of necessary equipment as the staffers
are not provided necessary training and skills required to run these state-of-the-art
equipment. Regular training of staff whenever new equipment is purchased is crucial,
so that expensive diagnostic equipment is adequately taken care of.
External agencies may be roped in for Bio-Medical Equipment Maintenance and
Management in order to reduce downtime of dysfunctional equipment and ensure
regular upkeep of the hospital equipment.
Provisions under the National Health Mission and State Health Department schemes
may be utilized to procure high-end equipment such as automatic analyzers, CT
Scan machines, advanced USG machines, ELISA readers, digital X-rays, etc. and the
supporting manpower strengthening may be facilitated through the DNB program.
Kulithalai Government Hospital, Karur, Tamil Nadu Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
47
3.6 BED OCCUPANCY RATE
3.6.1 Definition of the KPI
This KPI is classified under the domain of Output and falls under the control of the district
hospital. It reflects efficiency in the use of hospital beds. The bed occupancy rate is calculated
by dividing the total number of inpatient bed days added for a year by the number of functional
beds available in the hospital multiplied by 365 days. The ratio is multiplied by 100 to express
the figure in percentage. The number of inpatient bed-days refers to the sum of all inpatients at
midnight. The bed occupancy rate shows the effective utilization of available beds in a hospital.
Bed occupancy rate =
Total number of inpatient
bed days added for a year
× 100
Total Functional Beds × 365
3.6.2 Significance of the KPI in evaluating a district hospital
A high bed occupancy rate reflects good quality of services, infrastructure, trained staff, patient
care and satisfaction provided by the facility. From the point of view of public health planning,
the bed occupancy rate helps in identifying facilities with optimal resource utilization rate.
This further highlights the need of the facility to balance demand and supply side factors. The
indicator can be used to assess hospital performance and recognize areas for improvement.
The reasons for the respective level of utilization can be identified and future decisions can be
made based upon this. This indicator can be further used for comparison among facilities at
the state/region/national level and find their efficiency.
22
Very low bed occupancy rates (<42%) at primary health care level has indicated lack of medically
trained personnel, sporadic supply of drugs and other medical supplies and a complete
breakdown in the transfer and referral system.
23
High bed occupancy rate is an indicator of
health system under pressure. Hospitals cannot operate at 100% occupancy, as spare bed
capacity is needed to accommodate variations in demand.
24
Lack of available beds increase
delays in emergency departments, cause patients to be placed on clinically inappropriate wards
and increase the rate of hospital-acquired infections. This also puts staff under pressure to free
up beds that can pose a risk to patient safety.
25
22 World Bank (1993). Public hospitals in developing countries (available at: https://documents1.worldbank.org/
curated/en/919871468740383421/pdf/multi0page.pdf)
Aloh, H.E., Onwujekwe, O.E., Aloh, O.G., & Nweke, C.J. (2020). Is bed turnover rate a good metric for hospital
scale efficiency? A measure of resource utilization rate for hospitals in Southeast Nigeria. Cost Effectiveness and
Resource Allocation, 18(21). doi: 10.1186/s12962-020-00216-w
23 Okello, D., Guwatudde, D., Sebina, A., & Lubanga, R. (1994). Low bed occupancy rates in Uganda’s peripheral health
units: is it a policy problem? East African Medical Journal, 71(9), 601–603.
24 Madsen, F., Ladelund, S., Linneberg, A. (2014). High levels of bed occupancy associated with increased inpatient
and thirty-day hospital mortality in Denmark. Health Affairs, 33(7). doi: 10.1377/hlthaff.2013.1303
Friebel, R., Fisher, R., Deeny, S. R., Gardner, T., Molloy, A., & Steventon, A. (2019). The implications of high bed
occupancy rates on readmission rates in England: A longitudinal study. Health Policy, 123(8), 765–772. doi: 10.1016/j.
healthpol.2019.06.006
25 Rezaei, S., Hajizadeh, M., Nouri, B., Ahmadi, S., Rezaeian, S., Salimi, Y., & Karyani, A. K. (2019). Iranian hospital
efficiency: a systematic review and meta-analysis. International Journal of Health Care Quality Assurance, 32(2),
385–397. doi: 10.1108/IJHCQA-03-2018-0067 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
48
3.6.3 Juxtaposition of the KPI with recommended norms
A bed occupancy rate of 80-85% is considered ideal, at which a facility is designed to operate
most efficiently. IPHS guidelines, 2012 recommend the optimum bed occupancy in district
hospitals to be 80%.
3.6.4 District hospital performance and associated insights
Given that government hospitals cannot deny admission to patients, the bed occupancy rate
in many hospitals (n=123) were found to exceed 100% occupancy rate. In the framework used
in this analysis, bed occupancy rate is given a maximum limit of 90, and values above 90 are
considered as 90. Figure 3.6.1 depicts the average bed occupancy rate in a district hospital by
State/UT. The top performing district hospital in each State/UT for this KPI is listed in Annexure
4, while the average bed occupancy rate in small, mid-sized, and large hospitals by State/UT
are illustrated in Annexure 5.
90.00
90.00
83.42
83.15
80.07
75.34
74.64
74.07
73.34
72.79
68.41
65.68
64.85
60.57
60.09
59.81
59.60
57.28
57.17
56.50
56.2 8
54.92
52.49
48.62
48.01
45.41
44.48
44.06
37.96
33.95
33.47
33.35
32.82
31.01
26.39
23.98
22.73
21.38
Chandigarh
Dadra & Nagar Haveli
Maharashtra
West Bengal
Andhra Pradesh
Punjab
Delhi
Telangana
Tamil Nadu
Haryana
Mizoram
Odisha
Madhya Pradesh
Assam
Kerala
Meghalaya
Sikkim
Rajasthan
India
Tripura
Bihar
Karnataka
Chhattisgarh
Gujarat
Jammu & Kashmir
Uttar Pradesh
Uttarakhand
Puducherry
Jharkhand
Goa
A & N Islands
Daman & Diu
Himachal Pradesh
Ladakh
Nagaland
Manipur
Lakshadweep
Arunachal Pradesh
90
Ideal bed occupancy rate
Figure 3.6.1: Average bed occupancy rate (%) of a district hospital by State/UT
Of 707 hospitals, a total of 182 hospitals had bed occupancy rate of 90% or higher. Figure 3.6.2
shows the State/UT-wise percentage distribution of these 182 hospitals. Uttar Pradesh (14.8%)
had the highest proportion of hospitals with bed occupancy rate greater than or equal to 90%,
followed by Madhya Pradesh (10.9%), Maharashtra (8.2%), Odisha (8.2%), West Bengal (7.1%),
and Andhra Pradesh (5.5%). Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
49
27
20
1515
13
10
9
88
6666
44 4
33 3
222
111111
Uttar Pradesh
Madhya Pradesh
Maharashtra
Odisha
West Bengal
Andhra Pradesh
Punjab
Delhi
Haryana
Bihar
Karnataka
Rajasthan
Tamil Nadu
Chhattisgarh
Gujarat
Uttarakhand
Jammu & Kashmir
Meghalaya
Telangana
Assam
Jharkhand
Kerala
Chandigarh
Dadra & Nagar Haveli
Himachal Pradesh
Mizoram
Sikkim
Tripura
Figure 3.6.2: State/UT-wise number of district hospitals (n=182) with bed occupancy rate
of 90% or higher
Rajasthan
Gujarat
Ladakh
Maharashtra
Odisha
Bihar
Madhya Pradesh
Uttar Pradesh
Karnataka
Tamilnadu
Assam
Telengana
Andhra Pradesh
Chhattishgarh
Punjab
Jharkhand
West Bengal
Haryana
Uttarakhand
Meghalaya
Kerala
Arunachal Pradesh
Himachal Pradesh
Jammu and Kashmir
Manipur
Mizoram
Nagaland
Tripura
Sikkim
Goa
Delhi
Andaman & Nicobar
Puducherry
Daman and Diu and Dadra and Nagar Haveli
Chandigarh
Lakshadweep
Legend
India_State_Boundary
% of DHs with at least 80% bed occupancy
0.0
0.0 - 22.2
22.2 - 36.0
36.0 - 66.7
66.7 - 100.001 75 350 525 70087.5
Miles
Figure 3.6.3: Percentage of district hospitals in each State/UT that have a bed occupancy
rate of at least 80 per cent Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
50
As mentioned before, IPHS 2012 recommends a bed occupancy rate of at least 80%. The
percentage of district hospitals in each State/UT that meet this criterion is illustrated in Figure
3.6.3. Table 11 lists the top performing district hospitals in the country by hospital size category
with the highest bed occupancy rate of up to 100%.
26
Table 11: Top performing district hospitals in the country that have a bed
occupancy rate up to 100%
Small HospitalMid-Sized HospitalLarge Hospital
Paralakhemundi, Gajapati,
Odisha
(100% bed occupancy rate)
Balangir,
Odisha
(100% bed occupancy rate)
M. R. Bangur DH & SSH, South
Twenty Four Parganas, West Bengal
(99.20% bed occupancy rate)
Bandipora, Jammu
and Kashmir
(100% bed occupancy rate)
DH Tenali, Guntur, Andhra
Pradesh
(100% bed occupancy rate)
DH SDN Hospital,
Shahdara, Delhi
(95.20% bed occupancy rate)
Deogarh,
Odisha
(100% bed occupancy rate)
DH Vidisha, Vidisha, Madhya
Pradesh
(100% bed occupancy rate)
Shimoga District Hospital, Shimoga,
Karnataka
(93.44% bed occupancy rate)
National average: 66%
Range: 0–365.2%
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
M R Bangur Hospital, situated in the South 24 Parganas of West Bengal, categorized under large
hospitals, attribute their high performance to a no refusal to admissible patient policy. It started
functioning with a bed capacity of 500 and has gradually increased it to 625 over the years. In
addition to availability of multi-specialty services, the hospital has a 24X7 Pharmacy Service,
Blood Bank Service and PPP diagnostic Services like Echo, MRI, CT, Laboratory, 60-bedded
dialysis among others. Numerous efforts to keep waiting time and referrals to a minimum,
hygiene management, 24x7 grievance redressal cell have improved the performance of the
district hospital.
DH Bandipora, a newly upgraded District Hospital, is located in the northern border district
of Kashmir valley. The administration undertook key measures to utilize the limited space and
staff of the hospital, such as incorporating a time bound initial assessment and reassessment
schedule resulting in a timely discharge policy for the patients. Maintenance and upkeep of
medical equipment also paved way for decreased turn-around time for test results. All this has
led to a reduction in the average length of stay in the hospital and creation of space for new
patients. All these measures were diligently monitored and followed. Furthermore, new staff
positions were sanctioned which have increased the footfall and narrowed down the doctor/
nurse to patient ratio. Strong advocacy and IEC regarding availability of services was done for
improving admissions.
26 In case two or more hospitals had identical bed occupancy rates, their composite score (average of the scaled
values of all the 10 KPIs) was referred to, and the hospital with a higher composite score was regarded as a top
performing hospital for this particular indicator. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
51
Dynamic steps were undertaken by the Head of Departments in DH Tenali, Andhra Pradesh to
improve patient services. Overall, they ensured quality patient care provided by the doctors
and nursing staff, early discharges of stable patients, increased day care procedures and
major surgeries, prompt attendance of doctors in trauma care and emergency services, and
simultaneously provision of quality diet, hygiene, and good sanitation facilities.
DH Vidisha, a mid-sized hospital in Madhya Pradesh, ensured that the infrastructure met NQAS
and Kayakalp standards of quality, facilitated regular training for doctors and staff, developed
standard operating protocols, improved quality of care, patient safety, all of which consequently
reduced hospital acquired infection rate and improved patient satisfaction. These measures also
helped ensure maximum bed occupancy.
Two small and one mid-sized hospital in Odisha have high bed occupancy rates in India. In
Balangir District Hospital, the patient footfall has been increasing every day and has touched
approximately 9,000 to 10,000 inpatient bed days per month. Patients cannot be cured of
disease only with medicine; there is also need of appropriate ambience/ improved facilities. The
staff are pushed to follow respectful patient care. District Headquarter Hospital Paralakhemundi
utilizes the Ishikawa (Fishbonc Diagram) technique for brainstorming and mind mapping to
discover the cause-and-effect relationship of any identified underlying problem to increase
patient satisfaction during their stay in the hospital. The focus shifted towards cleanliness
of wards, installation of air conditions, clean beds, adequate lighting, clean toilets, providing
mosquito nets, blankets, cooked balanced diet, Aahar scheme
27
in hospital premises for the
attendants accompanying the patients. In District Headquarter Hospital, Deogarh too the
aforesaid key measures on housekeeping and cleaning upkeep, staff behaviour, laundry service,
availability of staff, counselling of patients, and the availability of patient centric services free
of cost have played a key role in ensuring a high bed occupancy rate.
Shimoga District Hospital, Karnataka is supervised by eminent specialists who ensure that the
hospital is well-equipped with all new technology, that all the specialities in the hospital are
operational 24×7, and that the entire staff is well-trained with respect to specialities. Patients
from within the district and surrounding districts come for treatments in large numbers. The
hospital therefore appointed specialists accordingly, and proactively filled any vacancies for
nursing and paramedical staffs. A new wing was constructed to cater to cardiology patients. The
OTs were upgraded with modern equipment and empanelled with Ayushman Bharat Schemes,
which is very helpful in giving free service to the poor people. Paperwork was minimized by
digitizing all work All of this contributed to an increase in OPD services, IPD services, and
emergency services.
“In SDN Hospital in Delhi Shahdara, shortage of manpower and HR vacancies used
to result in high workload on the existing staff, conversely resulting in longer waiting
periods and delayed admissions. However, this was addressed through timely
recruitment of staff and we were able to maintain high bed occupancy rates. During
the COVID-19 pandemic, the bed occupancy rate was as high as 110% with a 75%
patient satisfaction score.”
—Chief Medical Officer, SDN Hospital, Shahdara, Delhi
27 Aahar scheme is a food subsidisation program run by the Government of Odisha to provide cheap lunch to the
urban poor. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
52
Recommendations to district hospitals
Ensuring 24×7 availability of support services, diagnostic testing facilities, pharmacy,
and well-planned shifts of medical and paramedical staff would contribute to an
optimal bed occupancy and resource utilization.
Regular maintenance and upkeep of medical equipment reduces its downtime and
increases its optimal utilization.
Periodic monitoring of processes will help analyse gaps and acts on addressing it
thereby eventually ensuring smooth processes, reduced waiting time, and redressal
of any other administrative lacunae.
Timely recruitment and prompt steps to fill HR vacancies will allow for larger numbers
of patient examinations.
Kulithalai Government Hospital, Karur, Tamil Nadu Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
53
3.7 C-SECTION RATE
3.7.1 Definition of the KPI
This KPI lies in the domain of Output. The district hospital exercises control over this indicator.
It is calculated by dividing the number of Cesarean section deliveries performed in a year with
the total number of deliveries in the year. The figure is multiplied by 100 in order to express it
in percentage.
C-section rate =
()
Number of C-section deliveries
performed in the year
× 100
Total number of deliveries in the year
Normal + Assisted Deliveries + C Section
3.7.2 Significance of the KPI in evaluating a district hospital
Caesarean section (C-section) was introduced in clinical practice as a lifesaving procedure both
for the mother and the baby. C-section deliveries are absolutely critical to save lives in situations
where vaginal deliveries would pose risks, so all health systems must ensure timely access for
all women when needed. However, not all the C-sections carried out at the moment are needed
for medical reasons. Unnecessary surgical procedures can be harmful, both for a woman and
her baby. Both extremely low and extremely high rates of C-section deliveries pose adverse
effects within maternal health care,
28
and therefore, observing the trend of the C-section rate
is crucial in identifying its reasons.
C-section deliveries are associated with longer hospital stays, delayed initiation of breastfeeding
and higher out-of-pocket expenses due to longer duration of stay.
29
A high rate of C-section
deliveries can be associated with both short- and long-term risks which can extend for many
years beyond the current delivery and affect the health of the woman, her child, and future
pregnancies.
30

3.7.3 Juxtaposition of the KPI with global standards
Globally, there is an ongoing debate on what should be the optimal rates of C-section deliveries.
As per a WHO report, “At population level, C-section rates higher than 10% are not associated
28 Lee, H-Y., Kim, R., Oh, J., & Subramanian, S. V. (2021). Association between the type of provider and Cesarean
section delivery in India: A socioeconomic analysis of the National Family Health Surveys 1999, 2006, 2016. doi:
10.1371/journal.pone.0248283
29 Dongre, A., Surana, M. (2018). C-section deliveries and the role of the private health sector in India (available at:
https://www.ideasforindia.in/topics/productivity-innovation/c-section-deliveries-and-the-role-of-the-private-health-sector-in-india.
html)
30 World Health Organization. (2015). WHO Statement on Cesarean Section Rates. (available at: http://apps.who.int/
iris/bitstream/10665/161442/1/ WHO_RHR_15.02_eng.pdf) Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
54
with reductions in maternal and newborn mortality rates.”
31
However, there is no evidence
showing the benefits of C-section delivery for women who do not require the procedure. A
district hospital would receive multiple complicated cases of pregnancy that require performing
C-section surgery. The WHO states that every effort should be made to provide caesarean
sections to women in need, rather than striving to achieve a specific rate.
3.7.4 District hospital performance and associated insights
As mentioned above, cases that come to district hospitals are often emergency or complicated
cases. A surgical procedure cannot be avoided in such cases.
It is interesting to note the average percentage of C-section deliveries being performed in a
district hospital in India. Figure 3.7.1 gives a State/UT-wise distribution of this average, while the
same distribution by hospital size can be seen in Annexure 5. On an average, 20.8% C-section
deliveries are performed in a district hospital in India. In small hospitals having up to 200 beds
this average stands at 16.03%, mid-sized hospitals (201-300 beds) have an average of 25.08%,
while large hospitals (with more than 300 beds) have an average C-section rate of 31.3%.
55.15
53.51
48.79
44.22
43.46
42.74
39.76
38.82
37.09
35.76
34.69
34.46
33.70
33.10
32.21
25.48
24.01
23.22
21.14
20.80
19.69
18.99
17.50
17.38
16.47
15.87
14.64
14.58
12.43
12.21
11.48
11.12
10.73
10.58
8.35
5.85
5.36
5.13
Tamil Nadu
Telangana
Daman & Diu
Lakshadweep
Puducherr y
Andhra Prades h
Dadra & Nagar Haveli
Karnatak a
Goa
Jammu & Kashmir
Assam
Punjab
Kerala
West Bengal
Chandigarh
Maharashtr a
Ladakh
Odisha
Nagaland
India
Mizoram
Delhi
Gujarat
Haryana
Himachal Pradesh
Arunachal Pradesh
Madhya Pradesh
Tripura
Sikkim
Rajasthan
A & N Islands
Jharkhand
Chhattisgarh
Manipur
Uttar Pradesh
Bihar
Uttarakhand
Meghalaya
Figure 3.7.1: Average percentage of C-section deliveries in a district hospital by State/UT
Figure 3.7.2 represents the count of district hospitals in each State/UT with C-section rate of
less than 35%. Of the 707 hospitals, 450 district hospitals performed less than 35% C-section
deliveries.
31 World Health Organization. WHO Statement on Cesarean Section Rates, 2015, Available from: http://apps.who.
int/iris/bitstream/10665/161442/1/ WHO_RHR_15.02_eng.pdf.
Souza J, Gulmezoglu A, Lumbiganon P, et al. Cesarean section without medical indications is associated with an
increased risk of adverse shortterm maternal outcomes: the 2004-2008 WHO global survey on maternal and
perinatal health. BMC Med. 2010;8:71. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
55

11111 1
22
33
4
5
66 6
7
10101010
11
13
14
15
171717
20
23
2727
34
47
A & N Islands
Andhra Prades h
Chandigarh
Daman & Diu
Puducherr y
Tamil Nadu
Ladakh
Telangana
Nagaland
Sikkim
Arunachal Pradesh
Manipur
Kerala
Meghalaya
Tripura
Mizoram
Himachal Pradesh
Jammu & Kashmir
Punjab
Uttarakhand
Karnatak a
West Bengal
Maharashtr a
Assam
Chhattisgarh
Delhi
Haryana
Gujarat
Jharkhand
Odisha
Rajasthan
Bihar
Madhya Pradesh
Figure 3.7.2: Number of district hospitals by State/UT having C-section rate less than 35%
Note: As Uttar Pradesh and Uttarakhand have separate hospitals for men and women & children, the C-section rate
for male hospitals in recorded as 0; hospitals that were unable to provide data also have been assigned a value of 0.
Table 12 lists the hospitals that have the highest C-section rate among district hospitals in the
country within each hospital category. The district hospitals having the highest C-section rate
in each State/UT is listed in Annexure 4.
Table 12: District hospitals in India with the highest C-section rate
Small HospitalMid-Sized HospitalLarge Hospital
District Hospital JNLM, Srinagar,
Jammu and Kashmir
(90.8% C-section deliveries)
Bijapur District Hospital FRU,
Bijapur, Karnataka
(100% C-section deliveries)
DH Machilipatnam, Krishna,
Andhra Pradesh
(73.34% C-section deliveries)
DH Aluva, Ernakulam, Kerala
(67.04% C-section deliveries)
DH Karimnagar, Karim Nagar,
Telangana
(69.93% C-section deliveries)
DH Khammam, Khammam,
Telangana
(65.42% C-section deliveries)
DH Nagapattinam,
Nagapattinam, Tamil Nadu
(68.77% C-section deliveries)
National average: 20.8% C-section deliveries
Range: 0-100%
MEASURES UNDERTAKEN IN DISTRICT HOSPITALS WITH HIGH RATE
OF C-SECTION DELIVERIES
JLNM Hospital in Srinagar followed a multidisciplinary approach to effectively improve on
existing infrastructure and manpower including gynaecologists, medical officer, nursing staff and
other support staff who were available round the clock. The regional hospital has well equipped
Maternity Operation Theatres (OTs), including one emergency OT, for management of C-section
deliveries. Due to the hospital’s referral policy, it receives complicated cases from other district
hospitals so as to avoid congestion in medical college hospitals. The facility provides all the Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
56
drugs, consumables, diagnostics, diet and other entitlements as envisaged under JSSK free
of cost to the obstetric patients. These measures have made it possible to conduct C-section
deliveries around the clock.
“Integrating the health infrastructure with sufficient support services,
availability of fully functional blood bank and special newborn care
unit (SNCU) helped clinicians in managing high risk delivery cases
in the hospital.”
—District Surgeon,
JLNM Hospital, Srinagar
Lack of awareness regarding the benefits of a normal delivery and fear of labour pains forced
women in Karimnagar and Khammam District Hospitals, Telangana to opt for C-section deliveries.
The hospitals included one-to-one counselling of women by medical officers, obstetricians and
ANMs, and regularly conducted meetings in presence of MD, NHM of the state. This has led to
improved awareness and positive attitude in favour of normal deliveries.
Initially, District Hospital Machilipatnam in Krishna district of Andhra Pradesh, had limited space
for inpatients which led to a decline in their turnover. Limited gynaecologists, staff nurses,
supporting staff, operation theatres all led to issues in management of antenatal mothers. To
address these issues, the hospital increased the bed availability by developing a newly built full-
fledged MCH block with facilities like LDRs, HDUs, and well-equipped OTs. Number of specialists
were increased by appointing new gynaecologists, anaesthetists, general duty medical officers
in addition to support staff, and making them available round the clock under strengthening
of MCH services. The Dakshatha training, specifically designed to improve care and survival of
mothers, made the facility’s service delivery efficient. All these actions decreased referrals and
increased performance of the hospital.
Bijapur District Hospital in Karnataka appointed new specialists and created a separate MCH wing
with support from the State and local administration, which was followed by NQAS certification.
Good leadership, high staff motivation, regular training to identify early complications and
sustainability of quality care services are some of the key factors which have helped in achieving
minimal post-operative complications, less than 0.5% surgical site infection, low MMR and IMR.
District Hospital Aluva in Ernakulam district, Kerala also adopted a similar approach to increase
the overall deliveries, while also ensuring an improvement in the gynaecology services provided
by the department. The administration tackled two key issues — inadequate staff strength and
scope for improvement in the infrastructure. Consequently, both normal and C-section deliveries
saw an increase, coupled with reduction in maternal and infant deaths.
The staff in Nagapattinam District Hospital, Tamil Nadu worked in co-ordination with field-
level staff and mentored them for identification of high-risk cases at the earliest, follow-up,
and referral at appropriate time. A constant communication link was maintained with the
sub-district hospitals and higher referral centers for proper guidance and timely referral. The Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
57
doctors on duty were put on alert and were informed at the earliest of the likely patients
who may turn up for delivery. There was regular training and mentoring sessions, and a
separate team of nurses was created for postnatal care and post-operative care. Shortage
in manpower was addressed by putting in place schemes to hire private specialists such as
obstetricians and gynaecologists.
Recommendations to district hospitals
The proportion of caesarean sections at the population level is a measure of the
level of access to and use of this intervention. It can serve as a guideline for policy-
makers and governments in assessing progress in maternal and infant health and in
monitoring emergency obstetric care and resource use.
The C-section rate is a result of varied contextual factors, which should be analysed
so that tailored interventions can be implemented to stabilize the rate at large.
Leveraging the ANM–ASHA–Anganwadi Worker (AAA) network, institutional
deliveries over home deliveries should be encouraged and ensured. At the same
time, the primary health centres (PHCs) and community health centres (CHCs) should
be strengthened to cater to these deliveries and only emergency cases should be
referred to district hospitals for C-section. Further, the National Ambulance Service
must cater to emergency reference cases.
Overall, efforts must be made to reduce maternal and infant deaths. At the same
time, hospitals must adhere to the norms of complications that allow for a C-section
rather than a vaginal delivery.
Kulithalai Government Hospital, Karur, Tamil Nadu Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
58
3.8 SURGICAL PRODUCTIVITY INDEX
3.8.1 Definition of the KPI
This is an Output indicator. For the purpose of this assessment, this KPI is calculated by dividing
the total number of major surgeries performed in a year (excluding the surgeries related to
Obstetrics, Gynaecology and Ophthalmology) with the number of surgeons in the hospital.
This data element would be calculated by subtracting the surgeries related to Obstetrics,
Gynaecology and Ophthalmology from the total number of major surgeries performed at the
District Hospital.
This KPI is largely under the control of the district hospital.
Surgical productivity index =
Total number of major surgeries in a year
excluding obstetrics/gynaecology

and ophthalmology surgeries
Total number of surgeons
excluding obstetric/gynaecological
surgeon; ophthalmologist; denta



l surgeons



3.8.2 Significance of the KPI in evaluating a district hospital
Many different surgical societies define a minimum number of surgical procedures to acquire
and maintain surgical competence, though this varies from country to country. The Operations
Rooms (ORs) in the surgical centres are critical units in a hospital management.
32
They are
directly related to the larger function of a hospital production system, which is the intervention
to restore the patient’s health. They represent a large part of the hospital income and costs.
Also, ORs have a complex environment where the tolerance for mistakes is extremely low and
they can have a limited capacity to the number of available ORs, materials, human resources,
and equipment.
33
In this context, it is essential to develop tools that show how to improve and
analyze the OR’s efficiency.
3.8.3 District hospital performance and associated insights
A total of 177 district hospitals from 27 States/UTs fell in the upper quartile for Surgical
Productivity Index, which included hospitals performing more than 205 surgeries per surgeon
per year. The top share of hospitals is occupied by the States/UTs of Uttar Pradesh (21.9%),
followed by Rajasthan (6.7%), and Delhi (6.2%) (see Figure 3.8.1).
32 Souza, T.A., Roehe Vaccaro, G.L. and Lima, R.M. Operating Room effectiveness: a lean health-care performance
indicator. International Journal of Lean Six Sigma, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/
IJLSS-12-2017-0141. (2020).
33 Cima, R.R., Brown, M.J., Hebl, J.R., Moore, R., Rogers, J.C., Kollengode, A. and Team, S.P.I. Use of lean and six sigma
methodology to improve Operating Room efficiency in a high-volume zertiary-care academic medical center”,
Journal of the American College of Surgeons, Vol. 213 No. 1, pp. 83-92. (2011).
Demeulemeester, E., Beliën, J., Cardoen, B. and Samudra, M. Operating Room planning and scheduling”, in Denton,
B.T. (Ed.), Handbook of Healthcare Operations Management, Springer, New York, NY, pp. 121-152. (2013).
Rothstein DH, Raval M V. Operating Room efficiency. Seminars Pediatric Surgery. Vol. 27(2):79–85, (2018). Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
59
Figure 3.8.2 gives a State/UT-wise distribution of the average number of surgeries per surgeon
in a district hospital, while the same distribution by hospital size may be found in Annexure
5. On an average, 194 surgeries per surgeon are performed in a year in a district hospital in
India. In small hospitals having up to 200 beds this average stands at 140, mid-sized hospitals
(201-300 beds) have an average of 262, while in large hospitals (with more than 300 beds) a
surgeon performs an average of 300 surgeries in a year.
39
12
11
1010
999
888
7
55
44 4
33
2
1111111
Uttar Pradesh
Rajasthan
Delhi
Tamil Nadu
Gujarat
Madhya Pradesh
Jammu & Kashmir
Karnataka
Punjab
Maharashtra
Bihar
Haryana
West Bengal
Kerala
Telangana
Himachal Pradesh
Odisha
Uttarakhand
Andhra Pradesh
Assam
Dadra & Nagar Haveli
Chandigarh
Goa
Meghalaya
Mizoram
Puducherry
Chhattisgarh
Figure 3.8.1: State/UT-wise distribution of number of district hospitals (n=177) in the upper
quartile for surgical productivity index
547
491
481
439
314
307
300
298
295
266
242
242
240
235
229
215
194
165
162
156
147
125
121
98
94
90
73
71
63
47
46
43
30
29
24
21
7
2
Delhi
Telangana
Puducherry
Tamil Nadu
Haryana
Kerala
Gujarat
Himachal Pradesh
Dadra & Nagar Haveli
Rajasthan
Chandigarh
Bihar
Jammu & Kashmir
Karnataka
Punjab
Goa
India
Andhra Pradesh
Uttar Pradesh
West Bengal
Maharashtra
Uttarakhand
Madhya Pradesh
Odisha
Daman & Diu
Assam
Mizoram
Meghalaya
A & N Islands
Nagaland
Chhattisgarh
Ladakh
Arunachal Pradesh
Jharkhand
Lakshadweep
Manipur
Tripura
Sikkim
Figure 3.8.2: Average number of surgeries per surgeon performed in a year in a district
hospital by State/UT Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
60
Table 13 lists the top performing district hospitals in the country by hospital size for the KPI
surgical productivity index. The top performing district hospital in each State/UT for this KPI
is listed in Annexure 4.
Table 13: Top performing district hospitals in the country for the KPI
“surgical productivity index”
Small hospitalMid-sized hospitalLarge hospital
Hedgewar Hospital,
Shahdara, Delhi
(1823 surgeries per surgeon in
a year)
Sanjay Gandhi Memorial Hospital
Mangolpuri, North West, Delhi
(4523 surgeries per surgeon in a year)
Sadar Hospital Saharsa, Saharsa, Bihar
(3587 surgeries per surgeon in a year)
Chickmagalur District
Hospital FRU,
Chikmagalur, Karnataka
(2236 surgeries per
surgeon in a year)Tej Bahadur Sapru Hospital,
Prayagraj, Uttar Pradesh
(1686 surgeries per surgeon in
a year)
Mandi Zonal Hospital, Mandi,
Himachal Pradesh
(1424 surgeries per surgeon in a year)
National average: 194 surgeries per surgeon in a year
Range: 0–4523
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
Chikmagalur District Hospital FRU, Chikmagalur, Karnataka allows all surgeons to perform
surgeries on all days, including out of OPD / duty hours. To document all surgeries, an e-hospital
portal was implemented and all procedures that were performed were registered. More recently,
the Ayushman Bharat – Arogya Karnataka (ABArK) scheme has been influential in contributing
to the number of surgeries done - doctors are encouraged to operate 24x7 with paid incentives
(including ABArK). 
Sadar Hospital Saharsa in Bihar conducted detailed gap assessments of their infrastructure and
services, renovated the OT by adhering to the NQAS checklist and incorporating feedback from
the surgeons, and ensured regular capacity building of the dedicated staff.
The hospital is an old building and the OT had very poor infrastructure
and lacked a functional quality team. After conducting gap assessments,
the OT was renovated and a quality circle team was formulated — they
were oriented with quality tools like clinical discussion, PDCA cycles,
review meetings with paramedical staff, support staff and surgeons.
The Deputy Superintendent and Hospital Manager conduct regular and
random inspections for quality checks.
—Sadar Hospital Saharsa
Civil Surgeon, Saharsa, Bihar Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
61
Pre-intervention, there was no mechanism for scheduling surgeries in the OT at Saharsa
hospital, resulting in overcrowding of patients, unavailability of surgeons, and conflicts between
the hospital staff and the patients’ representatives. A management team and supporting
administrative staff were roped in for OT scheduling in coordination with surgeons. Surgeon-
wise days were fixed for operative procedures and waiting time was reduced by mapping end-
to-end processes from registering of a patient till transfer of a patient to the ward. Patients
have been providing positive feedback on the Mera Aspataal portal, a MoH&FW, GoI initiative
to capture patient feedback for the services received at the hospital.
Shri Tez Bahadur Sapru Hospital in Prayagraj, Uttar Pradesh, established in 1909, is a combination
of modern and ancient architecture. It caters to the medical demand from nearby districts
as a multispecialty referral centre. It provides a wide range of curative health care services
ensuring quality and cost-effectiveness. The optimal performance of one indicator depends on
the optimal performance of other related indicators. To complement a high rate of surgeries per
surgeon, the hospital also has a high bed occupancy rate and more than 2500 OPD patients
every day. Facilities such as diagnostic testing services, e-hospital, ambulance service, public
announcement system, etc. are well maintained. Along with declaration of the best employee
of the week in the hospital, vocational training of personnel is conducted regularly through
technical training sessions and workshops, and an employment satisfaction index is maintained.
Sanjay Gandhi Memorial Hospital in Mangolpuri, North West Delhi caters to a population of
25 lakh and has a huge inflow of patients. Initially, junior specialists would resign in short time
periods, making it difficult to run OTs in full capacity. Moreover, appointments for surgeries were
given with a waiting period of more than one month. To address this, the hospital ensured regular
recruitment of doctors, senior residents, and junior residents. More recently, DNB graduates are
being given separate training after gaining approval of the national board. Their intake proved
helpful in running the OPD, preparing the OT for surgeries, taking follow-ups, etc., thereby
strengthening the surgical teams. Further, OT days for each department were increased. Case
discussions are done regularly so as to avoid repetition of any lapse.
The result is owing to team work of the surgical team comprising
of six non-teaching specialists with approximately 25 SRs from
respective departments, along with three anaesthetists. For them
to run the show serving the underprivileged from Delhi as well as
other states and regions is commendable.
—Quality Nodal Officer,
Sanjay Gandhi Memorial Hospital, North West Delhi
Hedgewar Hospital, Shahdara, Delhi focuses on optimal usage of OTs by engaging in
communication with the patients and pre-planning surgeries and following a transparent
procedure in booking an OT for surgery. Patient data was computerized and mobile number
of the patient’s point of contact was recorded for direct coordination. Improved coordination
between the internal departments and timely procurement of surgical material were key in
enabling a high number of surgeries. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
62
Mandi Zonal Hospital, Himachal Pradesh has two functional OTs for round the clock services
with all diagnostic and lab investigations, which helped in scheduling operations at any hour
of the day. Maintenance of surgical instruments, training the support staff in using them, and
keeping the OT open 24×7 contributed to the increasing number of surgeries.
Recommendations for district hospitals
Providing logistic support including operation theatre facilities, manned by trained
nursing staff and paramedical support staff, and necessary surgical items helps
specialists to provide round the clock services.
Access to specialists from nearby medical colleges/ on contract specialists leads
to providing necessary services from different specialties at the DH. This leads to
improved access by rural populations and decreases regional disparities in access
to specialist services.
Ernakulam Government Hospital, Ernakulam, Kerala Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
63
3.9 OPD PER DOCTOR
3.9.1 Definition of the KPI
This indicator is classified under Output. It is a proxy indicator for accessibility and utilization
of health services that may reflect the quality of services. It is calculated by dividing the total
number of OPD patients in a year with the number of OPD days and the total number of
positioned doctors. The district hospital largely exercises control over this KPI.
OPD per doctor =
()Total number of OPD patients in a year Allopathic + AYUSH
Number of positioned doctors × OPD days in that year
3.9.2 Significance of the KPI in evaluating a district hospital
According to WHO, there is one doctor for every 1,445 Indians as per the country’s current
population estimate of 135 crore, which is lower than the WHO’s prescribed norm of one doctor
for 1,000 people.
34
In a tertiary care facility such as Post-Graduate Institute of Medical Education
& Research, Chandigarh about 500 new patients are registered daily in the OPD, and ideally each
new patient requires about 15 to 30 minutes.
35
Super specialty clinics in government hospitals
are over worked and under staffed with heavy patient load. There should be adequate number
of doctors to attend to expected patient load so that doctors can give adequate time and
quality treatment to patients, which is the basic right of every patient.
36
By measuring the OPD
patients per doctor for district hospitals, inter-district comparisons can be made accounting
for factors such as population, accessibility of the district hospital, etc. This will give insights
on resource allocation and will enable more informed decision-making.
3.9.3 District hospital performance and associated insights
To characterize the number of OPD patients attended in a district hospital per doctor in a day,
the data was divided into quartiles. Figure 3.9.1 depicts the percentage distribution of a total
of 177 out of 707 hospitals falling in the upper quartile (75
th
percentile) that included hospitals
with more than or equal to 34 OPD patients per doctor in a day. Uttar Pradesh (49.2%) had
the highest proportion of hospitals with ≥34 OPD patients per doctor, followed by Tamil Nadu
(12.4%), Bihar (7.3%), Karnataka (4.5%), and Delhi (3.4%).
34 Economic Times. (2019). Doctor-patient ratio in India less than WHO-prescribed norm of 1:1000: Govt (available
at: https://health.economictimes.indiatimes.com/news/industry/doctor-patient-ratio-in-india-less-than-who-
prescribed-norm-of-11000-govt/72135237)
35 The Indian Express. (2015). PGI faculty writes to director, seek fixing of doctor-patient ratio (available at: https://
indianexpress.com/article/cities/chandigarh/pgi-faculty-writes-to-director-seek-fixing-of-doctor-patient-ratio/)
36 Pandey, A., Singh, A., Singh, S., & Kumar, A. (2019). Patient-doctor ratio across nine super speciality clinics in
government hospital: a cross sectional study. International Journal of Community Medicine and Public Health
6(10). doi: 10.18203/2394-6040.ijcmph20194505 Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
64
87
22
13
8
66 655
32222 2111111
Uttar Pradesh
Tamil Nadu
Bihar
Karnatak a
Delhi
Gujarat
Madhya Pradesh
Haryana
Himachal Pradesh
Kerala
Rajasthan
Telangana
Odisha
Punjab
Jammu & Kashmir
Dadra & Nagar Haveli
Maharashtra
Uttarakhand
Chandigarh
West Bengal
Puducherry
Figure 3.9.1: State/UT-wise distribution of number of district hospitals (n=177) having
doctors attending to 34 or more OPD patients per day
Figure 3.9.2 gives a State/UT-wise distribution of the average number of OPD patients per
doctor in a district hospital, while the same distribution by hospital size can be seen in Annexure
5. On an average, 27 OPD patients are attended to by one doctor in a day in a district hospital
in India. In small hospitals having up to 200 beds this average stands at 28, mid-sized hospitals
(201-300 beds) have an average of 27, while in large hospitals (with more than 300 beds) a
doctor attends to an average of 26 OPD patients in a day.
47
4343
38
3534
32
303029
282827272727
2322
21
1919
1717
1615
14141413
11109
8
66
55
Dadra & Nagar…
Tamil Nadu
Uttar Pradesh
Chandigarh
Bihar
Himachal Pradesh
Gujarat
Delhi
Daman & Diu
Madhya Pradesh
Punjab
Karnataka
Haryana
India
Puducherry
Telangana
Jammu & Kashmir
Uttarakhand
A & N Islands
Rajasthan
Odisha
Kerala
Lakshadweep
Andhra Pradesh
Maharashtra
Assam
Goa
West Bengal
Jharkhand
Chhattisgarh
Sikkim
Mizora m
Tripura
Meghalaya
Arunachal Pradesh
Manipur
Nagaland
Figure 3.9.2: Average number of OPD patients per doctor in a day in a district
hospital by State/UT Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
65
Table 14 lists the top performing district hospitals in the country by hospital size for the KPI
OPD per doctor. The top performing district hospital in each State/UT for this KPI is listed in
Annexure 4.
Table 14: Top performing district hospitals in the country for the KPI
“OPD per doctor”
Small hospitalMid-sized hospitalLarge hospital
District Women Hospital, Mau,
Uttar Pradesh
(206 OPD patients per doctor)
Walajapet, Vellore,
Tamil Nadu
(130 OPD patients per doctor) DH Bhind, Bhind,
Madhya Pradesh
(312 OPD patients per doctor)
Balrampur Hospital,
Lucknow, Uttar Pradesh
(193 OPD patients per doctor)
DH Botad, Botad,
Gujarat
(134 OPD patients per doctor)
Malkhan Singh District Hospital,
Aligarh,
Uttar Pradesh
(104 OPD patients per doctor)
RNM District Joint Hospital,
Firozabad, Uttar Pradesh
(123 OPD patients per doctor)
Periakulam, Theni,
Tamil Nadu
(103 OPD patients per doctor)
National average: 27 OPD patients per doctor in a day
Range: 0.05–312
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
One large, one mid-sized, and two small hospitals in Uttar Pradesh have a high score of OPD
per doctor compared to the rest of the district hospitals in the country.
Balarampur Hospital in Lucknow district is Uttar Pradesh’s largest and most renowned hospital.
Owing to variety of specialties and super-specialties available here, many complex cases are
referred here from different districts of the state. The hospital provides OPD services and indoor
medical services round the clock on all days, except Sundays and National Holidays. The hospital
has a well-equipped OT wherein General Surgery, Urosurgery, Neurosurgery, Orthosurgery, ENT
and Ophthalmic surgeries are performed. In addition, it also operates an emergency OT. Given
the access to services, the hospital witnesses more than 2500 patients for treatment every day
in the OPD translating into a high OPD per doctor score.
Malkhan Singh District Hospital, a mid-sized hospital in Aligarh, witnesses a high footfall
of around 1500 new and 1200 old patients daily for treatment. The bed occupancy rate for
hospitalization generally remains 100% and on an average 10 to 15 major surgeries are performed
every day in the hospital.
Rajnarayan Maheshwari Government Hospital is a 100-bedded hospital situated in the Firozabad
district of Uttar Pradesh. The facility provides services to the rural population and witnesses
more than 1800 OPD patients every day. More recently, the hospital has also been witnessing
upward growth fueled by funding from Ayushman Bharat Yojana in the last few years. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
66
The District Female Hospital in Mau district is a 100-bedded facility for women, which attends
to more than 300 OPD patients on a daily basis. On average, 1–2 major surgeries (C-section)
and 3–5 minor surgeries are performed every day. The hospital has 24*7 availability of pathology
services.
In Botad District Hospital, Gujarat, one of the driving forces enabling doctors to attend to a
high number of OPD patients was efficient implementation of the Government of Gujarat’s
CM-SETU Yojana (Chief Minister Services of Experts at Treatment Unit). There were only two
specialists in 2016–17. Thus, specialist medical services were limited. Also, posts of Medical
Officers were vacant. Through the CM-SETU Yojana, private gynaecologists, surgeons, physicians,
orthopaedicians, ENT surgeons, ophthalmologists were recruited to visit the hospital on fixed
days and for a defined duration. Thus, multi-specialty OPDs were started and this led to an
increase in OPD patients at the centre. To sustain the improved footfall, a full-time gynaecologist
and surgeon were also appointed, and posts of nursing staff and other support staff were also
filled.
“Availability of human resources helped improve service availability
and utilization. Further, to capitalize on this, the district hospital
organized various camps such as for NCD awareness, disability
certification, ENT check-ups, etc. This was compounded with
extensive IEC in local mass media and print media to make people
aware of the available services and increase their utilization.”
—State Health Systems Resource Centre, Gujarat
“Periyakulam GHQH in Theni district has a high number of OPD
patients per doctor owing to many factors – while the patient
footfall is generally high in the OPD, there is a separate OPD wing
in the hospital with online registration facility. Additionally, there
are separate registration counters for men, women, and children,
separate consulting and injection rooms, 24×7 laboratory, 24×7
pharmacy, a separate dispensary for NCDs, facility for ECG, USG
scan, digital X-ray, among others. Due to the availability and
maintenance of facilities, waiting time is limited and doctors are
able to attend to more patients.”
—Joint Director, Medical and Rural Health Services,
Theni, Tamil Nadu
DH Bhind, a 300-bedded hospital in Madhya Pradesh, has enhanced the hospital infrastructure
to improve patient services. By developing digital sign boards, conducting behaviour training of
the doctors, and strengthening the implementation and monitoring of the Mera Aspataal portal, Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
67
patient satisfaction saw gradual improvement. Facilitating government schemes for the patients
also helped reduced their out-of-pocket expenditure. Overall, footfall of patients continued to
grow, while doctors were trained in effective management of patients.
Walajapet DH in Vellore, Tamil Nadu undertook regular exercises to map the gaps and the
critical processes that are carried out, analysed waiting time, and prepared an improved process
mapping. These activities also helped meet LaQshya and other NQAS requirements. The staff
is punctual, cordial, and respectful towards patients, all of which contribute to being able to
treat as many patients as possible.
Recommendations to district hospitals
Hospitals should encourage care seeking among the community through extension services,
as also make seeking care a hassle-free and productive experience. Tele-medicine services
can help increase OPD footfalls, with convenience to patients.
Work flow in OPDs, and functioning of departments needs to be so organized so as to limit
waiting time, increase speed of reporting of test results, and high quality consultations, as well
as outdoor procedures wherever feasible.
For maximal utilization of the infrastructure of public hospitals, provision should be made for both
morning and evening OPDs. The necessary staff, equipment, and space should be provisioned
for running such clinics and diagnostic set-up. Evening OPDs shall have the added advantage
of obviating “opportunity costs” for the poor who have to miss their daily wage to attend to the
hospital in the morning.
37
37 Bajpai, V. (2014). The challenges confronting public hospitals in India, their origins, and possible solutions. Advances
in Public Health, Article ID 898502. doi: 10.1155/2014/898502
Kulithalai Government Hospital, Karur, Tamil Nadu Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
68
3.10 BLOOD BANK REPLACEMENT RATE
3.10.1 Definition of the KPI
This KPI is categorized under Output. It falls under the control of the district hospital.
It is calculated by dividing the total number of blood units issued on replacement in the year
by the total number of blood units issued in that year and then multiplied by 100.
In this indicator, blood units issued in a year includes voluntary donation replacement. Number
of blood units issued on replacement donation means that a patient’s attendant is being asked
to give blood units, for getting blood from the blood bank. Replacement needs to be phased
out as the replacement donor has a chance of higher sero-positivity (giving a positive result in
a test of blood serum, e.g. for the presence of a virus.)
This indicator has negative valence, implying that lower the score, better the performance.
Blood bank replacement rate =
Total number of blood units
issued on replacement in the year
× 100
Total number of blood units issued in year
3.10.2 Significance of the KPI in evaluating a district hospital
An important aspect of patient care is the provision of safe and quality blood collection from
voluntary donors at an affordable cost to the general public and free of cost to the poor. Hence,
this indicator measures the ability of the hospital to provide as well as manage the supply of
blood from low-risk donors.
It helps in identifying how much voluntary replacements are made and how many are paid. In
an ideal situation the blood bank should be replenished with voluntary donations rather than
asking the patient’s caretakers to replace the blood units being issued to the patient. The idea
behind measuring this indicator is to encourage voluntary donations and maintain a replenished
blood bank. The spirit is not to refuse blood units by the patients’ caretakers when issued, but
also not insist upon replacing the blood units issued.
3.10.3 District hospital performance and associated insights
This segment presents data on a total of 554 out of 707 district hospitals; as the remaining
hospitals were unable to produce accurate records for this indicator, which were therefore
excluded from the analysis. On an average, 35% blood units are issued on replacement in a
year in a district hospital. Among the small hospitals, the national average stands at 39.49%.
In mid-sized hospitals, this figure is 33.89%. In large hospitals, 25.57% blood units are issued
on replacement. The State/UT-wise average percentage of the blood bank replacement rate is
presented in Figure 3.10.1. The States/UTs are arranged in ascending order, with a lower score
indicating better performance. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
69
012246
91012141616171921222223
26272728
31
35373738
4242
454647495152
58
66
96
Lakshadweep
Chandigarh
Haryana
Sikkim
Tamil Nadu
Punjab
Goa
Nagaland
Himachal Pradesh
Karnataka
West Bengal
Meghalaya
Daman & Diu
Tripura
Puducherry
Maharashtra
Mizora m
Ladakh
Telangana
Arunachal Pradesh
Dadra & Nagar…
Uttarakhand
Kerala
India
Manipur
Rajasthan
Odisha
Gujarat
Andhra Pradesh
Madhya Pradesh
Assam
Chhattisgarh
Jammu & Kashmir
Uttar Pradesh
Jharkhand
Delhi
Bihar
A & N Islands
Figure 3.10: Average number of blood units issued on replacement in a year in a district
hospital by State/UT
Table 15 lists the district hospitals in the country that have the least number of blood units
issued on replacement against the total number of blood units issued in the year.
38
The district
hospital having the least blood bank replacement rate in each State/UT is listed in Annexure 4.
Table 15: Top performing district hospitals in the country that have a blood
bank replacement rate of 0%
Small hospitalMid-sized hospitalLarge hospital
Usilampatti, Madurai,
Tamil Nadu
Civil Hospital, Panchkula,
Haryana
GH Ernakulam, Ernakulam,
Kerala
Civil Hospital, Hisar, HaryanaAlibag, Raigarh, Maharashtra Belgaum District Hospital,
Belgaum, Karnataka
Padhmanabapuram,
Kanniyakumari, Tamil Nadu
Mettur Dam, Salem,
Tamil Nadu
VIMS Bellary Medical College,
Bellary, Karnataka
National average: 26.94% blood units issued on replacement
Range: 0–100%
BEST PRACTICES OF WELL PERFORMING DISTRICT HOSPITALS
Civil Hospital Hisar, Haryana have collaborated with various NGOs/blood donation camp
organizers, out of which some are very active. The hospital tries to never miss any opportunity
to organize voluntary blood donation camps whenever offered by any organization. Every
Sunday has been mandatorily fixed to conduct blood donation camps on field. Days of national
importance are also celebrated by organizing blood donation drives.
Civil Hospital Panchkula, Haryana provides 24x7 Blood Bank services to the indoor patients,
private hospitals, and nursing homes in the region. It encourages 100 per cent voluntary donation
by arranging camps regularly — about 55–60 camps annually. Blood is issued without any
38 Similar to the method adopted for other indicators, if two or more hospitals had the same raw score, the hospital
with a higher composite score (average of the scaled values of all 10 KPIs) was regarded as the better performing
district hospital. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
70
replacement to those in need. A directory of Voluntary Blood Donors is also maintained and in
case of emergency or during times of low availability, donors are contacted directly. There is also
availability of transfusion services round the clock. The hospital maintains an association with
the Sarpanchs of villages of Panchkula and they conduct camps and outreach activities in their
village after every 3–4 months for Blood Donation camps. In addition to organizing regular blood
donation activities throughout the year, the hospital has been educating potential blood donors
and camp organizers regarding the technical aspects of these activities, specifically about the
limited shelf life of blood units. These measures help the hospital in ensuring an average amount
of blood stock throughout the year thereby meeting maximum number of requests.
It is very difficult to counsel the donors on a regular basis. One of our
measures is to motivate the donors to become regular donors for
lifetime by highlighting the importance of donation and recruitment
of the donor. We also conducted awareness through social media
webinars lecture/PPT presentation in the local language. This
created a positive impact from the donors which enhanced their
performance.
—Transfusion medicine specialist,
Belgaum District Hospital, Karnataka
One of the main interventions through which VIMS Bellary Medical College, Bellary dist.,
Karnataka ensured a low blood bank replacement rate was spreading awareness amongst the
youth. VIMS blood bank works closely with various educational institutes on spreading awareness
of voluntary blood donations and the numerous advantages it has. Many competitions were held
in colleges with the help of the District AIDS Prevention and Control Unit where voluntary blood
donations was the main topic. VIMS also worked with PHCs, wherein ASHA workers played a
huge role in motivating people to donate blood.
With increased number of blood storage centres in the district we
were able to conduct more number of voluntary blood donation
camps in the villages, where the number of donors went up from
initial 1-2 to 50 donors per camp.
—Blood bank officer, VIMS Hospital, Bellary
Pre-intervention, there was lack of knowledge about importance of blood and blood donation
in saving lives, coupled with lack of motivation for voluntary blood donation amongst people.
Limited or no coordination and cooperation between governmental and non-governmental
organisations also is a contributing factor in suboptimal blood donation. Assessing District Hospitals with respect to the Key Performance Indicators (KPIs)
71
With concerted efforts professional and replacement donors are
completely eliminated, and there has been an increase in the
number of voluntary donors as well as blood availability, thereby
ensuring increased supply to blood storage centres.
—Director, VIMS Medical College, Bellary
GH Ernakulam, Kerala regularly coordinate with several NGOs that organize voluntary blood
donation camps. Similarly, Usilampatti District Hospital in Madurai, Tamil Nadu has been involved
in sensitising the Block Medical Officers as well as local NGOs regarding the importance of
voluntary blood donation camps. Urgent and rare group blood requirements were met through
the maintenance of a voluntary blood donor registry, in addition to circulation of requests on
WhatsApp groups. Pre-intervention, the hospital used to replace blood units issued with blood
donated by the patients’ relatives. However, post-intervention, the blood bank is mostly in
stock, and if not, a list of backup donors is readily available. Government District Headquarters
Hospital Metturdam in Salem, Tamil Nadu, provides 24×7 blood transfusion services and
supplies blood units to the nearby government hospital for elective surgeries and its storage
centre. In addition to the measures adopted in Usilampatti DH, IEC material is used creatively
to educate college students on the importance of donation and its various aspects, which also
helps in the increased outreach of information. The blood bank at Padmanabapuram District
Government Headquarters Hospital, Kanyakumari district, Tamil Nadu is well-equipped with
quality infrastructure and adequate manpower. Any newly posted staff is trained on blank bank
related operations prior to being assigned related tasks. This ensures no operational hiccups.
On average, 2–5 blood donations camps are organized in a month.
In Alibag District Hospital, Raigad district, Maharashtra, blood donation camps are planned one
to two months in advance such that the average blood stock can be maintained throughout
the year to meet every request of blood requirement.
Recommendations for district hospitals
aHospitals may have a lifetime donor programme by motivating donors to become
regular donors for lifetime, and maintain a directory of blood donors who may be
reached out at the time of emergencies.
aBlood donation camps may be organized regularly and follow a fixed schedule to
enable donors to plan and schedule their blood donations.
aSocial media-education to encourage blood donation would increase the outreach
of the message to potential donors.
aAdequate facilities for storage along with provision for blood component separation
are necessary for a blood bank to function efficiently. Ensuring availability of
transfusion services round the clock will also help the hospital to maintain a low
blood bank replacement rate.
Challenges and
Limitations
4 Challenges and Limitations
73
This chapter highlights the main limitations and challenges faced during the exercise, including
those during on ground data collection and validation, issues related to KPIs and HMIS data
components, and limitations in the scoring process.
4.1  ISSUES AND CHALLENGES DURING THE DATA COLLECTION
AND VALIDATION EXERCISE
NABH undertook the onsite assessment and validation of HMIS data for the KPIs for 731 district
hospitals across the country. This involved conducting assessments across different districts
simultaneously on a pan India level, including hospitals in remote and difficult areas of the
country. Some challenges that were faced during the planning and execution of the assessment
and validation exercise are discussed below.
Difficult terrains and sensitive areas
Few districts in the States/UTs of Jammu and Kashmir, Arunachal Pradesh, Himachal
Pradesh, and Meghalaya were left out of the assessment owing to their extremely
difficult terrain, while some district hospitals in Nagaland and Chhattisgarh were not
assessed as they were located in sensitive parts of the states. Therefore, of the 731
district hospitals that were identified for the assessment, onsite data validation was
completed for 707 (97%) district hospitals.
Occasional administrative issues
The unpreparedness of some hospitals in keeping the records ready led to delay in
assessments.
Obtaining appropriate records was a challenge if the staff were untrained or newly
posted.
Absence of relevant staff of the said departments made the retrieval of documents/
registers difficult.
In case of unavailability or lack of detailed records in hospitals for an indicator, the
assessor had to rely on certified statements/ declarations provided by the Chief Medical
Officer or an equivalent authority at the time of the visit.
4.2  CONCERNS WITH REGARD TO KPI s AND THEIR ASSOCIATED
HMIS DATA COMPONENTS
Specific points of concern that had arisen with respect to the KPIs and their HMIS component
are summarized below:
Since the HMIS definitions are based on IPHS 2007, the data was collected based
on IPHS 2007 guidelines, and not the updated IPHS 2012 guidelines. Therefore, this
caused some discrepancy (e.g., inclusion of non-technical posts such as plumber in
the paramedic staff in IPHS 2007).
The questionnaire recorded annual scores for the numeric indicators, whereas in
the HMIS the same data is captured monthly. The assessor was required to take an Challenges and Limitations
74
aggregate score of 12 months for the reference period, which was cumbersome and
susceptible to error.
Components of the KPIs that were not captured in HMIS (e.g. total number of OPD days
in a year) or that had scope for different interpretations were not reported uniformly
across States/UTs.
Health being a state subject, there is a vast variation in designations and nomenclature
of the in service positions, due to which hospitals are unable to report all medical staff
on the HMIS portal (e.g., ‘Chief Nursing Officer’ position is present in Delhi region but
not mentioned in HMIS)
4.3 LIMITATIONS OF THE SCORING PROCESS 
Despite the assessment providing a holistic picture of the quality of services offered by district
hospitals, the scores should be looked at with caution. The identification of well performing
district hospitals in this exercise is not only based on the services being provided but also
dependent on a proper data recording and reporting system.
39
 
It is important to note that the missing indicator values and mathematically incorrect values
were assigned the worst possible indicator score (=0). This should be seen as a penalty on the
particular hospital for their inability to provide relevant data.
The original endeavour of the exercise was to assess district hospitals on the basis of a composite,
weighted score of 16 indicators (see Annexure 3). Due to significant limitations in the data, an
overall weighted average was not computed as it would not provide a complete reflection of
the service delivery of hospitals owing to significant missing data elements. Subsequent rounds
of this exercise can attempt to include more variables and compute a composite score to rank
the hospitals.
39 The data set used for the evaluation is for the period 2017-18 and not representative of the present-day scenario. Learnings and Way Forward
75

Learnings and
Way Forward
5 Learnings and Way Forward
76
A systematic assessment of district hospitals across the country can serve as a valuable resource
of their performance, and guide hospital managers perform better. With such a system in
place, the hospitals receiving a lower score on each individual parameters can learn from the
top performing ones. When such an assessment is undertaken annually, it will foster a sense of
healthy competition between district hospitals and provide them an opportunity to showcase
progress against individual indicators, such as health information systems, stockouts, functional
beds, among others.
5.1  KEY LEARNINGS AND OBSERVATIONS FROM THE DISTRICT
HOSPITAL PERFORMANCE ASSESSMENT
District hospitals cater to a wide spectrum of the population, including people from neighbouring
states and districts, depending on its ease of accessibility. The findings reveal that there is scope
for improvement in the quality and quantity of resources available in most district hospitals;
nevertheless, the services provided by district hospitals are indispensable for the masses.
It is encouraged that the best practices shared by top performing district hospitals be adopted
suitably by all district hospitals with the aim to serve the public in a better equipped and more
optimal manner.
Along with service delivery, maintenance of records and accurate data reporting are equally
important to assess the performance of the hospitals and analyse their outputs and outcomes.
District hospitals that had adopted digitized data reporting formats and had a dedicated staff
to monitor data not only fared better in the performance assessment but also were able to
utilize the data for internal decision-making and output improvement.
Data elements that were clearly defined or straightforward (such as the components under
core health care services and diagnostic testing services) were uniformly reported across
States/UTs, while the definition of elements such as the personnel in position (doctors, nurses,
paramedical staff) saw variations across States/UTs. It was also found that the format of the
physical records maintained by the hospitals did not always correspond their corresponding
HMIS format, thereby requiring additional measures for data collection.
This exercise highlights the importance of accurate and quality data reporting and is expected
to lead to an improvement in the quality of HMIS data. An institutional mechanism that helps
build capacity and sustain these practices would be useful. It is anticipated that this could
encourage policy makers and programme managers using HMIS data to undertake real-time
programme evaluation, course correction, and evidence-based policy formulation.
Overall, States/UTs gave very positive feedback regarding the whole validation exercise and
emphasised that it brought about awareness among district hospitals on HMIS and proper
record keeping.
5.2 ACTION POINTS FOR STAKEHOLDERS CONCERNED
Based on the results of this exercise and the process, some learnings have emerged, which
may be incorporated for an overall improvement in the health outcomes. Thereby, the following
action points have been formulated: Learnings and Way Forward
77
5.2.1 Improving data reporting in HMIS
Data reporting standards in HMIS may be enhanced through a largely improved understanding
of data definitions and an overall facility-level record maintenance.
Suggestions to the Ministry of Health and Family Welfare:
Strengthen HMIS system: HMIS should be strengthened through various means, for
example, clarification on the definitions (as it has been found that a number of hospitals
were not clear with respect to the accepted definitions of various terms), periodic
inspections (on the lines of this exercise) at the local level, and better data management
of data quality at the hospital level.
Increase regular trainings on digitisation: Frequent digital trainings/orientation of
data entry operators/officials concerned with regular assessment and reviews, besides
accountability for the quality of data entered on HMIS portal, should be undertaken.
Suggestions for States/UTs:
Increase resources to improve quality at district hospital: Adequate resources may
be provided to district hospitals towards digitization. This can be done by enabling
provision of good data network, organizing frequent training sessions, and encouraging
large-scale use of various platforms of Government of India like Mera Aspataal. National
and regional level trainings, workshops etc. may be organized to acknowledge as well
as disseminate hospitals’ best practices.
Maintain uniformity and continuity in data entry: Necessary regular posts should be
created by the State/UT to maintain continuity and uniformity in data management
work at the hospital.
Health system strengthening: After the data validation activity undertaken for this
exercise by NABH, there is now immense awareness regarding the HMIS portal, which
can be used to strengthen the quality of collection and collation of data in the district
hospitals.
Increase accountability: It is suggested that the accountability of the officer’s in-
charge of the facility for quality of data reporting should be increased and their role
clearly defined.
Suggestions for district hospitals:
Improve maintenance of records: The district hospital should maintain records
accurately and also as per the HMIS definitions. Documentation is also important for
audit and inventory management.
Encourage maximum participation: Awareness drives about the HMIS, Drugs and
Vaccine Distribution Management System, Mera Aspataal as well as the importance of
correct record keeping should be regularly undertaken.
Increase both in-person and digital trainings: District hospital staff should be
encouraged to attend trainings regularly and incorporate the learnings from the training
in their practice and day to day work to ensure quality, completeness, and continuity to Learnings and Way Forward
78
guidelines in maintaining records. The teachings of the trainings should also be passed
on to the new staff.
Encourage digitization: Heads of the hospitals should ensure that all the staff are
encouraged and adequately trained to enable digitization, so that use of Electronic
Medical Records and Hospital Management Information Systems are scaled up.
Align raw data with HMIS elements: District hospitals should focus on aligning the
raw data that they maintain as per the definition of the HMIS data elements.
5.2.2  Improving the framework of the performance assessment
exercise
Outcome-based measures of system functioning at the district level are needed to help
programme managers plan and prioritize their resources at the state and district levels. The
performance assessment of district hospitals presented in this report is the first step towards this
endeavour. Going forward, similar exercises will be repeated taking into account the challenges
and limitations faced during this initial stage with suitable measures to address them. It is
endeavoured that in the subsequent rounds, more KPIs will be included so that a weighted
average score of district hospitals is computed to generate a District Hospital Index, which
would enable ranking of all the district hospitals. To this end, the following recommendations
are proposed:
Leverage HMIS for monitoring of Sustainable Development Goals
India is committed to achieving SDGs by 2030. At present, monitoring of many health-related
indicators that measure the progress of SDGs is dependent on demographic surveys such as
the National Family Health Surveys that are conducted once every three to five years. This could
mean that by 2030, the year when the SDG goals have to be achieved, the country would have
only around two to three datasets to assess its progress. HMIS could serve as an important data
source for monitoring SDGs annually. Maintaining and assessing data on an annual basis could
support policy makers to respond with agility by planning interventions and revising policies
at a relatively shorter frequency, when required.
Refining the existing KPIs and expanding indicators to include child and
maternal health, communicable diseases, and NCDs
There is scope for refinement in the data variables of the KPIs of district hospitals such that they
are brought in parity with the HMIS definitions to allow for clear and uniform data capturing.
As this district hospital assessment exercise evolves, indicators may be refined and data reporting
processes expanded to reflect how the country is progressing on crucial aspects of health care.
Since the onset of the COVID-19 pandemic, health care resources are constantly engaged in
addressing the aftermath of the spread of the virus and its variants. The extent and quality
of response to district hospitals to the pandemic can also be included in their performance
assessment.
Further, optimum ranges for each KPI may be fixed in consultation with experts. Learnings and Way Forward
79
Assign appropriate weightage to outcome-based data
A large part of data acquisition in the public health care information system has traditionally
focused on the quality and quantity of infrastructure and the processes which the hospitals have
adopted. Many of the present variables included in the exercise, however, are proxy indicators
that reflect the health of the hospitals indirectly. As the exercise evolves, more indicators,
which directly represent the health outcomes and reflect the quality of services that are being
delivered at the public health facilities could be included.
It is hoped that the information shared in this report will be used by the States/UTs and districts
to improve their service delivery and thereby, improve performance on health outcomes. It
will also foster healthy competition and motivate district hospitals and States/UTs to take
corrective measures, where needed. On the whole, the findings of this first-ever facility-based
comprehensive exercise for measuring performance will set the foundation for more informed
policy formulation, strategy, and planning for better health outcomes.
While the performance of district hospitals presented in this report is for the financial year
2017–18, there was a setback in its timely release — this exercise being first of its kind
saw a few hiccups in data collection, validation, and analysis. Further, the onset of the
COVID-19 pandemic hammered the task of data analysis, validation, and report-writing.
Given the novelty of this exercise, its importance in assessing and improving performance
of an important element in our health care system, this delay may be overlooked. Future
reports may assess the performance against the 2017–18 baseline data. The report is
relevant, as it gives the first-ever insight into the district hospitals’ performance and will
help program managers in effective decision-making. It is hoped that subsequent rounds
of the assessment will be enhanced to incorporate additional indicators as well as improve
the methodological framework, such that the performance of district hospitals is reflected
in a holistic manner.
Govt Head Quarters Hospital, Mettur Dam, Salem, Tamil Nadu Learnings and Way Forward
80
Kulithalai Govenment Hospital, Karur, Tamil Nadu Annexures
81
ANNEXURES Annexures
82
ANNEXURE 1
HEALTH MANAGEMENT INFORMATION SYSTEM
HEALTH MANAGEMENT INFORMATION SYSTEM
A government to government (G2G) web-based monitoring information system, HMIS is
implemented by the Ministry of Health & Family Welfare (MoH&FW), Government of India with
the primary goal of monitoring the National Health Mission (NHM) and other health programmes.
The information that emerges from this exercise serves as evidence and analysis, which helps
shape policy formulation and strengthens programme interventions.
In 2011, facility-based reporting was initiated in the HMIS, which was refined as an information
technology platform of in.Net and MS SQL. It has proved to be a valuable tool that grades
health facilities, identifies aspirational districts, and reviews state programme implementation
plans (PIPs), among others. It is widely used by the central/state governments to monitor and
supervise the different functions that make up the public health system.
These HMIS formats are designed to capture data on a set of indicators that are vital to track and
measure performance of health programmes. The Monthly Service Delivery formats successfully
collate data on over 300 indicators that cover the length and breadth of the health programmes
and schemes run by the Health Ministry. They take into account aspects related to reproductive
and child health, health facility services, mortality, monthly inventory, and other programmes.
The Quarterly Training formats capture data on training imparted to medical and paramedical
staff at district and state levels and other NHM components. This covers the status of health
infrastructure, trainings conducted (in various NHM components for medical, paramedical, and
other staff of PMU), and additional NRHM components.
Formats on Annual Infrastructure take into account data on manpower, equipment, cleanliness,
building, and availability of medical services such as surgery, super specialties services such
as cardiology, diagnostics, paramedical, and clinical services. Specifically, the nine categories
under which infrastructure data is collected includes services, physical infrastructure, manpower,
operation theatre, blood bank/ storage, investigative and laboratory services, capacity-building,
equipment drugs and furniture and quality control. Annexures
83
ANNEXURE 2
SUMMARY OF HEALTH SYSTEMS STUDIED
1. IPHS GUIDELINES FOR DISTRICT HOSPITALS 
The IPHS guide the HMIS annual infrastructure form, from which multiple indicators were directly
picked. Revised in 2012, they cover the following domains, recommended by size: 
aServices 
aPhysical Infrastructure 
aManpower Requirements 
aEquipment norms 
aLaboratory Services at District Hospital 
aRecommended Allocation of Bed Strength 
aRequirements of Operation Theatre 
aList of Drugs/Lab Reagents/Other Consumables and Disposables for District Hospitals
Capacity Building 
aQuality Assurance and Quality Control of Processes and Service Delivery 
aStatutory Compliance 
aRogi Kalyan Samitis (RKS)/Hospital Management Committee (HMC) 
aCitizen’s Charter
2. STAR RATING SYSTEM FOR CHCS
Star Rating System of the CHCs provides a good reference as it makes use of data sources
that are readily available to us.
Categories considered 
aHuman Resources available 
aInfrastructure available 
aDrugs and supplies 
aService availability 
aClient orientation 
aService utilization
Calculating the outcome:
aHR + Infrastructure —> facility is eligible for Star Reporting and gets 1 Star; NA where
parameters are not reported or reported 0  Annexures
84
aWhere parameters have a non-zero value —> NE (Not eligible) 
aOne star each for fulfilling criteria of delineated for other aspects
aAll yes/no questions
3.  ACCREDITATION STANDARDS FOR HOSPITALS AND
HEALTHCARE PROVIDERS – NABH 
The following key domains to measure hospital quality are assessed: 
aAccess, Assessment and Continuity of Care (AAC) 
aCare of Patients (COP) 
aPatient Rights and Education (PRE) 
aInfection Control (IC) 
aContinuous Quality Improvement (CQI) 
aResponsibilities of Management (ROM) 
aFacilities, Management and Safety (FMS) 
aCommunity Participation and Integration (CPI) 
The orientation for assessment is truly patient-centred and provides a great  reference for a
vision for improving healthcare quality in India at the facility level. 
4.  INSTITUTE OF MEDICINE (IOM) REPORT – CROSSING THE
QUALITY CHASM  
The initial motivation for the report was to counter the alarmingly high rate of  preventable
medical errors in the United States. It is now referenced as a basis for measuring quality care
as the US shifts from a fee-for-service model to a value-based system —> for Affordable Care
and Patient Protection Act (ACA) 2010
Six quality aspects that are key to healthcare have been identified
aSafety
aEffectiveness
aTimeliness
aEfficiency
aPersonalization
aEquity
5. US NEWS AND WORLD REPORT BEST HOSPITALS RANKING
The four domains for hospital ranking are structure, process, outcomes, and patient safety.
Specifically for outcomes, the following measures are considered – risk-adjusted mortality based Annexures
85
on observed and expected values, and related indicators such as complications, readmissions,
patient safety, infection rate
Weighting
The weights given to each domain are as follows – 32.5% for outcomes, 30% for structure, 27.5%
for process, 10% for patient safety. Values normalized prior to weighting using the following
formula:
(Value – minimum possible) / (maximum possible – minimum possible)
6.  CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS) STAR
RATING – HOSPITAL QUALITY INITIATIVE
The aim was for patient’s to be able to choose hospitals based on ratings, which provides
incentive through profits gained by being patient’s choice.
The categories measured were informed by the IoM report, Agency for Healthcare Research
and Quality, National Quality Forum and The Joint Commission. A variety of data sources are
used to create The Hospital Compare profile, which consists of the following:
aGeneral Information
aSurvey of Patients’ Experience
aTimely and effective Care
aComplications
aReadmissions and deaths
aUse of medical imaging
aUsage rate by type of diagnostic test, to gauge over-usage or potential of missing a
diagnosis; often lower percentages are better or a recommended range is prescribed
aPayment and value of care
7.  STUDY OF SELECTED INTERNATIONAL HEALTH SYSTEMS – UK,
TAIWAN, JAPAN, GERMANY
Great Britain is seen to be a leader in preventive medicine and sees virtually no medical
bankruptcy.
Taiwan worked with a Harvard-led committee to examine the world’s best healthcare systems
before reforming their own. The underlying goals of reform were equal access, no waiting, and
competition among providers. An excellent information technology infrastructure was used to
create the ‘smart card’ for every citizen. No medical bankruptcy is observed, but the system,
however, is very financially strained.
Japan boasts of the world’s longest life expectancy and lowest infant mortality. The system is
one of social insurance – the government picks up a tab for those too poor to pay for healthcare.
The Japanese health ministry controls the price of healthcare tightly. Despite the system being
very popular among citizens, 50% hospitals are in financial deficit. Annexures
86
Germany: Sickness funds – premiums based on income to private insurers, are the main means of
healthcare funding. Health insurance continues with no change if citizens become unemployed.
The system is extremely efficient – medical providers and insurers negotiate standard prices.
Insurance plans actively compete though they are not allowed to profit.
SYSTEMS STUDIED FOR METHODOLOGY
1. Times Heath All India Multispeciality Hospitals Ranking Survey 2016
Desk Research, Factual Data Collection and a Perceptual Survey were used to choose hospitals
and identify indicators to be measured. A detailed scoring system was developed for each
parameter. After assigning scores to each parameter, raw scores were calculated. Based on
importance determined through a regression model, raw scores were weighted. The weighted
average of factual and perceptual score, with both given equal weight, yielded a final result.
2. WHO Ranking of World Health Systems
Methodologically, performance is measured by how well a country achieves the above five
goals, relative to how well it can given its resource and development level. It is acknowledged
that the overall goal attainment may not be ‘0’ even in the absence of a modern health system.
The framework is in reference to the minimum – the level of attainment that would exist even
in the absence of any health inputs.
A weighted average of the five component goals yields a conclusive result. A survey to gauge
preference of individuals in their valuation of each goal was used to reach the distribution. A
transcendental logarithmic model was used.
A linear equation is used to visualize the data, where the intercept is country-specific. Overall
efficiency is represented by [(composite)-(minimum)] / [(maximum-minimum)]
3. Times Higher Education Ranking
13 carefully calibrated performance indicators grouped into five areas – teaching, research,
citations, international outlook, industry income, each with different weights, are used.
On the rare occasions when the data are not provided, estimations are made – a low estimate
between average value of indicators and the lowest value reported i.e. the 25th percentile of
other indicators. That way, they avoid a harsh zero while being careful not to reward them for
withholding information
The standardization approach used is based on the distribution of data within a particular
indicator, and an evaluation is made on where a particular institution’s indicator sits within a
calculated cumulative probability function.
4. NBE Testing Methodology
Item response theory (IRT) is a psychometrically supported statistical model. The result is a
score that takes into account performance of the candidate as well as difficulty of the form.
The difficulty of each form may be perceived to vary. A post-equating process ensures fairness. Annexures
87
Exam items are concurrently analysed, and the estimated item parameters (item difficulty and
discrimination) are put onto a common metric.
5. Education Development Index – National University of Educational
Planning and Administration
Raw data is converted into a normalized form. First the Best and Worst values in an indicator
are identified. The BEST and the WORST values will depend upon the nature of a particular
indicator. The formula then used is: 1 – [best value – observed value] / [best value – worst value]
Once the Normalized Values are obtained for all the indicators across Districts/States, the
next step is to assign factor loadings and weights. Principal Component Analysis (PCA) is
used to compute the same. The objective of Principal Component analysis is to reduce the
dimensionality (number of indicators) of the data set but retain most of the original variability
in the data. The first Principal Component accounts for as much of the variability in the data
as possible, and each succeeding component accounts for as much of the remaining variability
as possible.
6. County Health Rankings and Roadmaps – Robert Wood Johnson
Foundation
Each measure within each state is standardized to the average of counties in that state. The
measures are in a number of different scales—some are percentages, some are rates, some
are averages of survey responses, or other metrics. Standardizing each of these measures
transforms them to the same metric—a mean (average) value of 0 and a standard deviation
(measure of spread) of 1. We refer to these as Z-scores where:
Z = [ (County Value)–(Average of Counties in State)] / [ (Standard Deviation of Counties in
State)]
Each Z-score is relative to the other counties in that state—not compared to an absolute
standard—and shown in the metric of standard deviations. A positive Z-score indicates a value
higher than the average of counties in that state; a negative Z-score indicates a value for that
county lower than the average of counties in that state. For most of the measures, a higher
Z-score score indicates poorer health, but for those that it doesn’t, the sign is merely reversed.
The overall scores computed are weighted composites of the Z-scores for individual measures
where the weights represent relative importance of the different measures. Annexures
88
ANNEXURE 3
DEFINITIONS OF KEY PERFORMANCE INDICATORS (KPI s) FOR THE
DISTRICT HOSPITAL PERFORMANCE ASSESSMENT
Indicator categories:
A–Indicators that are largely under the control of the State
B–Indicators that are largely under the control of the district hospital
Sr.
No.
Category
of the
KPI
Key
Performance
Indicator
(KPI)
NumeratorDenominator
Source of
Information
Domain: Structure
1 A Number of
functional
hospital
beds per
100,000
population
Number of functional
hospital beds X 100,000
Inclusion:
1. Beds available in hospital
for admissions
Exclusion:
1. Floor Beds*
2. Trolley Beds*
3. Labour Room/ OT
Tables
4. Observation Beds in
Emergency/OT/Labour
Room*
*To be captured to the
extent possible
Population of
district according
to Census 2011
Special
Consideration: If
the district has
more than one
district hospital,
the population
denominator will
be estimated in
the same ration as
ratio of number of
beds of particular
DH to DH level
beds
Numerator: HMIS
Infrastructure
format
Denominator:
Manual entry
(Census of India
2011)
2.1 A Ratio of
doctors in
position to
IPHS norms
Number of doctors in
position
Inclusion: MBBS/BDS/
AYUSH
Specialist
IPHS norm for
the respective
category hospitals
500 beds – 68
400 beds – 58
300 beds – 50
200 beds – 34
100 beds – 29
Numerator: HMIS
Infrastructure
format
Denominator:
Pre-entered value
(IPHS guidelines
for district
hospitals, 2012,
p. 37) Annexures
89
Sr.
No.
Category
of the
KPI
Key
Performance
Indicator
(KPI)
NumeratorDenominator
Source of
Information
2.2 A Ratio of staff
nurses in
position to
IPHS norm
Number of staff nurses in
position
Exclusion: ANM
IPHS norm for
the respective
category hospitals
500 beds – 225
400 beds – 180
300 beds – 135
200 beds – 90
100 beds – 45
Numerator: HMIS
Infrastructure
format
Denominator:
Pre-entered value
(IPHS guidelines
for district hospi-
tals, 2012, p. 37)
2.3 A Ratio of
paramedical
staff in
position to
IPHS norm
Number of paramedical
staff in position
Inclusion: All categories
included in IPHS
IPHS norm for
the respective
category hospitals
500 beds – 100
400 beds – 81
300 beds – 66
200 beds – 42
100 beds – 31
Numerator: HMIS
Infrastructure
format
Denominator:
Pre-entered value
(IPHS guidelines
for district
hospitals, 2012,
p. 37)
3 B Availability
of support
services
Proportion of the following
support services available
from the total:
i. Hospital information
system (At least OPD,
IPD and Pharmacy
Module)
ii. Sterilization and
Disinfection – CSSD
(Central Sterile Supply
Department)
iii. Blood Bank
iv. Waste management
including biomedical
waste
v. Medico-legal / post-
mortem
vi. Dietary services for
patient
vii. Electric supply backup
viii. Pharmacy
ix. Water supply
(plumbing)
x. Refrigeration
14 Numerator: For
item (i) – Manual
entry
For items (ii) to
(x) – IPHS
Infrastructure
format
Denominator:
Pre-entered value
(based on IPHS
guidelines for
district hospitals,
2012, p. 6) Annexures
90
Sr.
No.
Category
of the
KPI
Key
Performance
Indicator
(KPI)
NumeratorDenominator
Source of
Information
4 A Availability
of core
health care
services
Proportion of specialties
from the list that are
functional
i. General Medicine
ii. General Surgery
iii. Obstetrics and
Gynaecology
iv. Paediatrics, including
neonatology [as
required for a Level II
SNCU]
v. Emergency (Accident
and other emergency)
(Casualty 24x7 basis)
vi. Critical Care (ICU)
vii. Anaesthesia
viii. Ophthalmology
ix. ENT
x. Dermatology and
Venereology (Skin and
VD) RTI/STI
xi. Orthopaedics
xii. Dental Care
xiii. Public Health Unit
(may be collocated)
xiv. Radiology
14Numerator: HMIS
Infrastructure
format
Denominator:
Pre-entered value
(based on IPHS
guidelines for
district hospitals,
2012, p. 6)
5 A Availability
of diagnostic
testing
services
Number of diagnostic
services available
i. Urine analysis
ii. Stool analysis
iii. PAP Smear
iv. Sputum
v. Haematology
vi. Microbiology
vii. Serology
viii. Biochemistry
ix. Cardiac Investigation
x. Ophthalmology
xi. ENT
14Numerator: HMIS
Infrastructure
format
Denominator:
Pre-entered value
(based on IPHS
guidelines for
district hospitals,
2012, p. 58–60) Annexures
91
Sr.
No.
Category
of the
KPI
Key
Performance
Indicator
(KPI)
NumeratorDenominator
Source of
Information
xii. Radiology
xiii. Endoscopy
xiv. Physiology (Pulmonary
Function Test)
Inclusion:
In-house lab
Outsourced laboratories
Exclusion:
Test done through referral
laboratories
Domain: Output
6 B Bed
occupancy
rate
Total number of inpatient
bed days added for a year
X 100
Exclusion:
Day Care Patients; Newborn
admitted with mother in
maternity ward
Total Functional
Beds X 365
Exclusion:
1. Floor Beds
2. Trolley Beds
3. Labour Room/
OT Tables
4. Observation
Beds in
Emergency/OT/
Labour Room
Numerator:
Statement
from medical
superintendent
office (manual
entry)
Denominator:
HMIS
Infrastructure
format
7 B C-section
rate
Number of C-section
deliveries performed in the
year X 100
Total number of
deliveries in the
year (Normal +
Assisted Deliveries
+ C Section)
Numerator &
Denominator:
HMIS service
delivery format
8 B Surgical
productivity
index
Total number of major
surgeries in a year
Exclusion: Obstetrics
& Gynaecology,
Ophthalmology surgeries
Total number
of surgeons
excluding
Obstetric/
Gynaecological
surgeon;
Ophthalmologist;
Dental Surgeon
Numerator: OT
register
Denominator:
HMIS
Infrastructure
format Annexures
92
Sr.
No.
Category
of the
KPI
Key
Performance
Indicator
(KPI)
NumeratorDenominator
Source of
Information
9 B OPD per
doctor
Total number of OPD
patients in a year
Number of
positioned
doctors X OPD
days in that year
Numerator: HMIS
service delivery
format
Denominator:
HMIS
Infrastructure
format +
Statement
from medical
superintendent
office (manual
entry)
10 B Blood bank
replacement
rate
Total number of blood units
issued on replacement in
the year X 100
Total number of
blood units issued
in year
Inclusion:
Voluntary
donation;
Replacement
Numerator &
Denominator:
Blood bank issue
register
Note:
The original endeavour of the exercise was to assess district hospitals on the basis of a composite,
weighted score of 16 indicators. In order to compute the index, the hospital raw scores of each
KPI, which were not in uniform units, were to be scaled as per the formulae below. A composite
index was to be calculated by taking the average of the scaled values, a higher index indicating
a better hospital.
Scaling formula
Scaled value (positive indicator*) =
X – Minimum value
Maximum value – Minimum value
Scaled value (negative indicator*) =
Maximum value – X
Maximum value – Minimum value
* Three indicators (stockout rate of essential drugs, blood bank replacement rate, post-surgical infection rate)
shortlisted for the assessment had negative valence, while the rest of the KPIs had positive valence.
Due to significant limitations in the data, 6 KPIs were excluded from the assessment. The
excluded KPIs are listed in the table below, accompanied with their definitions. Due to this
exclusion, the composite index of hospitals was disregarded as it would not provide a complete
reflection of the service delivery of hospitals. Alternatively, the hospitals were assessed for their
performance on individual KPIs. However, in order to shortlist the top performing hospitals, in
the case of a tie in their raw score, the composite score of the hospital (average of the scaled
values of the above-listed 10 KPIs) was considered, and the district hospital with a higher
composite score was viewed as the better performing hospital. Annexures
93
List of KPIs excluded from the assessment:
Sr. No.
Category
of the KPI
Key
Performance
Indicator (KPI)
Numerator Denominator Source of Information
Domain: Process
1 B Kayakalp
score
Total obtained
score (on peer
assessment) X 100
Total no. of
Checkpoint X 2
Online where
possible (Kaykalp
score generated
using Kayakalp
assessment through
peer review process
validated by district
Kayakalp committee)
2 B Quality ScoreTotal obtained
score X 100
Total no. of
Checkpoint X 2
Online where
possible (QA score
generated using
NQAS assessment
tool for district
hospital)
Domain: Output and Outcome
3 B Number of
laboratory
tests per
technician
Number of lab
tests conducted
Inclusion: Test
done in in-house
laboratory
Exclusion: Lab
test done bed
side/ Point of
care lab test done
in outsourced
laboratory
Number of lab
technicians available
in-house
Inclusion: Lab
technician available
in-house, including
lab technician
deputed under
disease control
program such as
RNTCP, NVBDCP &
NACP.
Exclusion: Lab
technician in
outsourced
laboratory; lab
attendants
Numerator:
Laboratory register
Denominator:
Statement
from Medical
Superintendent
on Laboratory
Technician in Position
(taking into account
exclusion criteria)
4 B Stock-out
rate of
essential
drugs
Total no. of
stockout days in
the year X 100
Stock out days:
Total no. of stock
outs occurred daily
added for the year
Total number of
essential drugs X
365
Numerator and
Denominator:
Drug and Vaccine
Distribution
Management System
(DVDMS) Annexures
94
Sr. No.
Category
of the KPI
Key
Performance
Indicator (KPI)
Numerator Denominator Source of Information
5 B Post-surgical
infection rate
No. of surgical
cases developed
post- operative
surgical site
infection during
the year
Surgical site
infection – Any
purulent discharge
around the wound
or the insertion
site of the drain, or
spreading cellulitis
from the wound
Total No. of clean
surgeries performed
in the year
Numerator: OT septic
register
Denominator: OT
Register
6 B Patient
satisfaction
score
Feedback score
obtained by
patient satisfaction
survey X 100
Total no. of patients
interacted X
maximum score
As is calculated.
Where the DH has
no patient feedback
system, score will be
0. Annexures
95
ANNEXURE 4
STATE/UT-WISE TOP SCORING DISTRICT HOSPITAL FOR EACH KEY
PERFORMANCE INDICATOR (KPI)
Indicator
State/UT
1. Number of
functional beds
per 100,000
population
2.1 Number of
doctors in position
to IPHS norms
2.2 Number of
nurses in position
to IPHS norms
2.3 Number of
paramedicals in
position to IPHS
norms
Andaman and
Nicobar Islands
BJR Hospital,
Nicobar
G.B.Pant Hospital,
South Andaman
G.B.Pant Hospital,
South Andaman
G.B.Pant Hospital,
South Andaman
Andhra Pradesh
King George
Hospital TH,
Vishakapatnam
King George
Hospital TH,
Vishakapatnam
King George
Hospital TH,
Vishakapatnam
King George
Hospital TH,
Vishakapatnam
Arunachal
Pradesh
GH Pasighat, East
Siang
Tomo Riba Institute
of Medical Science
& Hospital, Papum
Pare
Tomo Riba Institute
of Medical Science
& Hospital, Papum
Pare
Tomo Riba
Institute of
Medical Science
& Hospital
Assam
Haflong Civil
Hospital, Dima
Hasao
Diphu Civil
Hospital, Karbi
Anglong
LGB Civil
Hospital, Tinsukia
200 Bedded
Civil Hospital,
Goalpara
Bihar
Sadar Hospital
Saharsa, Saharsa
Sadar Hospital
Jehanabad,
Jehanabad
Sadar Hospital
Samastipur,
Samastipur
Sadar Hospital
Nawada, Nawada
Chhattisgarh
Narayanpur DH,
Narayanpur,
Chhattisgarh
Raipur DH, Raipur,
Chhattisgarh
Raipur DH,
Raipur,
Chhattisgarh
Dantewada,
Dantewada,
Chhattisgarh
Daman and Diu
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Delhi
Hedgewar
Hospital,
Shahdara
Lal Bahadur Shastri
Hospital, East Delhi
Deendayal
Upadhyay
Hospital, West
Delhi
Deendayal
Upadhyay
Hospital, West
Delhi
Goa
South Goa
District Hospital,
South Goa
North Goa District
Hospital, North Goa
North Goa
District Hospital,
North Goa
North Goa
District Hospital,
North Goa
Gujarat
General Hospital
Dang, The Dangs
General Hospital
Dahod, Dahod
General Hospital
Vyara, Tapi
General Hospital
Dang, The Dangs
Haryana
Civil Hospital,
Panchkula
Civil Hospital,
Ambala
LNJP Civil
Hospital,
Kurukshetra
Civil Hospital,
Rohtak
Note: As the UTs of Chandigarh, Dadra and Nagar Haveli, and Lakshadweep had only one district hospital
participating in the assessment, these UTs are not included in this table.
Dadra & Nagar Haveli and Daman & Diu are regarded as separate UTs in this assessment Annexures
96
Indicator
State/UT
1. Number of
functional beds
per 100,000
population
2.1 Number of
doctors in position
to IPHS norms
2.2 Number of
nurses in position
to IPHS norms
2.3 Number of
paramedicals in
position to IPHS
norms
Himachal
Pradesh
Bilaspur RH,
Bilaspur
Nahan RH, Sirmaur Nahan RH,
Sirmaur
Bilaspur RH,
Bilaspur
Jammu and
Kashmir
DH Doda, Doda DH Anantnag,
Anantnag
DH Handwara,
Kupwara
DH Kargil, Kargil
Jharkhand
Hazaribagh
Sadar Hospital,
Hazaribagh
Ranchi Sadar
Hospital, Ranchi
Ranchi Sadar
Hospital, Ranchi
Purbi Singhbhum
Sadar Hospital,
Purbi Singhbhum
Karnataka
Dharwad DH
FRU, Dharwad
Victoria Hospital,
Bangalore Urban
Belgaum DH,
Belgaum
Shimoga DH,
Shimoga
Kerala
W&C Hospital
Thiruvananthapuram,
Thiruvananthapuram
GH Ernakulam,
Ernakulam
GH Ernakulam,
Ernakulam
GH Ernakulam,
Ernakulam
LadakhKargil DH, Leh Kargil DH, KargilKargil DH, KargilKargil DH, Kargil
Madhya Pradesh
DH Datia, DatiaDH Gwalior, GwaliorDH Rewa, Rewa DH Tikamgarh,
Tikamgarh
Maharashtra
DH Bhandara,
Bhandara
DH Hingoli, Hingoli DH Hingoli,
Hingoli
District Hospital
Jalna, Jalna
Manipur
Churachandpur
District Hospital,
Churachandpur
Churachandpur
District Hospital,
Churachandpur
Thoubal District
Hospital, Thoubal
Churachandpur
District Hospital,
Churachandpur
Meghalaya
Ganesh Das
Hospital, East
Khasi Hills
Tura Civil Hospital,
West Garo Hills
Tura Maternity
and Child
Hospital, West
Garo Hills
Nongpoh DH,
Ri Bhoi
Mizoram
Lunglei DH,
Lunglei
Aizawl Civil
Hospital, Aizawl
West
Aizawl Civil
Hospital, Aizawl
West
Aizawl Civil
Hospital, Aizawl
West
Nagaland
Ongpangkong
DH, Mokokchung
Dimapur DH,
Dimapur
Dimapur DH,
Dimapur
Ongpangkong
DH, Mokokchung
Odisha
Subarnapur,
Sonapur
Balangir DH,
Balangir
Rayagada DH,
Rayagada
Phulbani DH,
Kandhamal
Puducherry
Govt. General
Hospital, Mahe
RGGW & CH,
Pondicherry
Govt. General
Hospital, Yanam
Govt. General
Hospital, Karaikal
Punjab
Nawanshahar DH,
Nawanshahr
Bathinda DH,
Bathinda
Amritsar DH,
Amritsar
Mansa DH, Mansa
Rajasthan
District Hospital
Chittaurgarh,
Chittaurgarh
B.D.K. Hospital
Jhunjhunun,
Jhunjhunun
District Sahadat
Hospital Tonk,
Tonk
Govt Hospitls
Sriganganagar,
Ganganagar
Sikkim
Mangan Hospital,
North Sikkim
Namchi District
Hospital, South
Sikkim
District Hospital
Gyalshing, West
Sikkim
Singtam Hospital,
East Sikkim Annexures
97
Indicator
State/UT
1. Number of
functional beds
per 100,000
population
2.1 Number of
doctors in position
to IPHS norms
2.2 Number of
nurses in position
to IPHS norms
2.3 Number of
paramedicals in
position to IPHS
norms
Tamil Nadu
Perambalur DH,
Perambalur
Kilpauk Hospital,
Chennai
Kilpauk Hospital,
Chennai
Kilpauk Hospital,
Chennai
Telangana
DH Sangareddy,
Sangareddy
DH Khammam,
Khammam
Tandur DH,
Vikarabad
Kingkoti DH,
Hyderabad
Tripura
District Hospital
Unakoti District,
Unakoti
District Hospital
Gomati District,
Gomati
District Hospital
North Tripura,
North Tripura
District Hospital
South, South
Tripura
Uttar Pradesh
Rani Laxmi
Bai Combined
Hospital,
Lucknow
Lokbandhu
Raj Narain DH,
Lucknow
Mahatma Jyotiba
Phule DH,
Ambedkar Nagar
Combined DH,
Kannauj
Uttarakhand
Shyam Lal Shah
DH, Bageshwar
B D Pandey District
Male Hospital,
Pithoragarh
DH Bauradi, Tehri
Garhwal
DH Bauradi, Tehri
Garhwal
West Bengal
Jhargram DH &
SSH, Jhargram
M. R. Bangur DH &
SSH, South Twenty
Four Parganas
M. R. Bangur DH &
SSH, South Twenty
Four Parganas
Tamluk District
Hospital, Purba
Medinipur
Indicator
State/UT
3. Support
services
4. Core healthcare
services
 5. Diagnostic
testing services
6. Bed occupancy
rate
Andaman and
Nicobar Islands
BJR Hospital,
Nicobar
G.B.Pant Hospital,
South Andaman
Dr. R.P.Hospital,
North and Middle
Andaman
G.B.Pant Hospital,
South Andaman
Andhra Pradesh
Govt.Maternity
Hospl.TH,
Chittoor
RIMS Srikakulam
TH, Srikakulam
King George
Hospital TH,
Vishakapatnam
GGH Anantapur,
Anantapur
Arunachal
Pradesh
DH Roing, Lower
Dibang Valley
Tomo Riba Institute
of Medical Science
& Hospital, Papum
Pare
Tomo Riba
Institute of
Medical Science &
Hospital, Papum
Pare
Tomo Riba
Institute of
Medical Science
& Hospital,
Papum Pare
Assam
Barpeta Civil
Hospital
Kalgachia,
Barpeta
Sivasagar Civil
Hospital, Sibsagar
200 Bedded
Civil Hospital,
Goalpara
North Lakhimpur
Civil Hospital,
Lakhimpur
Bihar
Sadar Hospital
Sitamarhi,
Sitamarhi
Sadar Hospital
Motihari Purbi
Champaran,
East Champaran
Sadar Hospital
Purnia, Purnia
Sadar Hospital
Hajipur Vaishali,
Vaishali
Chhattisgarh
Raipur DH,
Raipur
Indira Gandhi DH
Korba, Korba
Indira Gandhi DH
Korba, Korba
Dantewada DH,
Dantewada Annexures
98
Indicator
State/UT
3. Support
services
4. Core healthcare
services
 5. Diagnostic
testing services
6. Bed occupancy
rate
Daman and Diu
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Delhi
Sanjay Gandhi
Memorial
Hospital
Mangolpuri,
North West Delhi
Sanjay Gandhi
Memorial Hospital
Mangolpuri, North
West Delhi
Pt. Madan Mohan
Malviya Hospital,
South Delhi
Guru Govind
Singh Govt
Hospital, West
Delhi
Goa
North Goa
District Hospital,
North Goa
South Goa District
Hospital, South Goa
North Goa
District Hospital,
North Goa
North Goa
District Hospital,
North Goa
Gujarat
General Hospital
Mehsana,
Mahesana
General Hospital
Vyara,Tapi
General Hospital
Dahod, Dahod
PK General
Hospital, Rajkot
Haryana
Civil Hospital,
Rohtak
Civil Hospital,
Rohtak
Civil Hospital,
Panchkula
LNJP Civil
Hospital,
Kurukshetra
Himachal
Pradesh
DDU ZH, Shimla Nahan RH, Sirmaur Mandi ZH, Mandi Kullu RH, Kullu
Jammu and
Kashmir
DH Baramula,
Baramula
District Hospital
JNLM, Srinagar
DH Baramula DH Kulgam,
Kulgam
Jharkhand
Kodrma Sadar
Hospital,
Kodarma
Ranchi Sadar
Hospital, Ranchi
Jamtara Sadar
Hospital, Jamtara
Lohardaga
Sadar Hospital,
Lohardaga
Karnataka
Shimoga DH,
Shimoga
Shimoga DH,
Shimoga
Shimoga DH,
Shimoga
Gadag DH FRU,
Gadag
Kerala
GH Ernakulam,
Ernakulam
GH Ernakulam,
Ernakulam
GH Thrissur,
Thrissur
DH
Mananthavady,
Wayanad
LadakhLeh DH, Leh Kargil DH, Kargil Leh DH, Leh Kargil DH, Kargil
Madhya Pradesh
DH Satna, Satna DH Satna, Satna DH Sehore,
Sehore
DH Dhar, Dhar
Maharashtra
District Hospital
Alibag, Raigarh
District Hospital
Nashik, Nashik
District Hospital
Gadchiroli,
Gadchiroli
Women Hospital
Parbhani,
Parbhani
Manipur
Thoubal District
Hospital, Thoubal
Thoubal District
Hospital, Thoubal
Bishnupur
District Hospital,
Bishnupur
Churachandpur
District Hospital,
Churachandpur Annexures
99
Indicator
State/UT
3. Support
services
4. Core healthcare
services
 5. Diagnostic
testing services
6. Bed occupancy
rate
Meghalaya
Ganesh Das
Hospital, East
Khasi Hills
Jowai Civil Hospital,
West Jaintia Hills
Shillong Civil
Hospital, East
Khasi Hills
Tura Maternity
and Child
Hospital, West
Garo Hills
Mizoram
Aizawl Civil
Hospital, Aizawl
West
Aizawl Civil
Hospital, Aizawl
West
Aizawl Civil
Hospital, Aizawl
West
Serchhip DH,
Serchhip
Nagaland
Ongpangkong
DH, Mokokchung
Ongpangkong DH,
Mokokchung
Ongpangkong
DH, Mokokchung
Ongpangkong
DH, Mokokchung
Odisha
DH Balangir,
Balangir
Capital Hospital,
Khordha
Capital Hospital,
Khordha
DH Baripada,
Mayurbhanj
Puducherry
Govt. General
Hospital, Karaikal
Govt. General
Hospital, Karaikal
Govt. General
Hospital, Karaikal
RGGW & CH,
Pondicherry
Punjab
Amritsar DH,
Amritsar
Jalandhar DH,
Jalandhar
Ludhiana DH,
Ludhiana
Gurdaspur DH,
Gurdaspur
Rajasthan
Govt Hospitls
Sriganganagar,
Ganganagar
Govt Hospitls
Sriganganagar,
Ganganagar
M G Hospital
Bhilwara, Bhilwara
District Sahadat
Hospital Tonk,
Tonk
Sikkim
Namchi District
Hospital, South
Sikkim
Namchi District
Hospital, South
Sikkim
Singtam DH, East
Sikkim
Namchi District
Hospital, South
Sikkim
Tamil Nadu
Dindigul DH,
Dindigul
Kilpauk Hospital,
Chennai
Kilpauk Hospital,
Chennai
Krishnagiri DH,
Krishnagiri
Telangana
DH Khammam,
Khammam
DH Khammam,
Khammam
Karimnagar DH,
Karim Nagar
DH Khammam,
Khammam
Tripura
District Hospital
Gomati District,
Gomati
District Hospital
Gomati District,
Gomati
District Hospital
Gomati District,
Gomati
District Hospital
Gomati District,
Gomati
Uttar Pradesh
Ram Manohar
Lohiya DH,
Lucknow
Ram Manohar
Lohiya DH,
Lucknow
Shyama Prasad
Mukherjee DH,
Lucknow
District Female
Hospital, Mainpuri
Uttarakhand
J.L.N. District
Hospital, Udham
Singh Nagar
Shyam Lal Shah
DH, Bageshwar
B.D.Pandey Male
Hospital, Nainital
H G Pant District
Female Hospital,
Pithoragarh
West Bengal
Tamluk District
Hospital, Purba
Medinipur
M. R. Bangur DH &
SSH, South Twenty
Four Parganas
M. R. Bangur DH
& SSH, South
Twenty Four
Parganas
Alipurduar
District Hospital,
Alipurduar Annexures
100
Indicator
State/UT
7. C-section rate
(Hospital with max.
value)
8. Surgical
Productivity
Index
9. OPD per
Doctor
10. Bloodbank
Replacement Rate
(Hospital with min.
value)
Andaman and
Nicobar Islands
G.B.Pant Hospital,
South Andaman
G.B.Pant Hospital,
South Andaman
G.B.Pant Hospital,
South Andaman
BJR Hospital,
Nicobar
Andhra
Pradesh
DH Machilipatnam,
Krishna
DH Proddutur,
Cuddapah
DH Tenali, GunturRIMS Ongole TH,
Prakasam
Arunachal
Pradesh
Tomo Riba Institute
of Medical Science
& Hospital, Papum
Pare
Tomo Riba
Institute of Medical
Science & Hospital,
Papum Pare
DH Roing, Lower
Dibang Valley
General Hospital
Aalo, West Siang
Assam
Sonapur District
Hospital, Kamrup M
(C-section rate)
Dhemaji Civil
Hospital, Dhemaji
Mangaldai Civil
Hospital, Darrang
TRB Civil
Hospital, Kamrup
R
Bihar
Sadar Hospital
Motihari Purbi
Champaran, East
Champaran
Sadar Hospital
Saharsa, Saharsa
Sadar Hospital
Jamui, Jamui
Sadar Hospital
Khagaria,
Khagaria
Chhattisgarh
Bilaspur DH,
Bilaspur
DH Baloda Bazar,
Baloda Bazar
DH Baloda Bazar,
Baloda Bazar
Dhamtari DH,
Dhamtari
Daman and Diu
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Government
Hospital Daman,
Daman
Delhi
Hedgewar Hospital,
Shahdara Delhi
Sanjay Gandhi
Memorial Hospital
Mangolpuri, North
West Delhi
Deep Chand
Bandhu Hospital,
North West Delhi
Kasturba Hospital,
Central Delhi
Goa
South Goa District
Hospital, South Goa
North Goa District
Hospital, North
Goa
South Goa
District Hospital,
South Goa
South Goa
District Hospital,
South Goa
Gujarat
General Hospital
Mehsana, Mahesana
S.S.Hospital Petlad,
Anand
Jam Khambhalia,
Devbhumi
Dwarka (OPD
Gujarat)
General Hospital
Vyara,Tapi
Haryana
Civil Hospital,
Panchkula
Civil Hospital,
Mahendragarh
Civil Hospital,
Bhiwani
Civil Hospital,
Panchkula
Himachal
Pradesh
Una RH, Una Mandi ZH, Mandi Chamba RH MCH
Centre, Chamba
Hamirpur RH,
Hamirpur
Jammu and
Kashmir
District Hospital
JNLM, Srinagar
DH Reasi, Reasi DH Shopain,
Shopian
DH Bandipora,
Bandipora
Jharkhand
Ranchi Sadar
Hospital, Ranchi
Garhwa Sadar
Hospital, Garhwa
Ranchi Sadar
Hospital, Ranchi
Jamtara Sadar
Hospital, Jamtara Annexures
101
Indicator
State/UT
7. C-section rate
(Hospital with max.
value)
8. Surgical
Productivity
Index
9. OPD per
Doctor
10. Bloodbank
Replacement Rate
(Hospital with min.
value)
Karnataka
Bijapur DH FRU,
Bijapur
Chikmagalur DH
FRU, Chikmagalur
Uttara Kannada
District Hospital
FRU
Belgaum DH,
Belgaum
Kerala
DH Aluva,
Ernakulam
General Hospital
Thiruvananthapuram
DH Tirur,
Malappuram
GH Ernakulam,
Ernakulam
LadakhLeh DH, Leh Leh DH, Leh Leh DH, Leh Kargil DH, Kargil
Madhya
Pradesh
DH Balaghat,
Balaghat
DH Gwalior,
Gwalior
DH Bhind, Bhind DH Mandsaur,
Mandsaur
Maharashtra
Sindhudurg DH,
Sindhudurg
Sindhudurg DH,
Sindhudurg
District Hospital
Jalgaon, Jalgaon
Lt Karntisigh
Nana Patil Civil
Hospital Satara,
Satara
Manipur
Thoubal District
Hospital, Thoubal
Churachandpur
District Hospital,
Churachandpur
Thoubal District
Hospital, Thoubal
Bishnupur
District Hospital,
Bishnupur
Meghalaya
Ganesh Das
Hospital, East Khasi
Hills
Shillong Civil
Hospital, East
Khasi Hills
Mairang DH,
West Khasi Hills
Tura Civil
Hospital, West
Garo Hills
Mizoram
Lunglei DH,
Lunglei
Aizawl Civil
Hospital, Aizawl
West
Aizawl Civil
Hospital, Aizawl
West
Mamit DH, Mamit
Nagaland
Ongpangkong DH,
Mokokchung
District Hospital,
Dimapur
Ongpangkong
DH, Mokokchung
Wokha DH, Woha
Odisha
DH Paralakhemundi,
Gajapati
Capital Hospital,
Khordha
DH Nayagarh,
Nayagarh
DH Baripada,
Mayurbhanj
Puducherry
Govt. General
Hospital, Karaikal
Govt. General
Hospital, Karaikal
Govt. General
Hospital, Mahe
RGGW & CH,
Pondicherry
Punjab
Sangrur DH,
Sangrur
Sangrur DH,
Sangrur
Tarn Taran DH,
Tarn Taran
Sangrur DH,
Sangrur
Rajasthan
District Hospital
Banswara,
Banswara
District Hospital
Barmar, Barmer
A K Hospital
Beawar Ajmer,
Ajmer
A K Hospital
Beawar Ajmer,
Ajmer
Sikkim
Namchi District
Hospital, South
Sikkim
Namchi District
Hospital, South
Sikkim
Namchi District
Hospital, South
Sikkim
Singtam DH, East
Sikkim
Tamil Nadu
Padhmanamapuram
DH, Kanniyakumari
Tenkasi DH,
Tirunelveli
Walajapet, DH
Vellore
Thiruvallur DH,
Thiruvallur
Telangana
Karimnagar DH,
Karim Nagar
Karimnagar DH,
Karim Nagar
Tandur DH,
Vikarabad
Nalgonda DH,
Nalgonda Annexures
102
Indicator
State/UT
7. C-section rate
(Hospital with max.
value)
8. Surgical
Productivity
Index
9. OPD per
Doctor
10. Bloodbank
Replacement Rate
(Hospital with min.
value)
Tripura
District Hospital
Gomati District,
Gomati
District Hospital
Unakoti District,
Unakoti
Khowai District
Hospital, Khowai
District Hospital
Gomati District,
Gomati
Uttar Pradesh
Lokbandhu
Raj Narain DH,
Lucknow
Tej Bahadur Sapru
Hospital, Prayagraj
District Women
Hospital,
Maunathbhanjan
DH Male Agra,
Agra
Uttarakhand
H G Pant District
Female Hospital,
Pithoragarh
District Hospital,
Uttarkashi
J.L.N. District
Hospital, Udham
Singh Nagar
B.D.Pandey Male
Hospital, Nainital
West Bengal
M. R. Bangur DH &
SSH, South Twenty
Four Parganas
M. R. Bangur DH
& SSH, South
Twenty Four
Parganas
Barasat DH,
North Twenty
Four Parganas
Imambara District
Hospital, Hugli Annexures
103
ANNEXURE 5
GRAPHS ILLUSTRATING THE STATE/UT-WISE AVERAGE RAW
SCORE OF EACH KPI FOR EACH HOSPITAL CATEGORY (SMALL,
MID-SIZED, AND LARGE)
KPI 1: NUMBER OF FUNCTIONAL BEDS PER 100,000 POPULATION
294
199
114
102
96
78
70
6257
4944
333024242321201917 17171615151312111099853
Puducherry
A & N Islands
Ladakh
Daman & Diu
Arunachal Pradesh
Lakshadweep
Sikkim
Mizoram
Delhi
Nagaland
Himachal Pradesh
Meghalaya
Tripura
Manipur
Uttarakhand
Odisha
India
Chhattisgarh
Punjab
Jammu & Kashmir
Karnataka
Assam
Gujarat
Rajasthan
Madhya Pradesh
Maharashtra
Uttar Pradesh
Haryana
West Bengal
Tamil Nadu
Jharkhand
Kerala
Bihar
Telangana
Figure A1-1: Average number of beds in small district hospitals (up to 200 beds) for every
1 lakh population by State/UT
187
144
70
46
36
322928
232221202018171615141413131211
8
Ladakh
Arunachal Pradesh
Mizoram
Himachal Pradesh
Haryana
Goa
Karnataka
Chhattisgarh
India
Assam
Kerala
Madhya Pradesh
Gujarat
Odisha
Rajasthan
Delhi
Telangana
Uttar Pradesh
Tamil Nadu
West Bengal
Andhra Pradesh
Maharashtra
Bihar
Punjab
Figure A1-2: Average number of beds in mid-sized district hospitals (201–300 beds) for
every 1 lakh population by State/UT
200
150
119
9289
57
38
3330292828252322212121201916131212
A & N Islands
Puducherry
Meghalaya
Dadra & Nagar Haveli
Delhi
Chandigarh
Karnataka
India
Gujarat
Uttar Pradesh
Tamil Nadu
Madhya Pradesh
Kerala
Assam
Rajasthan
Punjab
Andhra Pradesh
Odisha
West Bengal
Jharkhand
Maharashtra
Telangana
Chhattisgarh
Bihar
Figure A1-3: Average number of beds in large district hospitals (more than 300 beds) for
every 1 lakh population by State/UT Annexures
104
KPI 2: RATIO OF DOCTORS, STAFF NURSES, AND PARAMEDICAL
STAFF IN PROPORTION TO IPHS NORMS
For hospitals with up to 100 beds:
2.42
1.46
1.21
1.08
1.01
1.00
0.93
0.90
0.87
0.80
0.77
0.77
0.72
0.70
0.70
0.69
0.62
0.58
0.57
0.57
0.56
0.55
0.49
0.48
0.47
0.45
0.41
0.41
0.34
0.24
Delhi
Haryana
West Bengal
Jammu & Kashmir
Manipur
Puducherry
Madhya Pradesh
Odisha
Punjab
Maharashtra
Assam
Sikkim
Lakshadweep
India
Chhattisgarh
Telangana
Bihar
Arunachal Pradesh
Tripura
Jharkhand
Meghalaya
Uttar Pradesh
Karnataka
Nagaland
Uttarakhand
Daman & Diu
A & N Islands
Mizoram
Gujarat
Himachal Pradesh
Meets 
requirement1
Figure A2.1-1: State/UT-wise average ratio of doctors in hospitals with up to 100 beds in
position to the IPHS requirement of 29 doctors
1.99
1.36
1.25
0.98
0.98
0.97
0.96
0.89
0.88
0.82
0.80
0.75
0.70
0.67
0.63
0.61
0.60
0.58
0.53
0.49
0.47
0.47
0.44
0.40
0.38
0.36
0.33
0.32
0.23
0.13
Delhi
Puducherry
Madhya Pradesh
West Bengal
Haryana
Maharashtra
Tripura
Odisha
Punjab
Telangana
Meghalaya
Bihar
Manipur
Chhattisgarh
Gujarat
India
Karnataka
Assam
Sikkim
Uttar Pradesh
Arunachal Pradesh
Lakshadweep
Daman & Diu
Mizoram
Uttarakhand
A & N Islands
Nagaland
Jammu & Kashmir
Jharkhand
Himachal Pradesh
Meets 
requirement1
Figure A2.1-2: State/UT-wise average ratio of nurses in hospitals with up to 100 beds in
position to the IPHS requirement of 45 nurses
3.36
2.87
2.81
2.71
2.62
2.10
2.05
2.02
2.00
1.87
1.80
1.77
1.52
1.45
1.41
1.39
1.34
1.31
1.25
1.22
1.18
1.02
1.00
0.97
0.93
0.65
0.60
0.55
0.39
0.29
Delhi
Tripura
Haryana
Punjab
Manipur
West Bengal
Odisha
Arunachal Pradesh
Puducherry
Mizoram
Sikkim
Nagaland
India
Uttar Pradesh
Madhya Pradesh
A & N Islands
Bihar
Chhattisgarh
Jammu & Kashmir
Karnataka
Jharkhand
Maharashtra
Assam
Lakshadweep
Uttarakhand
Meghalaya
Gujarat
Himachal Pradesh
Telangana
Daman & Diu
Meets 
requirement1
Figure A2.1-3: State/UT-wise average ratio of paramedical staff in hospitals with up to 100
beds in position to the IPHS requirement of 31 paramedical staff Annexures
105
For hospitals with 101-200 beds:
2.57
2.12
1.51
1.44
1.31
1.22
1.08
1.07
1.00
0.99
0.97
0.92
0.91
0.91
0.86
0.85
0.83
0.82
0.82
0.82
0.79
0.79
0.76
0.75
0.72
0.69
0.65
0.59
0.56
0.56
0.51
0.24
Delhi
Manipur
Haryana
Arunachal Pradesh
Jammu & Kashmir
Rajasthan
Maharashtra
Meghalaya
Ladakh
Punjab
Kerala
India
Mizoram
Sikkim
Chhattisgarh
Assam
Odisha
Karnataka
Jharkhand
Madhya Pradesh
Nagaland
Daman & Diu
Telangana
Tripura
Uttar Pradesh
Bihar
Tamil Nadu
Himachal Pradesh
Gujarat
Puducherry
Uttarakhand
A & N Islands
Meets 
requirement1
Figure A2.2-1: State/UT-wise average ratio of doctors in hospitals with up to 200 beds in
position to the IPHS requirement of 34 doctors
1.20
1.02
0.83
0.82
0.81
0.72
0.69
0.68
0.64
0.63
0.62
0.58
0.58
0.57
0.54
0.53
0.53
0.51
0.50
0.48
0.47
0.46
0.44
0.41
0.40
0.40
0.38
0.35
0.32
0.29
0.28
0.23
Delhi
Maharashtra
Rajasthan
Puducherry
Madhya Pradesh
Mizoram
Ladakh
Punjab
Daman & Diu
Haryana
Tripura
Meghalaya
Assam
Manipur
India
Nagaland
Chhattisgarh
Gujarat
Telangana
Odisha
Jharkhand
Karnataka
Tamil Nadu
Kerala
Arunachal Pradesh
Himachal Pradesh
Bihar
Uttar Pradesh
Jammu & Kashmir
Sikkim
A & N Islands
Uttarakhand
Meets 
requirement1
Figure A2.2-2: State/UT-wise average ratio of nurses in hospitals with up to 200 beds in
position to the IPHS requirement of 90 nurses
6.69
4.74
3.55
3.21
3.21
3.07
2.58
2.50
2.38
2.29
2.19
2.19
2.10
2.07
1.81
1.68
1.67
1.50
1.49
1.41
1.35
1.32
1.20
1.09
1.05
1.02
1.02
0.98
0.87
0.75
0.50
0.48
Manipur
Ladakh
Mizoram
Arunachal Pradesh
Telangana
Delhi
Nagaland
Puducherry
Haryana
Sikkim
Punjab
Madhya Pradesh
Tripura
Jammu & Kashmir
Maharashtra
Rajasthan
India
Odisha
Assam
Uttar Pradesh
Chhattisgarh
Jharkhand
Himachal Pradesh
Karnataka
Bihar
Gujarat
Tamil Nadu
A & N Islands
Meghalaya
Kerala
Daman & Diu
Uttarakhand
Meets 
requirement1
Figure A2.2-3: State/UT-wise average ratio of paramedical staff in hospitals with up to 200
beds in position to the IPHS requirement of 42 paramedical staff Annexures
106
For hospitals with 201 - 300 beds:
2.10
1.75
1.66
1.40
1.28
1.13
0.93
0.92
0.88
0.88
0.87
0.79
0.78
0.77
0.76
0.74
0.70
0.66
0.60
0.58
0.56
0.54
0.51
0.44
Arunachal Pradesh
Delhi
Mizoram
Goa
Odisha
West Bengal
Haryana
Punjab
Rajasthan
Maharashtra
Andhra Pradesh
Telangana
Kerala
India
Ladakh
Assam
Madhya Pradesh
Uttar Pradesh
Himachal Pradesh
Karnataka
Tamil Nadu
Bihar
Gujarat
Chhattisgarh
Meets 
requirement1
Figure A2.3-1: State/UT-wise average ratio of doctors in hospitals with up to 300 beds in
position to the IPHS requirement of 50 doctors
1.32
1.31
1.07
1.00
0.92
0.89
0.81
0.79
0.64
0.59
0.58
0.58
0.52
0.50
0.49
0.45
0.45
0.43
0.42
0.41
0.37
0.36
0.35
0.33
Mizoram
Delhi
Goa
Haryana
Arunachal Pradesh
Maharashtra
Madhya Pradesh
West Bengal
Rajasthan
Assam
India
Gujarat
Kerala
Chhattisgarh
Telangana
Andhra Pradesh
Tamil Nadu
Punjab
Ladakh
Odisha
Karnataka
Uttar Pradesh
Bihar
Himachal Pradesh
Meets 
requirement1
Figure A2.3-2: State/UT-wise average ratio of nurses in hospitals with up to 300 beds in
position to the IPHS requirement of 135 nurses
5.95
3.35
2.88
2.63
2.23
2.05
1.96
1.91
1.68
1.67
1.41
1.37
1.36
1.22
1.21
1.16
1.12
1.08
1.05
1.03
0.92
0.76
0.56
0.38
Mizoram
Arunachal Pradesh
Ladakh
Goa
Delhi
Haryana
Madhya Pradesh
Maharashtra
Telangana
West Bengal
Chhattisgarh
Assam
India
Odisha
Rajasthan
Himachal Pradesh
Bihar
Kerala
Uttar Pradesh
Andhra Pradesh
Karnataka
Tamil Nadu
Punjab
Gujarat
Meets 
requirement1
Figure A2.3-3: State/UT-wise average ratio of paramedical staff in hospitals with up to
300 beds in position to the IPHS requirement of 66 paramedical staff Annexures
107
For hospitals with 301 - 400 beds:
2.84
1.17
0.99
0.96
0.91
0.91
0.90
0.87
0.86
0.85
0.84
0.78
0.64
0.62
0.61
0.58
0.38
Delhi
Dadra & Nagar Haveli
Maharashtra
Kerala
Gujarat
Meghalaya
Uttar Pradesh
Rajasthan
India
Odisha
West Bengal
Madhya Pradesh
Andhra Pradesh
Tamil Nadu
Assam
Karnataka
Jharkhand
Meets 
requirement
1
Figure A2.4-1: State/UT-wise average ratio of doctors in hospitals with up to 400 beds in
position to the IPHS requirement of 58 doctors
0.86
0.85
0.85
0.81
0.74
0.69
0.63
0.57
0.53
0.49
0.48
0.46
0.43
0.41
0.38
0.35
0.07
Maharashtra
Dadra & Nagar Haveli
Delhi
West Bengal
Meghalaya
Madhya Pradesh
Rajasthan
India
Kerala
Andhra Pradesh
Assam
Odisha
Tamil Nadu
Uttar Pradesh
Karnataka
Gujarat
Jharkhand
1
Meets 
requirement
Figure A2.4-2: State/UT-wise average ratio of nurses in hospitals with up to 400 beds in
position to the IPHS requirement of 180 nurses
4.26
2.62
2.17
1.85
1.61
1.60
1.50
1.44
1.39
1.18
0.93
0.78
0.63
0.54
0.43
0.40
0.31
Dadra & Nagar Haveli
Maharashtra
Rajasthan
Delhi
Uttar Pradesh
Assam
Madhya Pradesh
West Bengal
India
Andhra Pradesh
Tamil Nadu
Meghalaya
Kerala
Jharkhand
Odisha
Gujarat
Karnataka
1
Meets 
requirement
Figure A2.4-3: State/UT-wise average ratio of paramedical staff in hospitals with up to
400 beds in position to the IPHS requirement of 81 paramedical staff Annexures
108
For hospitals with more than 400 beds:
2.82
2.20
2.02
1.90
1.38
1.29
1.18
1.12
1.07
1.07
0.98
0.91
0.88
0.87
0.84
0.79
0.71
0.67
0.49
0.34
Delhi
Andhra Pradesh
Karnataka
Odisha
Chandigarh
India
Uttar Pradesh
Punjab
Puducherry
Tamil Nadu
West Bengal
Meghalaya
Rajasthan
Kerala
Maharashtra
A & N Islands
Chhattisgarh
Madhya Pradesh
Telangana
Bihar
1
Meets 
requirement
Figure A2.5-1: State/UT-wise average ratio of doctors in hospitals with more than 400
beds in position to the IPHS requirement of 68 doctors
1.75
1.18
1.11
0.89
0.88
0.87
0.86
0.81
0.80
0.79
0.70
0.70
0.66
0.63
0.60
0.54
0.53
0.52
0.48
0.13
Delhi
Andhra Pradesh
Chandigarh
Madhya Pradesh
Karnataka
A & N Islands
West Bengal
Puducherry
Odisha
India
Maharashtra
Kerala
Rajasthan
Meghalaya
Uttar Pradesh
Tamil Nadu
Punjab
Chhattisgarh
Telangana
Bihar
1
Meets 
requirement
Figure A2.5-2: State/UT-wise average ratio of nurses in hospitals with more than 400 beds
in position to the IPHS requirement of 225 nurses
5.16
4.00
3.56
2.69
2.39
2.21
2.10
1.81
1.78
1.74
1.63
1.31
1.23
1.20
1.16
0.85
0.67
0.60
0.41
0.29
Delhi
Andhra Pradesh
Puducherry
A & N Islands
Uttar Pradesh
Odisha
Maharashtra
Kerala
Chandigarh
Madhya Pradesh
India
Chhattisgarh
Tamil Nadu
Karnataka
Rajasthan
West Bengal
Meghalaya
Telangana
Bihar
Punjab
1
Meets 
requirement
Figure A2.5-3: State/UT-wise average ratio of paramedical staff in hospitals with more
than 400 beds in position to the IPHS requirement of 100 paramedical staff Annexures
109
KPI 3: AVAILABILITY OF SUPPORT SERVICES
14
13
131212
1212111111
11101010 1010101010101099 9999 9998
8
4
3
Daman & Diu
Tamil Nadu
Telangana
Rajasthan
Haryana
Madhya Pradesh
Bihar
Gujarat
Chhattisgarh
Himachal Pradesh
Jammu & Kashmir
Tripura
Sikkim
Delhi
India
Punjab
Maharashtra
Odisha
Assam
Uttar Pradesh
Kerala
Manipur
Meghalaya
Jharkhand
Karnataka
Puducherry
West Bengal
Mizoram
Arunachal Pradesh
Uttarakhand
Nagaland
Ladakh
A & N Islands
Lakshadweep
14
Availability of all identified services
Figure A3-1: Average number of support services in small district hospitals (up to 200
beds) by State/UT
14 14 14 14
131313 13
13
12121212121212
1111
101010
10
99
Chhattisgarh
Haryana
Mizoram
Telangana
Tamil Nadu
Rajasthan
Goa
West Bengal
Andhra Pradesh
Karnataka
Delhi
India
Bihar
Gujarat
Madhya Pradesh
Odisha
Maharashtra
Himachal Pradesh
Uttar Pradesh
Kerala
Arunachal Pradesh
Assam
Ladakh
Punjab
14
Availability of all identified services
Figure A3-2: Average number of support services in mid-sized district hospitals (201–300
beds) by State/UT
14
1313 1313
13
12
12 12 121212
11
1111 111111
10 10 10
10
9
3
Dadra & Nagar Haveli
Rajasthan
Gujarat
Telangana
Tamil Nadu
West Bengal
Andhra Pradesh
Bihar
Chandigarh
Madhya Pradesh
Karnataka
India
Uttar Pradesh
Maharashtra
Delhi
Odisha
Kerala
Meghalaya
Chhattisgarh
Jharkhand
Punjab
Puducherry
Assam
A & N Islands
14
Availability of all identified services
Figure A3-3: Average number of support services in large district hospitals (more than
300 beds) by State/UT Annexures
110
KPI 4: AVAILABILITY OF CORE HEALTH CARE SERVICES
14
13 13
131312
12121212
1111
10101010 10 10 1010
10 109
999988
8
77
3
2
Kerala
Ladakh
Telangana
Rajasthan
Puducherry
Tamil Nadu
Himachal Pradesh
Punjab
Delhi
Haryana
Madhya Pradesh
Jammu & Kashmir
Odisha
Bihar
Chhattisgarh
Assam
Nagaland
Tripura
West Bengal
Gujarat
Daman & Diu
Sikkim
India
Mizoram
Maharashtra
Karnataka
Jharkhand
Meghalaya
Manipur
Arunachal Pradesh
Uttarakhand
Uttar Pradesh
Lakshadweep
A & N Islands
14
Availability of all identified services
Figure A4-1: Average number of core health care services in small district hospitals (up to
200 beds) by State/UT
14 14
14 1413
13 13 13 13 13131313
121212 12 12
12
11
11
1111
10
Mizoram
Telangana
Goa
West Bengal
Maharashtra
Delhi
Ladakh
Punjab
Rajasthan
Himachal Pradesh
Odisha
Tamil Nadu
Gujarat
Karnataka
India
Arunachal Pradesh
Chhattisgarh
Haryana
Madhya Pradesh
Bihar
Andhra Pradesh
Assam
Uttar Pradesh
Kerala
14
Availability of all identified services
Figure A4-2: Average number of core health care services in mid-sized district hospitals
(201–300 beds) by State/UT
14 14
1414131313
13 13 131313131312121212
12
11 11
11
10 10
Dadra & Nagar Haveli
Punjab
West Bengal
Telangana
Andhra Pradesh
Tamil Nadu
Rajasthan
Bihar
Chandigarh
Gujarat
Maharashtra
Odisha
India
Delhi
Karnataka
Kerala
Madhya Pradesh
Jharkhand
Assam
A&N Islands
Chha�sgarh
U�ar Pradesh
Meghalaya
Puducherry
14
Availability of all identified services
Figure A4-3: Average number of core health care services in large district hospitals (more
than 300 beds) by State/UT Annexures
111
KPI 5: AVAILABILITY OF DIAGNOSTIC TESTING SERVICES
14
11111111
11
10 10101010
999998888888888
87
7766
6
4
Telangana
Ladakh
Punjab
Delhi
TamilNadu
Rajasthan
Gujarat
Kerala
Sikkim
Mizoram
Haryana
Jammu&Kashmir
Puducherry
MadhyaPradesh
HimachalPradesh
Odisha
Chha�sgarh
Assam
Nagaland
Tripura
Maharashtra
Daman&Diu
Lakshadweep
India
Jharkhand
Manipur
Karnataka
Bihar
Meghalaya
A&NIslands
U�arPradesh
ArunachalPradesh
U�arakhand
WestBengal
14
Availability of all identified services
Figure A5-1: Average number of diagnostic testing services in small district hospitals (up
to 200 beds) by State/UT
14 14
13 13
12
1212 12
111111
101010 1010
9
99
999
88
Mizoram
Telangana
Goa
Punjab
Ladakh
Gujarat
Delhi
Haryana
Andhra Pradesh
Maharashtra
Tamil Nadu
Odisha
Karnataka
Arunachal Pradesh
India
Himachal Pradesh
Madhya Pradesh
Bihar
Rajasthan
Assam
Uttar Pradesh
West Bengal
Kerala
Chhattisgarh
14
Availability of all identified services
Figure A5-2: Average number of diagnostic testing services in mid-sized district hospitals
(201–300 beds) by State/UT
14
14
13
13
1212 121212
1111
101010 10 1010101010
9
88
5
Dadra & Nagar…
Telangana
Gujarat
Andhra Pradesh
Delhi
Chandigarh
Punjab
Tamil Nadu
Karnataka
India
Rajasthan
Maharashtra
Uttar Pradesh
Assam
Kerala
Meghalaya
West Bengal
Madhya Pradesh
Odisha
Puducherry
Jharkhand
Bihar
Chhattisgarh
A & N Islands
14
Availability of all identified services
Figure A5-3: Average number of diagnostic testing services in large district hospitals
(more than 300 beds) by State/UT Annexures
112
KPI 6: BED OCCUPANCY RATE
90.00
83.87
82.95
77.36
73.87
73.53
70.63
67.04
65.21
63.87
63.77
60.28
59.60
57.00
56.50
55.24
53.44
52.28
52.26
48.01
46.45
45.00
44.48
43.90
40.66
38.69
33.77
33.35
26.39
24.15
23.98
22.73
13.23
12.76
West Bengal
Tamil Nadu
Maharashtra
Delhi
Punjab
Haryana
Kerala
Mizoram
Odisha
Meghalaya
Madhya Pradesh
Assam
Sikkim
Gujarat
Tripura
Bihar
India
Rajasthan
Chhattisgarh
Jammu & Kashmir
Uttar Pradesh
Telangana
Uttarakhand
Puducherry
Ladakh
Jharkhand
Himachal Pradesh
Daman & Diu
Nagaland
Karnataka
Manipur
Lakshadweep
A & N Islands
Arunachal Pradesh
90
Desired maximum rate
Figure A6-1: Average bed occupancy rate (%) in small district hospitals (up to 200 beds)
by State/UT
90.00
90.00
90.00
90.00
84.32
83.67
79.09
77.99
77.99
69.33
66.96
66.85
64.49
64.38
59.94
58.91
58.82
57.91
47.90
46.22
35.88
33.95
32.46
21.36
Andhra Pradesh
Punjab
Telangana
West Bengal
Maharashtra
Delhi
Bihar
Assam
Mizoram
Odisha
Madhya Pradesh
Haryana
Arunachal Pradesh
Kerala
India
Chhattisgarh
Karnataka
Tamil Nadu
Rajasthan
Gujarat
Uttar Pradesh
Goa
Himachal Pradesh
Ladakh
90
Desired maximum rate
Figure A6-2: Average bed occupancy rate (%) in mid-sized district hospitals (201–300
beds) by State/UT
90.00
90.00
90.00
87.21
83.20
81.94
77.06
74.56
73.94
66.81
65.87
64.09
63.58
61.93
61.08
55.83
50.02
45.60
45.03
44.39
44.21
21.92
21.15
12.12
Chandigarh
Dadra & Nagar Haveli
Punjab
Telangana
Maharashtra
West Bengal
Tamil Nadu
Andhra Pradesh
A & N Islands
Rajasthan
India
Odisha
Madhya Pradesh
Delhi
Karnataka
Kerala
Chhattisgarh
Meghalaya
Assam
Uttar Pradesh
Puducherry
Jharkhand
Bihar
Gujarat
90
Desired maximum rate
Figure A6-3: Average bed occupancy rate (%) in large district hospitals (more than 300
beds) by State/UT Annexures
113
KPI 7: C-SECTION RATE
0.00
1.88
4.25
5.36
5.51
6.19
9.26
9.57
9.76
10.38
10.58
11.21
12.43
14.24
14.58
15.70
16.03
16.07
16.60
18.84
19.86
21.14
21.48
25.26
34.35
35.18
35.76
37.22
42.30
44.22
46.55
46.63
48.79
59.96
A & N Islands
West Bengal
Meghalaya
Uttarakhand
Bihar
Rajasthan
Uttar Pradesh
Madhya Pradesh
Chhattisgarh
Jharkhand
Manipur
Arunachal Pradesh
Sikkim
Gujarat
Tripura
Delhi
India
Himachal Pradesh
Haryana
Mizoram
Ladakh
Nagaland
Odisha
Maharashtra
Punjab
Puducherry
Jammu & Kashmir
Assam
Telangana
Lakshadweep
Karnataka
Kerala
Daman & Diu
Tamil Nadu
Figure A7-1: Average percentage of C-section deliveries in small district hospitals (up to
200 beds) by State/UT
0.00
8.75
10.74
16.62
16.63
17.19
18.27
22.80
23.58
23.66
25.08
25.63
28.15
28.53
31.69
32.23
34.21
37.09
39.15
40.73
41.82
45.67
48.92
50.88
Uttar Pradesh
Rajasthan
Bihar
Himachal Pradesh
Madhya Pradesh
Delhi
Chhattisgarh
Odisha
Gujarat
Haryana
India
Mizoram
Ladakh
Maharashtra
Assam
West Bengal
Punjab
Goa
Arunachal Pradesh
Andhra Pradesh
Kerala
Karnataka
Telangana
Tamil Nadu
Figure A7-2: Average percentage of C-section deliveries in mid-sized district hospitals
(201–300 beds) by State/UT
1.84
7.52
8.23
11.06
17.81
19.66
19.67
21.67
23.09
26.82
27.35
29.78
31.28
31.39
32.21
33.53
34.43
35.04
36.99
39.76
43.86
51.74
55.68
69.33
Bihar
Uttar Pradesh
Meghalaya
Gujarat
Rajasthan
Madhya Pradesh
Chhattisgarh
Assam
Maharashtra
Kerala
Jharkhand
Delhi
Odisha
India
Chandigarh
Karnataka
A & N Islands
Tamil Nadu
West  Bengal
Punjab
Andhra Pradesh
Puducherry
Telangana
Dadra & Nagar Haveli
Figure A7-3: Average percentage of C-section deliveries in large district hospitals (more
than 300 beds) by State/UT Annexures
114
KPI 8: SURGICAL PRODUCTIVITY INDEX
326
322
314
308
302
301
240
233
160
149
140
138
126
125
106
94
94
81
79
75
56
51
47
39
36
31
24
21
9
7
2
1
1
0
Rajasthan
Gujarat
Delhi
Telangana
Tamil Nadu
Haryana
Jammu & Kashmir
Punjab
Bihar
Puducherry
India
Uttar Pradesh
Madhya Pradesh
Uttarakhand
Maharashtra
Assam
Daman & Diu
Odisha
Karnataka
Kerala
Himachal Pradesh
Mizoram
Nagaland
Chhattisgarh
Meghalaya
Jharkhand
Lakshadweep
Manipur
Arunachal Pradesh
Tripura
Sikkim
Ladakh
West Bengal
A & N Islands
Figure A8-1: Average number of surgeries per surgeon performed in a year in small district
hospitals (up to 200 beds) by State/UT
2262
1202
426
389
325
318
301
281
262
226
215
205
192
179
145
134
133
120
100
87
85
81
72
47
Delhi
Bihar
Haryana
Himachal Pradesh
Tamil Nadu
Telangana
Gujarat
Uttar Pradesh
India
Mizoram
Goa
Rajasthan
Karnataka
Maharashtra
West Bengal
Arunachal Pradesh
Andhra Pradesh
Punjab
Madhya Pradesh
Odisha
Ladakh
Chhattisgarh
Assam
Kerala
Figure A8-2: Average number of surgeries per surgeon performed in a year in mid-sized
district hospitals (201–300 beds) by State/UT
846
814
523
498
390
331
300
296
295
282
253
242
195
189
183
183
174
170
167
142
113
81
0
0
Telangana
Puducherry
Tamil Nadu
Kerala
Delhi
Uttar Pradesh
India
Karnataka
Dadra & Nagar Haveli
Rajasthan
Punjab
Chandigarh
Meghalaya
A & N Islands
Odisha
Andhra Pradesh
Gujarat
Maharashtra
West Bengal
Madhya Pradesh
Chhattisgarh
Assam
Bihar
Jharkhand
Figure A8-3: Average number of surgeries per surgeon performed in a year in large district
hospitals (more than 300 beds) by State/UT Annexures
115
KPI 9: OPD PER DOCTOR
44
42
4040
3737
36
33
3029
2827
26
2424
22
20
19181817
15
1313
111010
88
6655
Gujarat
Uttar Pradesh
Tamil Nadu
Telangana
Kerala
Puducherry
Bihar
Delhi
Daman & Diu
Punjab
India
Himachal Pradesh
Haryana
Jammu & Kashmir
Madhya Pradesh
Uttarakhand
Odisha
Karnataka
West Bengal
A & N Islands
Lakshadweep
Rajasthan
Jharkhand
Assam
Maharashtra
Chhattisgarh
Sikkim
Mizoram
Tripura
Arunachal Pradesh
Meghalaya
Manipur
Nagaland
Figure A9-1: Average number of OPD patients per doctor in a day in small district
hospitals (up to 200 beds) by State/UT
57
43
41
39
3837
33
29
27
23
2221201919
171616
1414 1413
6
0
Tamil Nadu
Uttar Pradesh
Telangana
Delhi
Haryana
Himachal Pradesh
Bihar
Karnataka
India
Andhra Pradesh
Madhya Pradesh
Rajasthan
Gujarat
Punjab
Chhattisgarh
Maharashtra
Assam
Mizoram
Odisha
Goa
Jammu & Kashmir
Kerala
Arunachal Pradesh
West Bengal
Figure A9-2: Average number of OPD patients per doctor in a day in mid-sized district
hospitals (201–300 beds) by State/UT
53
50
47
3837
29
272626
2020191919181717
1615
1111
8
2
0
Uttar Pradesh
Madhya Pradesh
Dadra & Nagar Haveli
Chandigarh
Tamil Nadu
Karnataka
A & N Islands
India
Bihar
Maharashtra
Rajasthan
Assam
Punjab
Odisha
Puducherry
Kerala
Delhi
Chhattisgarh
West Bengal
Andhra Pradesh
Gujarat
Meghalaya
Jharkhand
Telangana
Figure A9-3: Average number of OPD patients per doctor in a day in large district
hospitals (more than 300 beds) by State/UT Annexures
116
KPI 10: BLOOD BANK REPLACEMENT RATE
0000
22
6
81010
15
1719
23
2728 2830
3233
35
37
3940
46
495051
55
6666
74
96
Karnataka
Kerala
Lakshadweep
Tamil Nadu
Haryana
Sikkim
Punjab
Himachal Pradesh
Nagaland
Ladakh
Telangana
Daman & Diu
Tripura
Mizoram
Meghalaya
Rajasthan
Uttarakhand
Madhya Pradesh
Puducherry
Arunachal Pradesh
Gujarat
Manipur
India
Assam
Odisha
Jammu & Kashmir
Uttar Pradesh
Chhattisgarh
Jharkhand
Bihar
Maharashtra
Delhi
A & N Islands
Figure A10-1: Average percentage of blood units issued on replacement in a year in small
district hospitals (up to 200 beds) by State/UT
000 01
4
991010
13
19
34
3536
38
4748
52
54
56565758
Chhattisgarh
Maharashtra
Haryana
Arunachal Pradesh
Tamil Nadu
Punjab
Goa
West Bengal
Karnataka
Odisha
Himachal Pradesh
Mizoram
India
Delhi
Ladakh
Gujarat
Rajasthan
Kerala
Andhra Pradesh
Uttar Pradesh
Assam
Bihar
Telangana
Madhya Pradesh
Figure A10-2: Average percentage of blood units issued on replacement in a year in mid-
sized district hospitals (201–300 beds) by State/UT
00 1134
7
151618
2627272729
353637
4646
63
92
100
Jharkhand
Meghalaya
Chandigarh
Telangana
Maharashtra
Punjab
Tamil Nadu
Puducherry
West Bengal
Karnataka
India
Kerala
Delhi
Dadra & Nagar Haveli
Odisha
Rajasthan
Chhattisgarh
Andhra Pradesh
Uttar Pradesh
Madhya Pradesh
Assam
Bihar
Gujarat
Figure A10-3: Average percentage of blood units issued on replacement in a year in large
district hospitals (more than 300 beds) by State/UT Annexures
117
ANNEXURE 6
LIST OF DISTRICT HOSPITALS HAVING ALL REQUISITE SERVICES
(SUPPORT SERVICES, CORE HEALTH CARE SERVICES, DIAGNOSTIC
TESTING SERVICES)
ANNEXURE 6 - TABLE 6A: LIST OF DISTRICT HOSPITALS HAVING
ALL IDENTIFIED SUPPORT SERVICES (N=14)
State/UTDistrictDistrict Hospital
Hospital
category*
Andhra Pradesh
Chittoor Govt. Maternity Hospital THM
NelloreGovt. General Hospital NelloreL
BiharSitamarhi Sadar Hospital SitamarhiS
Chhattisgarh Dhamtari DH DhamtariM
Dadra and Nagar
Haveli
Dadra and Nagar
Haveli
Shri Vinoba Bhave Civil HospitalL
Daman and Diu
DamanGovernment Hospital DamanS
DiuGovernment Hospital DiuS
GoaNorth Goa North Goa District HospitalM
Gujarat
Devbhumi Dwarka Jam KhambhaliaS
Mahesana General Hospital MehsanaM
Panch Mahals General Hospital GodhraM
Haryana
BhiwaniCivil HospitalM
HisarCivil HospitalS
KaithalIGMS Civil HospitalS
Kurukshetra LNJP Civil HospitalS
Panchkula Civil HospitalM
RohtakCivil HospitalS
SonipatCivil Hospital SonepatS
Jammu and
Kashmir
Baramula Baramula DHS
PulwamaPulwama DHS
Karnataka
Bangalore Urban KC General HospitalL
Chitradurga Chitradurga District Hospital FRUL
Dakshina Kannada Lady Goshan Hospital Mangalore DH
FRU
M
* Hospital category - S: small (up to 200 beds); M: mid-sized (201-300 beds); L: large (more than 300 beds) Annexures
118
State/UTDistrictDistrict Hospital
Hospital
category*
Karnataka
DharwadDharwad District Hospital FRUM
Gulbarga Gulbarga District Hospital FRUL
HassanHassan District HospitalL
KoppalKoppal District Hospital FRUM
MandyaMandya District HospitalL
ShimogaShimoga District HospitalL
KeralaErnakulam GH ErnakulamL
Madhya Pradesh
HardaDH HardaS
JhabuaDH JhabuaS
SatnaDH SatnaL
Tikamgarh DH TikamgarhS
Maharashtra
Amravati District General Hospital Amravati L
RaigarhDH AlibagM
MizoramAizawl West Aizawl Civil HospitalM
Odisha
Balangir DH BalangirM
Baleshwar DH BalasoreL
Kendrapara DH KendrapadaS
Rajasthan
AjmerA K Hospital Beawar AjmerL
Chittaurgarh District Hospital ChittaurgarhL
ChuruD B Government Hospital ChuruM
DausaDistrict Hospital DausaM
Dhaulpur Sadar Hospital DholpurL
Ganganagar Govt Hospital SriganganagarL
Hanumangarh DH Hanumangarh TownL
Jaisalmer Jawahar Hospital JaisalmerS
Jhunjhunun B.D.K. Hospital JhunjhununS
Rajsamand R K District Hospital RajsamandM
Tamil Nadu
Ariyalur DH AriyalurM
Coimbatore DH PollachiL
Dindigul DH DindigulL
ErodeDH ErodeL
Kanniyakumari DH PadhmanabapuramS
MaduraiDH UsilampattiS
Nagapattinam DH NagapattinamL Annexures
119
State/UTDistrictDistrict Hospital
Hospital
category*
Tamil Nadu
Namakkal DH NamakkalL
Nilgiris DH UthagamandalamL
Ramanathapuram DH RamanathapuramL
SalemDH Mettur DamM
TheniDH PeriakulamM
Thiruvallur DH ThiruvallurL
Thiruvarur DH MannargudiL
Tiruchirappalli DH ManapparaiM
Tirunelveli DH TenkasiM
Toothukudi DH KovilpattiL
Virudhunagar DH VirudhunagarL
Telangana
KhammamDH KhammamM
Nalgonda DH NalgondaL
Sangareddy DH SangareddyM
Vikarabad DH TandurS
Uttar Pradesh
Ambedkar Nagar Mahatma Jyotiba Phule District
Hospital
S
Azamgarh District Hospital AzamgarhM
BudaunDistrict Hospital BadaunM
LucknowDH Ram Manohar LohiyaL
Maharajganj District Combined HospitalS
Prayagraj Moti Lal Nehru District HospitalS
RampurDistrict Male HospitalS
Sant Kabir Nagar District Combined Hospital Sant Kabir
Nagar
S
Varanasi Pt. Deen Dayal Upadhyay Govt
Hospital
S
West Bengal
Alipurduar Alipurduar District HospitalM
Dakshin Dinajpur Balurghat DH & SSHL
Jalpaiguri Jalpaiguri DH & SSHL
Koch Bihar MJN District HospitalL
NadiaDistrict Hospital NadiaL
Purba Medinipur Tamluk District HospitalL
Puruliya D.M. Sadar DH & SSHL
Uttar Dinajpur Raiganj DH & SSHL Annexures
120
ANNEXURE 6 - TABLE 6B: LIST OF DISTRICT HOSPITALS HAVING
ALL IDENTIFIED CORE HEALTH CARE SERVICES (N=14)
State/UTDistrictDistrict Hospital
Hospital
category*
Andhra Pradesh
Anantapur GGH AnantapurL
East Godavari DH RajahmundryM
NelloreGovt. General Hospital NelloreL
Prakasam RIMS Ongole THL
Srikakulam RIMS Srikakulam THL
AssamSibsagar Sivasagar Civil HospitalL
Dadra and Nagar
Haveli
Dadra and Nagar
Haveli
Shri Vinoba Bhave Civil HospitalL
DelhiDelhi North West
Sanjay Gandhi Memorial Hospital
Mangolpuri
M
GoaSouth Goa South Goa District HospitalM
Gujarat
AmreliGeneral Hospital AmreliM
DahodGeneral Hospital DahodL
Panch Mahals General Hospital GodhraM
TapiGeneral Hospital VyaraM
The Dangs General Hospital DangS
Himachal Pradesh
Bilaspur Bilaspur RHM
MandiMandi ZHM
SirmaurNahan RHM
Karnataka
Bagalkote Bagalkote District Hospital FRUM
Bangalore Urban Jayanagar General HospitalM
BidarBidar District HospitalL
Chamrajnagar Chamarajnagar District Hospital FRU M
DharwadHubli KIMS District HospitalL
Gulbarga Gulbarga District Hospital FRUL
HassanHassan District HospitalL
KodaguKodagu District Hospital FRUL
KolarKolar District Hospital FRUL
* Hospital category - S: small (up to 200 beds); M: mid-sized (201-300 beds); L: large (more than 300 beds) Annexures
121
State/UTDistrictDistrict Hospital
Hospital
category*
Karnataka
MandyaMandya District HospitalL
RaichurRaichur District HospitalL
ShimogaShimoga District HospitalL
TumkurTumkur District Hospital FRUL
Uttara Kannada Uttara Kannada District Hospital FRU L
Kerala
Ernakulam DH AluvaM
Ernakulam GH ErnakulamL
KannurGH ThalasseryL
Kasaragod DH KanhangadL
Kozhikode General Hospital CalicutL
Malappuram DH TirurS
Malappuram GH ManjeriL
Pathanamthitta General Hosp PathanamthittaL
Thrissur GH ThrissurM
WayanadDH MananthavadyM
Madhya Pradesh SatnaDH SatnaL
Maharashtra
Ahmednagar DH AhmednagarM
BeedDistrict Hospital BeedL
NashikDistrict Hospital NashikL
PuneDH AundhL
RaigarhDH AlibagM
Ratnagiri District Hospital RatnagiriS
Satara
Lt Karntisigh Nana Patil Civil Hospital
Satara
M
ThaneDistrict Hospital ThaneM
MizoramAizawl West Aizawl Civil HospitalM
Odisha
Balangir DH BalangirM
Baleshwar DH BalasoreL
KhordhaCapital HospitalL
Mayurbhanj DH BaripadaM
PuriDH PuriL
Puducherry
Karaikal Govt. General HospitalL
MaheGovt. General HospitalS Annexures
122
State/UTDistrictDistrict Hospital
Hospital
category*
PunjabJalandhar Jalandhar DHL
Rajasthan
Bharatpur RBM Hospital, BharatpurL
ChuruD B Government Hospital ChuruM
Ganganagar Govt Hospital SriganganagarL
Hanumangarh DH Hanumangarh TownL
Jhunjhunun B.D.K. Hospital JhunjhununS
KarauliGeneral Hospital KarauliM
Rajsamand R K District Hospital RajsamandM
SikarS K Hospital, SikarL
TonkDistrict Sahadat Hospital TonkS
Tamil Nadu
Ariyalur DH AriyalurM
ChennaiKilpauk HospitalL
Cuddalore DH CuddaloreL
Tamil Nadu
Dindigul DH DindigulL
ErodeDH ErodeL
Kancheepuram DH KancheepuramL
KarurDH KulithalaiS
Krishnagiri DH KrishnagiriL
Namakkal DH NamakkalL
Ramanathapuram DH RamanathapuramL
SalemDH Mettur DamM
Sivaganga DH KaraikudiM
Thiruvallur DH ThiruvallurL
TirupurDH TiruppurL
Toothukudi DH KovilpattiL
VelloreDH WalajapetM
Virudhunagar DH VirudhunagarL
Telangana
Karim Nagar DH KarimnagarL
KhammamDH KhammamM
Sangareddy DH SangareddyM
Vikarabad DH TandurS
Uttar Pradesh LucknowDH Ram Manohar LohiyaL Annexures
123
State/UTDistrictDistrict Hospital
Hospital
category*
West Bengal
BirbhumRampuhat DH & SSHM
Darjiling Siliguri DHL
Darjiling Darjeeling DHL
HugliImambara District HospitalL
Jalpaiguri Jalpaiguri DH & SSHL
Jhargram Jhargram DH & SSHL
North Twenty Four
Parganas
Barasat DHL
Paschim
Barddhaman
Asansol DH & SSHL
Purba Medinipur Tamluk District HospitalL
Puruliya D.M. Sadar DH & SSHL
South Twenty Four
Parganas
M. R. Bangur DH & SSHL
ANNEXURE 6 - TABLE 6C: LIST OF DISTRICT HOSPITALS HAVING
ALL IDENTIFIED DIAGNOSTIC TESTING SERVICES (N=14)
State/UTDistrictDistrict Hospital
Hospital
category*
Andhra Pradesh
NelloreGovt. General Hospital NelloreL
Srikakulam RIMS Srikakulam THL
Vishakapatnam King George Hospital THL
Dadra and Nagar
Haveli
Dadra and Nagar
Haveli
Shri Vinoba Bhave Civil HospitalL
DelhiDelhi South Pt. Madan Mohan Malviya HospitalS
Gujarat
DahodGeneral Hospital DahodL
Panch Mahals General Hospital GodhraM
Karnataka
Bangalore Urban Vanivilas HospitalL
BellaryVIMS Bellary Medical CollegeL
Dakshina Kannada Wenlock Hospital Mangalore DHL
DharwadHubli KIMS District HospitalL
HassanHassan District HospitalL
ShimogaShimoga District HospitalL Annexures
124
State/UTDistrictDistrict Hospital
Hospital
category*
Maharashtra Gadchiroli District Hospital GadchiroliM
MizoramAizawl West Aizawl Civil HospitalM
Rajasthan Bhilwara M G Hospital BhilwaraL
Tamil Nadu ChennaiKilpauk HospitalL
Telangana
Karim Nagar KarimnagarL
KhammamDH KhammamM
Sangareddy DH SangareddyM
Vikarabad DH TandurS
* Hospital category - S: small (up to 200 beds); M: mid-sized (201-300 beds); L: large (more than 300 beds) Annexures
125
ANNEXURE 7
KPI-WISE RAW SCORES FOR DISTRICT HOSPITALS
Key for Table 7A and Table 7B:
KPI Name of the KPI Numerator (Num.) Denominator (Den.) Raw Score
Table 7A
KPI 1
No. of functional
hospital beds per
100,000 population
No. of functional beds
available in the hospital
District population
Num. ×
100000 /
Den.
KPI 2.1
Ratio of doctors
in position to IPHS
norms
No. of doctors
positioned in the
hospital
No. of doctors required
as per IPHS norm
Num. / Den.
KPI 2.2
Ratio of staff nurses
in position to IPHS
norms
No. of staff nurses
positioned in the
hospital
No. of staff nurses
required as per IPHS
norm
Num. / Den.
KPI 2.3
Ratio of paramedical
staff in position to
IPHS norms
No. of paramedical staff
are positioned in the
hospital
No. of paramedical staff
required as per IPHS
norm
Num. / Den.
KPI 3
Availability of support
services
Total no. of support
services available
Total services identified
(N=14)
Num. / Den.
KPI 4
Availability of core
health care services
Total no. of core health
care services available
Total services identified
(N=14)
Num. / Den.
KPI 5
Availability of
diagnostic testing
services
Total no. of diagnostic
testing services
available
Total services identified
(N=14)
Num. / Den.
Table 7B
KPI 6 Bed occupancy rate
Total number of
inpatient bed days in a
year
No. of functional beds
available in the hospital
(Num. ×
100) / (Den.
× 365)
KPI 7 C-section rate
Total number of
C-section deliveries
performed in a year
Total number of
deliveries performed in a
year (Normal + Assisted
Deliveries + C Section)
Num. × 100
/ Den.
KPI 8
Surgical Productivity
Index
Total number of major
surgeries in a year
(excluding - Obstetrics
& Gynecology,
Ophthalmology
Surgeries)
Total number of
surgeons in this hospital
(excluding Obstetric/
Gynecological Surgeon
& Ophthalmologist)
Num. / Den.
KPI 9 OPD per doctor
Total number of OPD
patients in a year
(Allopathic + AYUSH
outpatient attendance)
(i) Total number of OPD
days in a year
(ii) Total number of
positioned doctors
Num. / (i)
× (ii)
KPI 10
Blood bank
replacement rate
Total number of
blood units issued on
replacement in a year
Total number of blood
units issued in a year
(inclusive voluntary
blood donation)
Num. × 100
/ Den. Annexures
126
ANNEXURE 7 - TABLE 7A - KPI
s
1-5
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D1
DH1
S
126
36842
342.00
8
34
0.24
25
90
0.28
41
42
0.98
4
2
6
D2
DH2
S
60
105597
56.82
12
29
0.41
16
45
0.36
43
31
1.39
4
1
7
D3
DH3
L
476
238142
199.88
54
68
0.79
196
225
0.87
269
100
2.69
3
11
5
D4
DH4
L
500
4081148
12.25
135
68
1.99
161
225
0.72
235
100
2.35
13
14
11
D5
DH5
M
300
895721.9
33.49
35
50
0.70
31
135
0.23
40
66
0.61
14
4
9
D5
DH6
L
1098
3278342
33.49
157
68
2.31
198
225
0.88
327
100
3.27
13
13
13
D6
DH7
L
350
2882469
12.14
29
58
0.50
74
180
0.41
30
81
0.37
12
13
13
D7
DH8
M
250
5154296
4.85
40
50
0.80
86
135
0.64
149
66
2.26
13
14
13
D8
DH9
M
257
4887813
5.26
38
50
0.76
57
135
0.42
23
66
0.35
11
11
11
D9
DH10
L
350
4517398
7.75
39
58
0.67
60
180
0.33
36
81
0.44
10
13
13
D10
DH11
M
300
4053463
7.40
46
50
0.92
71
135
0.53
24
66
0.36
12
13
11
D11
DH12
L
1077
2963557
36.34
103
68
1.51
341
225
1.52
22
100
0.22
14
14
14
D12
DH13
L
500
3397448
14.72
93
68
1.37
197
225
0.88
286
100
2.86
12
14
11
D13
DH14
L
500
2703114
18.50
89
68
1.31
229
225
1.02
459
100
4.59
13
14
14
D14
DH15
L
2042
4290589
47.59
320
68
4.71
461
225
2.05
1071
100
10.71
12
13
14
D15
DH16
M
300
2344474
12.80
59
50
1.18
62
135
0.46
103
66
1.56
13
13
12
D16
DH17
L
350
3936966
8.89
43
58
0.74
131
180
0.73
220
81
2.72
12
13
10
Note: Hospital category - S: small (up to 200 beds); M: mid-sized (201-300 beds); L: large (more than 300 beds)
0
- data not provided/ error in submitted data Annexures
127
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D17
DH18
S
150
99214
151.19
49
34
1.44
36
90
0.40
135
42
3.21
10
12
10
D18
DH19
S
68
145726
46.66
21
29
0.72
21
45
0.47
32
31
1.03
5
7
6
D19
DH20
S
72
54080
133.14
11
29
0.38
25
45
0.56
13
31
0.42
11
4
3
D20
DH21
M
254
176573
143.85
105
50
2.10
124
135
0.92
221
66
3.35
10
12
10
D21
DH22
S
38
49977
76.03
13
29
0.45
14
45
0.31
86
31
2.77
9
7
6
D22
DH23
S
80
112274
71.25
22
29
0.76
25
45
0.56
119
31
3.84
8
9
7
D23
DH24
S
70
950075
7.37
21
29
0.72
24
45
0.53
12
31
0.39
9
7
8
D24
DH25
S
45
1693622
2.66
22
29
0.76
22
45
0.49
12
31
0.39
13
10
9
D25
DH26
S
160
738804
21.66
25
34
0.74
38
90
0.42
101
42
2.40
11
11
8
D26
DH27
S
82
1736617
4.72
21
29
0.72
35
45
0.78
92
31
2.97
9
7
7
D27
DH28
S
100
482162
20.74
15
29
0.52
32
45
0.71
9
31
0.29
8
8
7
D28
DH29
S
200
928500
21.54
29
34
0.85
66
90
0.73
26
42
0.62
8
10
8
D29
DH30
S
160
686133
23.32
27
34
0.79
63
90
0.70
22
42
0.52
9
10
8
D30
DH31
S
200
1949258
10.26
30
34
0.88
63
90
0.70
18
42
0.43
11
11
10
D31
DH32
S
136
214102
63.52
20
34
0.59
44
90
0.49
109
42
2.60
9
10
9
D32
DH33
S
200
1008183
19.84
29
34
0.85
31
90
0.34
134
42
3.19
11
12
11
D33
DH34
L
325
1066888
30.46
31
58
0.53
78
180
0.43
22
81
0.27
9
10
9
D34
DH35
S
102
659296
15.47
16
34
0.47
35
90
0.39
97
42
2.31
9
8
7
D35
DH36
S
50
1253938
3.99
30
29
1.03
29
45
0.64
14
31
0.45
8
8
9
D36
DH37
S
40
1517542
2.64
25
29
0.86
15
45
0.33
47
31
1.52
12
10
6
D37
DH38
S
200
956313
20.91
52
34
1.53
65
90
0.72
27
42
0.64
9
10
8 Annexures
128
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D38
DH39
S
169
1228686
13.75
32
34
0.94
48
90
0.53
114
42
2.71
11
13
8
D39
DH40
S
200
887142
22.54
29
34
0.85
68
90
0.76
14
42
0.33
11
13
10
D40
DH41
M
220
1042137
21.11
43
50
0.86
104
135
0.77
21
66
0.32
9
10
7
D41
DH42
S
150
957423
15.67
34
34
1.00
46
90
0.51
73
42
1.74
10
11
10
D42
DH43
L
302
2823768
10.69
39
58
0.67
93
180
0.52
197
81
2.43
9
11
11
D43
DH44
M
235
771639
30.45
39
50
0.78
57
135
0.42
117
66
1.77
11
12
10
D44
DH45
L
309
1151050
26.85
37
58
0.64
86
180
0.48
169
81
2.09
9
14
10
D45
DH46
M
262
1924110
13.62
29
50
0.58
78
135
0.58
133
66
2.02
9
10
9
D46
DH47
S
150
1327929
11.30
31
34
0.91
71
90
0.79
60
42
1.43
10
11
8
D47
DH48
S
121
831668
14.55
20
34
0.59
42
90
0.47
20
42
0.48
8
10
9
D48
DH49
S
100
2811569
3.56
17
29
0.59
15
45
0.33
41
31
1.32
12
8
6
D49
DH50
S
97
700843
13.84
18
29
0.62
19
45
0.42
28
31
0.90
11
9
8
D50
DH51
S
114
2540073
4.49
17
34
0.50
16
90
0.18
40
42
0.95
12
9
6
D51
DH52
S
124
2034763
6.09
16
34
0.47
47
90
0.52
56
42
1.33
11
8
8
D52
DH53
S
108
2970541
3.64
22
34
0.65
49
90
0.54
14
42
0.33
13
12
10
D53
DH54
S
30
3037766
0.99
22
29
0.76
26
45
0.58
11
31
0.35
11
9
9
D54
DH55
S
150
2728407
5.50
35
34
1.03
37
90
0.41
14
42
0.33
12
13
8
D55
DH56
S
100
1706352
5.86
23
29
0.79
27
45
0.60
39
31
1.26
11
11
5
D56
DH57
S
160
5099371
3.14
33
34
0.97
31
90
0.34
48
42
1.14
11
13
8
D57
DH58
S
60
4391418
1.37
12
29
0.41
50
45
1.11
59
31
1.90
10
6
9
D58
DH59
S
105
2562012
4.10
21
34
0.62
21
90
0.23
37
42
0.88
12
13
8 Annexures
129
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D59
DH60
S
100
1760405
5.68
12
29
0.41
25
45
0.56
39
31
1.26
10
9
5
D60
DH61
S
100
1125313
8.89
32
29
1.10
54
45
1.20
14
31
0.45
9
13
9
D61
DH62
S
102
1626384
6.27
15
34
0.44
29
90
0.32
42
42
1.00
12
10
6
D62
DH63
S
120
3071029
3.91
19
34
0.56
30
90
0.33
55
42
1.31
12
11
8
D63
DH64
S
100
1666886
6.00
14
29
0.48
53
45
1.18
11
31
0.35
12
12
8
D64
DH65
S
100
1690400
5.92
14
29
0.48
20
45
0.44
67
31
2.16
12
9
8
D65
DH66
S
75
1000912
7.49
16
29
0.55
48
45
1.07
17
31
0.55
12
10
1
D66
DH67
S
80
2001762
4.00
14
29
0.48
30
45
0.67
10
31
0.32
13
11
8
D67
DH68
S
110
4487379
2.45
21
34
0.62
43
90
0.48
55
42
1.31
10
12
8
D68
DH69
S
160
1367765
11.70
26
34
0.76
50
90
0.56
84
42
2.00
11
11
7
D69
DH70
S
164
4801062
3.42
20
34
0.59
34
90
0.38
57
42
1.36
10
12
9
D70
DH71
M
300
2877653
10.43
24
50
0.48
50
135
0.37
59
66
0.89
10
11
9
D71
DH72
S
82
2219146
3.70
18
29
0.62
52
45
1.16
102
31
3.29
13
9
7
D72
DH73
M
300
3264619
9.19
41
50
0.82
52
135
0.39
147
66
2.23
12
12
10
D73
DH74
S
100
2959918
3.38
22
29
0.76
36
45
0.80
83
31
2.68
12
10
8
D74
DH75
M
281
1900661
14.78
16
50
0.32
40
135
0.30
15
66
0.23
13
11
8
D75
DH76
S
98
4261566
2.30
18
29
0.62
65
45
1.44
101
31
3.26
11
9
5
D76
DH77
S
135
3951862
3.42
24
34
0.71
29
90
0.32
41
42
0.98
12
12
9
D77
DH78
S
83
636342
13.04
23
29
0.79
31
45
0.69
51
31
1.65
11
9
8
D78
DH79
S
76
656246
11.58
15
29
0.52
12
45
0.27
12
31
0.39
11
7
4
D79
DH80
S
73
3423574
2.13
12
29
0.41
27
45
0.60
21
31
0.68
14
9
7 Annexures
130
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D80
DH81
S
100
3330464
3.00
19
29
0.66
22
45
0.49
48
31
1.55
12
11
8
D81
DH82
S
84
2229076
3.77
20
29
0.69
28
45
0.62
36
31
1.16
11
11
8
D82
DH83
S
136
3495021
3.89
35
34
1.03
29
90
0.32
32
42
0.76
12
12
10
D83
DH84
L
470
3935042
11.94
23
68
0.34
29
225
0.13
41
100
0.41
12
13
8
D84
DH85
L
598
1055450
56.66
94
68
1.38
249
225
1.11
178
100
1.78
12
13
12
D85
DH86
S
100
352700
28.35
22
29
0.76
15
45
0.33
6
31
0.19
11
11
8
D86
DH87
S
100
467697
21.38
12
29
0.41
17
45
0.38
6
31
0.19
11
11
10
D87
DH88
S
60
285481
21.02
11
29
0.38
16
45
0.36
8
31
0.26
13
8
8
D88
DH89
S
178
2663629
6.68
40
34
1.18
55
90
0.61
71
42
1.69
12
12
9
D89
DH90
S
175
533638
32.79
54
34
1.59
86
90
0.96
186
42
4.43
10
11
8
D90
DH91
M
225
799781
28.13
22
50
0.44
67
135
0.50
93
66
1.41
14
12
8
D91
DH92
L
410
3343872
12.26
48
68
0.71
118
225
0.52
131
100
1.31
10
11
8
D92
DH93
S
60
585494
10.25
12
29
0.41
12
45
0.27
54
31
1.74
7
6
5
D93
DH94
S
93
1619707
5.74
28
29
0.97
43
45
0.96
64
31
2.06
11
10
8
D94
DH95
S
126
851669
14.79
20
34
0.59
36
90
0.40
15
42
0.36
13
12
11
D95
DH96
S
160
748941
21.36
21
34
0.62
24
90
0.27
16
42
0.38
13
13
9
D96
DH97
S
100
822526
12.16
21
29
0.72
38
45
0.84
79
31
2.55
12
11
7
D97
DH98
S
163
605073
26.94
20
34
0.59
25
90
0.28
79
42
1.88
11
8
7
D98
DH99
S
114
1206640
9.45
28
34
0.82
57
90
0.63
15
42
0.36
13
13
12
D99
DH100
S
165
1032754
15.98
22
34
0.65
50
90
0.56
14
42
0.33
10
12
9
D100
DH101
S
60
275036
21.82
13
29
0.45
16
45
0.36
24
31
0.77
11
7
7 Annexures
131
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D101
DH102
S
100
139820
71.52
17
29
0.59
30
45
0.67
48
31
1.55
12
7
8
D102
DH103
S
100
4063872
2.46
48
29
1.66
74
45
1.64
53
31
1.71
11
12
10
D103
DH104
S
100
576702
17.34
19
29
0.66
39
45
0.87
63
31
2.03
10
7
8
D104
DH105
L
316
343709
91.94
68
58
1.17
153
180
0.85
345
81
4.26
14
14
14
D105
DH106
S
170
191173
88.92
27
34
0.79
58
90
0.64
21
42
0.50
14
12
10
D106
DH107
S
60
52074
115.22
13
29
0.45
20
45
0.44
9
31
0.29
14
7
6
D107
DH108
S
147
123344.4
119.18
111
34
3.26
84
90
0.93
166
42
3.95
12
12
10
D107
DH109
S
97
81390.55
119.18
28
29
0.97
44
45
0.98
116
31
3.74
11
6
7
D107
DH110
L
450
377585
119.18
254
68
3.74
140
225
0.62
199
100
1.99
13
11
12
D108
DH111
S
188
1709346
11.00
163
34
4.79
117
90
1.30
253
42
6.02
10
13
11
D109
DH112
S
100
197328.4
50.68
131
29
4.52
113
45
2.51
105
31
3.39
9
12
11
D109
DH113
S
150
295992.7
50.68
34
34
1.00
105
90
1.17
50
42
1.19
9
13
13
D109
DH114
S
200
394656.9
50.68
88
34
2.59
124
90
1.38
250
42
5.95
8
11
8
D110
DH115
M
222
2241624
9.90
117
50
2.34
115
135
0.85
186
66
2.82
11
12
11
D111
DH116
S
200
886433.7
22.56
36
34
1.06
109
90
1.21
38
42
0.90
9
12
11
D111
DH117
M
300
1329651
22.56
58
50
1.16
239
135
1.77
108
66
1.64
13
14
12
D111
DH118
L
325
1440455
22.56
132
58
2.28
130
180
0.72
54
81
0.67
10
13
11
D112
DH119
S
103
2731929
3.77
31
34
0.91
89
90
0.99
63
42
1.50
12
13
14
D113
DH120
S
100
2292958
4.36
91
29
3.14
95
45
2.11
41
31
1.32
11
12
13
D114
DH121
S
100
276439.5
36.17
31
29
1.07
106
45
2.36
155
31
5.00
8
13
12
D114
DH122
S
180
497591
36.17
108
34
3.18
99
90
1.10
149
42
3.55
13
12
9 Annexures
132
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D114
DH123
L
640
1769213
36.17
130
68
1.91
647
225
2.88
832
100
8.32
9
13
13
D115
DH124
S
200
113309.1
176.51
128
34
3.76
140
90
1.56
61
42
1.45
10
13
11
D115
DH125
L
370
209621.9
176.51
198
58
3.41
175
180
0.97
246
81
3.04
12
13
13
D116
DH126
M
235
818008
28.73
74
50
1.48
147
135
1.09
290
66
4.39
14
13
13
D117
DH127
M
230
640537
35.91
66
50
1.32
143
135
1.06
57
66
0.86
12
14
13
D118
DH128
M
220
1514190
14.53
11
50
0.22
55
135
0.41
14
66
0.21
13
14
12
D119
DH129
S
119
2092745
5.69
13
34
0.38
33
90
0.37
13
42
0.31
13
10
11
D120
DH130
L
320
728535
43.92
37
58
0.64
84
180
0.47
44
81
0.54
13
12
12
D121
DH131
M
210
1551019
13.54
31
50
0.62
62
135
0.46
31
66
0.47
9
13
11
D122
DH132
S
64
652000
9.82
5
29
0.17
25
45
0.56
5
31
0.16
9
9
6
D123
DH133
S
100
1070000
9.35
14
29
0.48
27
45
0.60
5
31
0.16
12
9
8
D124
DH134
L
363
2127086
17.07
69
58
1.19
43
180
0.24
21
81
0.26
13
14
14
D125
DH135
S
150
752484
19.93
13
34
0.38
40
90
0.44
9
42
0.21
14
11
12
D126
DH136
S
160
2299885
6.96
30
34
0.88
42
90
0.47
30
42
0.71
12
13
10
D127
DH137
M
214
2035064
10.52
32
50
0.64
74
135
0.55
32
66
0.48
14
13
11
D128
DH138
S
50
994624
5.03
5
29
0.17
27
45
0.60
55
31
1.77
8
5
7
D129
DH139
M
206
960329
21.45
19
50
0.38
48
135
0.36
16
66
0.24
8
8
10
D130
DH140
S
81
590297
13.72
16
29
0.55
34
45
0.76
9
31
0.29
13
11
10
D131
DH141
M
230
1329672
17.30
29
50
0.58
72
135
0.53
22
66
0.33
13
13
11
D132
DH142
M
264
2390776
11.04
21
50
0.42
76
135
0.56
18
66
0.27
14
14
14
D133
DH143
M
241
585449
41.16
33
50
0.66
90
135
0.67
46
66
0.70
12
11
12 Annexures
133
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D134
DH144
S
115
3804558
3.02
24
34
0.71
39
90
0.43
78
42
1.86
11
9
11
D135
DH145
S
110
1756268
6.26
17
34
0.50
73
90
0.81
30
42
0.71
11
8
11
D136
DH146
M
235
807022
29.12
29
50
0.58
148
135
1.10
23
66
0.35
10
14
12
D137
DH147
S
200
228291
87.61
23
34
0.68
43
90
0.48
126
42
3.00
12
14
12
D138
DH148
S
200
4165626
4.80
13
34
0.38
50
90
0.56
15
42
0.36
11
10
12
D139
DH149
S
200
1128350
17.72
72
34
2.12
34
90
0.38
80
42
1.90
13
12
11
D140
DH150
M
300
1634445
18.35
42
50
0.84
116
135
0.86
26
66
0.39
14
11
11
D141
DH151
S
200
1809733
11.05
48
34
1.41
61
90
0.68
22
42
0.52
12
12
8
D142
DH152
S
100
942011
10.62
22
29
0.76
51
45
1.13
29
31
0.94
13
11
8
D143
DH153
S
176
1743931
10.09
47
34
1.38
93
90
1.03
202
42
4.81
14
12
11
D144
DH154
S
100
958405
10.43
54
29
1.86
52
45
1.16
182
31
5.87
13
13
10
D145
DH155
S
90
1334152
6.75
35
29
1.21
31
45
0.69
28
31
0.90
8
10
10
D146
DH156
S
175
1074304
16.29
36
34
1.06
64
90
0.71
201
42
4.79
14
11
7
D147
DH157
S
92
964655
9.54
41
29
1.41
62
45
1.38
96
31
3.10
14
13
9
D148
DH158
S
100
922088
10.84
36
29
1.24
41
45
0.91
19
31
0.61
13
8
8
D149
DH159
S
48
1089263
4.41
47
29
1.62
24
45
0.53
46
31
1.48
12
11
9
D150
DH160
S
100
1042708
9.59
44
29
1.52
31
45
0.69
46
31
1.48
13
10
8
D151
DH161
M
300
561293
53.45
51
50
1.02
154
135
1.14
244
66
3.70
14
13
12
D152
DH162
S
83
1205437
6.89
47
29
1.62
51
45
1.13
73
31
2.35
8
13
10
D153
DH163
S
109
900332
12.11
62
34
1.82
48
90
0.53
151
42
3.60
10
12
11
D154
DH164
S
100
1061204
9.42
55
29
1.90
53
45
1.18
264
31
8.52
14
13
11 Annexures
134
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D155
DH165
S
120
1295189
9.27
47
34
1.38
37
90
0.41
20
42
0.48
12
12
12
D156
DH166
S
200
1450001
13.79
47
34
1.38
57
90
0.63
24
42
0.57
14
12
10
D157
DH167
M
270
381956
70.69
20
50
0.40
35
135
0.26
138
66
2.09
12
14
8
D158
DH168
M
300
519080
57.79
8
50
0.16
31
135
0.23
15
66
0.23
9
11
11
D159
DH169
M
216
454768
47.50
25
50
0.50
38
135
0.28
35
66
0.53
10
12
11
D160
DH170
M
215
1510075
14.24
26
50
0.52
49
135
0.36
112
66
1.70
11
12
9
D161
DH171
M
300
437903
68.51
28
50
0.56
54
135
0.40
96
66
1.45
11
13
8
D162
DH172
S
20
31564
63.36
7
29
0.24
6
45
0.13
17
31
0.55
10
10
9
D163
DH173
M
300
999777
30.01
25
50
0.50
13
135
0.10
46
66
0.70
11
14
12
D164
DH174
M
261
814010
32.06
39
50
0.78
39
135
0.29
31
66
0.47
13
13
9
D165
DH175
M
250
529855
47.18
67
50
1.34
95
135
0.70
137
66
2.08
12
14
11
D166
DH176
S
180
580320
31.02
22
34
0.65
36
90
0.40
76
42
1.81
12
13
8
D167
DH177
S
200
521173
38.37
18
34
0.53
36
90
0.40
25
42
0.60
11
13
9
D168
DH178
S
110
412000.4
26.70
20
34
0.59
23
90
0.26
45
42
1.07
10
5
4
D168
DH179
S
178
666691.6
26.70
67
34
1.97
29
90
0.32
126
42
3.00
13
10
10
D169
DH180
S
64
753745
8.49
50
29
1.72
7
45
0.16
25
31
0.81
12
11
9
D170
DH181
S
20
392232
5.10
23
29
0.79
17
45
0.38
37
31
1.19
13
9
9
D171
DH182
S
200
1008039
19.84
66
34
1.94
31
90
0.34
105
42
2.50
14
12
13
D172
DH183
S
160
409936
39.03
23
34
0.68
17
90
0.19
79
42
1.88
8
11
8
D173
DH184
S
40
297446
13.45
31
29
1.07
15
45
0.33
38
31
1.23
8
11
11
D174
DH185
S
135
843038.1
16.01
56
34
1.65
40
90
0.44
34
42
0.81
12
12
10 Annexures
135
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D174
DH186
S
58
686919.9
8.44
38
29
1.31
14
45
0.31
27
31
0.87
9
10
9
D175
DH187
S
160
616435
25.96
28
34
0.82
33
90
0.37
73
42
1.74
11
11
8
D176
DH188
S
36
424483
8.48
36
29
1.24
18
45
0.40
40
31
1.29
10
12
9
D177
DH189
S
50
870354
5.74
38
29
1.31
23
45
0.51
50
31
1.61
9
10
9
D178
DH190
S
54
560440
9.64
55
29
1.90
20
45
0.44
49
31
1.58
14
12
10
D179
DH191
S
40
283713
14.10
17
29
0.59
11
45
0.24
48
31
1.55
8
11
9
D180
DH192
S
50
314667
15.89
11
29
0.38
8
45
0.18
35
31
1.13
8
11
8
D181
DH193
S
70
318898
21.95
23
29
0.79
10
45
0.22
31
31
1.00
9
12
8
D182
DH194
S
32
266215
12.02
22
29
0.76
14
45
0.31
45
31
1.45
9
10
9
D183
DH195
S
150
1236829
12.13
61
34
1.79
30
90
0.33
116
42
2.76
13
13
12
D184
DH196
S
200
554985
36.04
35
34
1.03
27
90
0.30
116
42
2.76
10
11
11
D185
DH197
S
100
2062330
4.85
22
29
0.76
8
45
0.18
24
31
0.77
3
7
10
D186
DH198
S
27
1042886
2.59
11
29
0.38
10
45
0.22
45
31
1.45
9
5
6
D187
DH199
S
100
1492073
6.70
24
29
0.83
12
45
0.27
8
31
0.26
9
12
8
D188
DH200
S
103
1321442
7.79
23
34
0.68
30
90
0.33
20
42
0.48
10
11
9
D189
DH201
S
100
1322784
7.56
20
29
0.69
9
45
0.20
26
31
0.84
11
10
8
D190
DH202
S
100
2445474
4.09
17
29
0.59
6
45
0.13
26
31
0.84
11
10
8
D191
DH203
S
100
1313551
7.61
17
29
0.59
6
45
0.13
35
31
1.13
5
9
7
D192
DH204
S
182
1025213
17.75
19
34
0.56
20
90
0.22
64
42
1.52
10
9
7
D193
DH205
L
326
1734495
18.80
22
58
0.38
12
180
0.07
44
81
0.54
10
12
9
D194
DH206
S
100
791042
12.64
12
29
0.41
8
45
0.18
38
31
1.23
9
9
11 Annexures
136
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D195
DH207
S
60
531885
11.28
15
29
0.52
14
45
0.31
37
31
1.19
9
6
6
D196
DH208
S
100
716259
13.96
12
29
0.41
13
45
0.29
20
31
0.65
13
9
8
D197
DH209
S
60
726978
8.25
12
29
0.41
11
45
0.24
51
31
1.65
10
7
7
D198
DH210
S
50
461790
10.83
19
29
0.66
12
45
0.27
45
31
1.45
11
6
9
D199
DH211
S
100
900422
11.11
9
29
0.31
7
45
0.16
50
31
1.61
6
6
5
D200
DH212
S
200
1939869
10.31
25
34
0.74
16
90
0.18
74
42
1.76
11
12
8
D201
DH213
S
100
1502338
6.66
23
29
0.79
31
45
0.69
51
31
1.65
10
7
7
D202
DH214
S
100
2293919
4.36
20
29
0.69
11
45
0.24
101
31
3.26
9
9
10
D203
DH215
S
40
949443
4.21
19
29
0.66
2
45
0.04
31
31
1.00
8
10
8
D204
DH216
S
200
2914253
6.86
44
34
1.29
103
90
1.14
63
42
1.50
10
13
10
D205
DH217
S
60
1150567
5.21
15
29
0.52
0
45
0.00
0
31
0.00
10
7
8
D206
DH218
S
80
1065056
7.51
14
29
0.48
9
45
0.20
9
31
0.29
8
6
8
D207
DH219
S
100
599578
16.68
17
29
0.59
21
45
0.47
59
31
1.90
9
8
7
D208
DH220
M
300
1889752
15.88
19
50
0.38
56
135
0.41
16
66
0.24
12
14
11
D209
DH221
S
120
350405.5
34.25
11
34
0.32
36
90
0.40
75
42
1.79
13
5
5
D209
DH222
S
200
584009.2
34.25
44
34
1.29
71
90
0.79
28
42
0.67
7
11
9
D209
DH223
M
285
832213.1
34.25
53
50
1.06
93
135
0.69
25
66
0.38
13
14
11
D209
DH224
L
536
1565145
34.25
167
68
2.46
210
225
0.93
29
100
0.29
6
5
14
D209
DH225
L
764
2230915
34.25
285
68
4.19
233
225
1.04
68
100
0.68
10
9
11
D209
DH226
L
360
1051216
34.25
46
58
0.79
91
180
0.51
21
81
0.26
14
13
10
D209
DH227
L
1030
3007647
34.25
114
68
1.68
110
225
0.49
42
100
0.42
12
12
12 Annexures
137
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D210
DH228
L
740
4779661
15.48
131
68
1.93
335
225
1.49
386
100
3.86
10
13
12
D211
DH229
M
210
2452595
8.56
43
50
0.86
65
135
0.48
208
66
3.15
9
12
10
D211
DH230
L
1017
2452595
41.47
170
68
2.50
170
225
0.76
63
100
0.63
11
13
14
D212
DH231
L
450
1703300
26.42
179
68
2.63
306
225
1.36
49
100
0.49
11
14
11
D213
DH232
M
250
2177331
11.48
17
50
0.34
71
135
0.53
41
66
0.62
12
13
9
D214
DH233
M
300
1020791
29.39
58
50
1.16
29
135
0.21
45
66
0.68
12
14
12
D215
DH234
S
140
1255104
11.15
29
34
0.85
16
90
0.18
34
42
0.81
9
12
9
D216
DH235
L
400
1137961
35.15
28
58
0.48
58
180
0.32
46
81
0.57
13
11
7
D217
DH236
L
450
1659456
27.12
33
68
0.49
94
225
0.42
112
100
1.12
14
13
11
D218
DH237
M
272
482909.5
56.33
33
50
0.66
78
135
0.58
185
66
2.80
14
5
7
D218
DH238
L
905
1606739
56.33
117
68
1.72
125
225
0.56
19
100
0.19
10
13
14
D219
DH239
S
100
1945497
5.14
8
29
0.28
46
45
1.02
42
31
1.35
5
4
5
D219
DH240
L
930
1945497
47.80
38
68
0.56
105
225
0.47
26
100
0.26
13
13
11
D220
DH241
M
250
318452.2
78.50
20
50
0.40
54
135
0.40
11
66
0.17
14
13
11
D220
DH242
L
1200
1528571
78.50
284
68
4.18
314
225
1.40
79
100
0.79
12
14
14
D221
DH243
M
250
1064570
23.48
9
50
0.18
35
135
0.26
65
66
0.98
10
9
7
D222
DH244
L
560
2566326
21.82
106
68
1.56
154
225
0.68
60
100
0.60
14
14
13
D223
DH245
L
750
1776421
42.22
176
68
2.59
324
225
1.44
54
100
0.54
14
14
14
D224
DH246
M
300
1597668
18.78
31
50
0.62
27
135
0.20
45
66
0.68
12
13
11
D225
DH247
L
410
554519
73.94
80
68
1.18
144
225
0.64
282
100
2.82
12
14
12
D226
DH248
L
400
1536401
26.03
43
58
0.74
59
180
0.33
26
81
0.32
12
14
11
D227
DH249
M
300
1389920
21.58
8
50
0.16
11
135
0.08
9
66
0.14
14
13
11 Annexures
138
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D228
DH250
L
650
1805769
36.00
197
68
2.90
290
225
1.29
61
100
0.61
14
14
13
D229
DH251
L
410
860463
47.65
83
68
1.22
86
225
0.38
13
100
0.13
9
4
5
D229
DH252
L
1020
2140664
47.65
45
68
0.66
49
225
0.22
85
100
0.85
12
11
12
D230
DH253
L
640
1928812
33.18
124
68
1.82
266
225
1.18
77
100
0.77
13
14
12
D231
DH254
S
100
1082636
9.24
16
29
0.55
14
45
0.31
23
31
0.74
11
10
8
D232
DH255
L
950
1752753
54.20
148
68
2.18
261
225
1.16
654
100
6.54
14
14
14
D233
DH256
L
400
2678980
14.93
43
58
0.74
80
180
0.44
26
81
0.32
13
14
13
D234
DH257
M
250
1177361
21.23
28
50
0.56
25
135
0.19
18
66
0.27
12
13
11
D235
DH258
L
316
1437169
21.99
9
58
0.16
55
180
0.31
7
81
0.09
12
14
12
D236
DH259
S
100
1174271
8.52
19
29
0.66
21
45
0.47
48
31
1.55
9
10
9
D237
DH260
M
255
2127789
11.98
24
50
0.48
65
135
0.48
14
66
0.21
10
5
5
D237
DH261
L
400
2127789
18.80
54
58
0.93
78
180
0.43
69
81
0.85
8
12
11
D238
DH262
M
227
860395
26.38
32
50
0.64
46
135
0.34
34
66
0.52
11
14
9
D238
DH263
L
639
2421993
26.38
91
68
1.34
394
225
1.75
602
100
6.02
14
14
12
D239
DH264
S
144
1108974
12.98
32
34
0.94
42
90
0.47
14
42
0.33
9
13
9
D240
DH265
L
541
2523003
21.44
56
68
0.82
119
225
0.53
62
100
0.62
9
14
9
D241
DH266
L
364
1307375
27.84
52
58
0.90
94
180
0.52
39
81
0.48
10
14
9
D242
DH267
M
273
2635375
10.36
31
50
0.62
98
135
0.73
16
66
0.24
7
5
5
D242
DH268
L
537
2635375
20.38
63
68
0.93
149
225
0.66
44
100
0.44
11
11
9
D243
DH269
L
360
1974551
18.23
61
58
1.05
113
180
0.63
45
81
0.56
11
13
8
D244
DH270
L
525
3086293
17.01
60
68
0.88
124
225
0.55
35
100
0.35
10
14
12 Annexures
139
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D245
DH271
S
164
4112920
3.99
34
34
1.00
31
90
0.34
49
42
1.17
10
14
11
D245
DH272
L
501
4112920
12.18
48
68
0.71
106
225
0.47
21
100
0.21
11
14
10
D246
DH273
M
250
2809934
8.90
21
50
0.42
61
135
0.45
24
66
0.36
13
4
5
D246
DH274
L
544
2809934
19.36
47
68
0.69
117
225
0.52
234
100
2.34
13
11
13
D247
DH275
L
403
1197412
33.66
55
68
0.81
56
225
0.25
21
100
0.21
12
14
9
D248
DH276
M
300
671476.7
44.68
54
50
1.08
65
135
0.48
34
66
0.52
10
12
10
D248
DH277
L
747
1671977
44.68
77
68
1.13
214
225
0.95
367
100
3.67
10
11
10
D248
DH278
L
428
957973.4
44.68
38
68
0.56
137
225
0.61
244
100
2.44
10
6
8
D249
DH279
M
240
3121200
7.69
48
50
0.96
80
135
0.59
169
66
2.56
10
14
13
D250
DH280
M
296
817420
36.21
63
50
1.26
73
135
0.54
208
66
3.15
10
14
10
D251
DH281
S
160
140802
113.63
34
34
1.00
62
90
0.69
199
42
4.74
8
13
11
D252
DH282
M
250
133487
187.28
38
50
0.76
57
135
0.42
190
66
2.88
9
13
12
D253
DH283
S
50
64473
77.55
21
29
0.72
21
45
0.47
30
31
0.97
3
3
8
D254
DH284
S
100
571278
17.50
22
29
0.76
54
45
1.20
14
31
0.45
12
9
9
D255
DH285
S
110
728999
15.09
34
34
1.00
56
90
0.62
80
42
1.90
12
9
5
D256
DH286
S
100
749237
13.35
20
29
0.69
51
45
1.13
16
31
0.52
12
9
9
D257
DH287
S
100
845071
11.83
27
29
0.93
54
45
1.20
12
31
0.39
11
11
10
D258
DH288
M
300
1701698
17.63
31
50
0.62
136
135
1.01
211
66
3.20
11
12
8
D259
DH289
M
300
1385881
21.65
35
50
0.70
103
135
0.76
195
66
2.95
10
12
5
D260
DH290
M
300
1575362
19.04
28
50
0.56
138
135
1.02
36
66
0.55
13
11
11
D261
DH291
L
350
1703005
20.55
50
58
0.86
82
180
0.46
30
81
0.37
13
12
10 Annexures
140
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D262
DH292
L
330
2371061
13.92
76
58
1.31
158
180
0.88
87
81
1.07
11
12
9
D263
DH293
S
200
757847
26.39
23
34
0.68
71
90
0.79
25
42
0.60
12
9
8
D264
DH294
M
300
1762375
17.02
57
50
1.14
92
135
0.68
131
66
1.98
13
11
8
D265
DH295
L
400
2090922
19.13
53
58
0.91
154
180
0.86
163
81
2.01
13
13
11
D266
DH296
M
300
1264219
23.73
32
50
0.64
92
135
0.68
25
66
0.38
12
11
9
D267
DH297
L
350
786754
44.49
44
58
0.76
48
180
0.27
86
81
1.06
12
11
10
D268
DH298
L
400
1563715
25.58
43
58
0.74
140
180
0.78
204
81
2.52
13
13
9
D269
DH299
M
300
2185793
13.72
46
50
0.92
108
135
0.80
161
66
2.44
11
12
9
D270
DH300
S
100
704524
14.19
21
29
0.72
66
45
1.47
85
31
2.74
9
10
10
D271
DH301
L
400
1241519
32.22
35
58
0.60
108
180
0.60
154
81
1.90
11
13
9
D272
DH302
S
200
2032036
9.84
45
34
1.32
81
90
0.90
128
42
3.05
13
12
9
D273
DH303
S
100
570465
17.53
31
29
1.07
58
45
1.29
39
31
1.26
14
13
10
D274
DH304
M
300
1241350
24.17
38
50
0.76
117
135
0.87
208
66
3.15
12
11
12
D275
DH305
S
100
3276697
3.05
37
29
1.28
63
45
1.40
22
31
0.71
10
11
9
D276
DH306
L
500
2463289
20.30
48
68
0.71
224
225
1.00
306
100
3.06
11
11
10
D277
DH307
S
200
1025048
19.51
27
34
0.79
69
90
0.77
31
42
0.74
14
12
9
D278
DH308
S
200
1292042
15.48
24
34
0.71
85
90
0.94
73
42
1.74
10
13
9
D279
DH309
L
400
1310061
30.53
28
58
0.48
115
180
0.64
64
81
0.79
9
12
10
D280
DH310
M
300
1873046
16.02
41
50
0.82
104
135
0.77
45
66
0.68
10
12
10
D281
DH311
M
300
1054905
28.44
25
50
0.50
132
135
0.98
114
66
1.73
13
13
10
D282
DH312
L
500
1340411
37.30
34
68
0.50
165
225
0.73
22
100
0.22
11
13
11 Annexures
141
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D283
DH313
M
300
1965970
15.26
42
50
0.84
114
135
0.84
126
66
1.91
13
13
11
D284
DH314
M
300
1091854
27.48
22
50
0.44
116
135
0.86
139
66
2.11
13
12
8
D285
DH315
S
200
826067
24.21
28
34
0.82
46
90
0.51
81
42
1.93
13
12
9
D286
DH316
S
200
1016520
19.67
21
34
0.62
74
90
0.82
173
42
4.12
11
10
9
D287
DH317
S
200
1331597
15.02
32
34
0.94
70
90
0.78
98
42
2.33
11
12
11
D288
DH318
M
300
1545814
19.41
21
50
0.42
86
135
0.64
115
66
1.74
12
12
10
D289
DH319
L
500
1455069
34.36
45
68
0.66
170
225
0.76
52
100
0.52
13
12
10
D290
DH320
S
100
2365106
4.23
35
29
1.21
67
45
1.49
91
31
2.94
12
13
10
D291
DH321
M
300
2378458
12.61
37
50
0.74
146
135
1.08
257
66
3.89
9
12
10
D292
DH322
L
400
2228935
17.95
50
58
0.86
152
180
0.84
268
81
3.31
14
14
12
D293
DH323
M
240
1311332
18.30
29
50
0.58
102
135
0.76
105
66
1.59
11
12
13
D294
DH324
L
400
1379131
29.00
27
58
0.47
168
180
0.93
36
81
0.44
13
10
6
D295
DH325
M
300
1066063
28.14
38
50
0.76
99
135
0.73
159
66
2.41
13
12
10
D296
DH326
S
200
1512681
13.22
20
34
0.59
68
90
0.76
109
42
2.60
12
11
9
D297
DH327
S
100
687861
14.54
31
29
1.07
53
45
1.18
56
31
1.81
13
11
9
D298
DH328
M
300
1726050
17.38
45
50
0.90
87
135
0.64
117
66
1.77
13
11
9
D299
DH329
M
300
1127033
26.62
26
50
0.52
121
135
0.90
43
66
0.65
10
10
8
D300
DH330
S
120
1178273
10.18
24
34
0.71
81
90
0.90
21
42
0.50
9
8
7
D301
DH331
S
200
1445166
13.84
27
34
0.79
98
90
1.09
192
42
4.57
14
10
10
D302
DH332
L
700
1986864
35.23
54
68
0.79
245
225
1.09
315
100
3.15
12
12
10
D303
DH333
S
100
644758
15.51
18
29
0.62
42
45
0.93
57
31
1.84
10
10
7 Annexures
142
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D304
DH334
M
300
1458875
20.56
39
50
0.78
87
135
0.64
144
66
2.18
10
11
8
D305
DH335
M
274
4543159
6.03
54
50
1.08
143
135
1.06
56
66
0.85
11
14
11
D306
DH336
L
379
1927325
19.66
50
58
0.86
155
180
0.86
51
81
0.63
14
11
9
D306
DH337
S
189
961119.9
19.66
34
34
1.00
59
90
0.66
26
42
0.62
8
4
5
D307
DH338
L
320
2585049
12.38
62
58
1.07
136
180
0.76
220
81
2.72
11
14
11
D308
DH339
L
482
1200334
40.16
61
68
0.90
142
225
0.63
222
100
2.22
10
13
11
D309
DH340
L
306
2586258
11.83
71
58
1.22
158
180
0.88
225
81
2.78
11
12
9
D310
DH341
M
252
1072942
23.49
33
50
0.66
120
135
0.89
22
66
0.33
11
12
14
D311
DH342
S
100
1177345
8.49
52
29
1.79
89
45
1.98
47
31
1.52
13
11
7
D312
DH343
L
356
4229917
8.42
25
58
0.43
166
180
0.92
217
81
2.68
10
13
9
D313
DH344
S
60
452087.5
13.27
18
29
0.62
34
45
0.76
20
31
0.65
8
3
6
D313
DH345
S
200
1506958
13.27
47
34
1.38
110
90
1.22
220
42
5.24
11
11
9
D314
DH346
S
200
1648295
12.13
37
34
1.09
101
90
1.12
45
42
1.07
10
10
10
D315
DH347
L
541
6107187
8.86
66
68
0.97
203
225
0.90
379
100
3.79
11
14
11
D316
DH348
M
236
1657576
14.24
42
50
0.84
147
135
1.09
155
66
2.35
11
13
10
D316
DH349
S
60
1657576
3.62
16
29
0.55
33
45
0.73
56
31
1.81
9
6
9
D317
DH350
L
406
1836086
22.11
44
68
0.65
130
225
0.58
29
100
0.29
11
12
11
D317
DH351
S
60
1836086
3.27
7
29
0.24
19
45
0.42
4
31
0.13
9
6
7
D318
DH352
L
333
9429408
3.53
80
58
1.38
159
180
0.88
347
81
4.28
11
14
12
D319
DH353
M
272
2634200
10.33
47
50
0.94
88
135
0.65
42
66
0.64
14
14
10
D320
DH354
S
200
1615069
12.38
35
34
1.03
111
90
1.23
32
42
0.76
11
14
12 Annexures
143
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D321
DH355
M
242
3003741
8.06
41
50
0.82
123
135
0.91
—
—
—
11
14
11
D322
DH356
S
200
849651
23.54
40
34
1.18
99
90
1.10
24
42
0.57
10
12
9
D323
DH357
M
278
11060148
2.51
40
50
0.80
129
135
0.96
256
66
3.88
11
14
9
D324
DH358
M
282
1300774
21.68
50
50
1.00
95
135
0.70
70
66
1.06
10
13
12
D325
DH359
S
200
1197160
16.71
28
34
0.82
72
90
0.80
109
42
2.60
11
11
8
D326
DH360
S
50
237399
21.06
39
29
1.34
25
45
0.56
92
31
2.97
9
10
10
D327
DH361
S
29
144182
20.11
28
29
0.97
30
45
0.67
80
31
2.58
8
7
6
D328
DH362
S
141
274143
51.43
72
34
2.12
51
90
0.57
281
42
6.69
11
10
8
D329
DH363
S
50
479148
10.44
17
29
0.59
24
45
0.53
76
31
2.45
8
7
7
D330
DH364
S
36
140651
25.60
11
29
0.38
19
45
0.42
53
31
1.71
9
6
8
D331
DH365
S
64
422168
15.16
59
29
2.03
57
45
1.27
119
31
3.84
11
12
9
D332
DH366
S
50
183998
27.17
21
29
0.72
33
45
0.73
68
31
2.19
9
6
7
D333
DH367
S
100
317917
31.45
13
29
0.45
39
45
0.87
14
31
0.45
9
6
3
D334
DH368
L
386
323332.5
119.38
53
58
0.91
134
180
0.74
63
81
0.78
12
9
8
D334
DH369
L
600
502589.5
119.38
62
68
0.91
142
225
0.63
67
100
0.67
9
11
12
D335
DH370
S
74
258840
28.59
17
29
0.59
31
45
0.69
35
31
1.13
10
8
8
D336
DH371
S
50
643291
7.77
19
29
0.66
46
45
1.02
6
31
0.19
8
5
4
D336
DH372
S
200
643291
31.09
50
34
1.47
52
90
0.58
27
42
0.64
10
11
8
D337
DH373
S
108
395124
27.33
23
34
0.68
53
90
0.59
46
42
1.10
10
11
8
D338
DH374
S
100
191730.5
52.16
20
29
0.69
28
45
0.62
30
31
0.97
9
10
9
D338
DH375
S
100
191730.5
52.16
12
29
0.41
36
45
0.80
15
31
0.48
9
8
7 Annexures
144
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D339
DH376
M
280
400309
69.95
83
50
1.66
178
135
1.32
393
66
5.95
14
14
14
D340
DH377
S
73
125745
58.05
14
29
0.48
21
45
0.47
64
31
2.06
9
9
10
D341
DH378
S
60
83955
71.47
10
29
0.34
19
45
0.42
55
31
1.77
9
8
8
D342
DH379
S
34
117894
28.84
12
29
0.41
15
45
0.33
58
31
1.87
9
7
9
D343
DH380
S
143
161428
88.58
31
34
0.91
65
90
0.72
149
42
3.55
10
13
12
D344
DH381
S
26
86364
30.11
10
29
0.34
11
45
0.24
39
31
1.26
8
8
9
D345
DH382
S
45
56574
79.54
11
29
0.38
23
45
0.51
64
31
2.06
9
7
7
D346
DH383
S
51
64937
78.54
14
29
0.48
19
45
0.42
67
31
2.16
8
10
12
D347
DH384
S
150
378811
39.60
36
34
1.06
54
90
0.60
67
42
1.60
9
11
9
D348
DH385
S
150
194622
77.07
18
34
0.53
42
90
0.47
150
42
3.57
9
11
10
D349
DH386
S
50
166343
30.06
14
29
0.48
15
45
0.33
55
31
1.77
7
8
6
D350
DH387
S
163
1273821
12.80
31
34
0.91
42
90
0.47
13
42
0.31
10
13
9
D351
DH388
M
236
1648997
14.31
113
50
2.26
61
135
0.45
156
66
2.36
14
14
11
D352
DH389
L
360
2320529
15.51
73
58
1.26
95
180
0.53
33
81
0.41
14
14
11
D353
DH390
S
160
1481255
10.80
22
34
0.65
49
90
0.54
62
42
1.48
12
9
8
D354
DH391
S
93
441162
21.08
28
29
0.97
17
45
0.38
38
31
1.23
8
7
5
D355
DH392
M
269
1506337
17.86
38
50
0.76
54
135
0.40
17
66
0.26
12
13
11
D356
DH393
S
130
2624470
4.95
33
34
0.97
31
90
0.34
22
42
0.52
11
8
8
D357
DH394
S
128
312520
40.96
16
34
0.47
35
90
0.39
54
42
1.29
11
9
9
D358
DH395
M
288
1192811
24.14
29
50
0.58
41
135
0.30
69
66
1.05
11
11
8
D359
DH396
S
111
577817
19.21
25
34
0.74
28
90
0.31
88
42
2.10
11
11
10 Annexures
145
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D360
DH397
S
137
3529031
3.88
33
34
0.97
36
90
0.40
119
42
2.83
11
13
10
D361
DH398
S
126
1136971
11.08
25
34
0.74
38
90
0.42
33
42
0.79
11
13
8
D362
DH399
L
305
1827192
16.69
30
58
0.52
90
180
0.50
44
81
0.54
10
12
8
D363
DH400
S
116
579505
20.02
25
34
0.74
43
90
0.48
53
42
1.26
10
12
8
D364
DH401
S
165
1576869
10.46
33
34
0.97
55
90
0.61
17
42
0.40
11
13
11
D365
DH402
S
186
733110
25.37
39
34
1.15
49
90
0.54
178
42
4.24
11
13
10
D366
DH403
S
195
1440361
13.54
25
34
0.74
32
90
0.36
13
42
0.31
14
13
8
D367
DH404
S
162
405272
39.97
40
34
1.18
65
90
0.72
103
42
2.45
10
13
10
D368
DH405
L
675
1851254
36.46
129
68
1.90
179
225
0.80
221
100
2.21
12
14
12
D368
DH406
S
146
400419.3
36.46
43
34
1.26
45
90
0.50
43
42
1.02
10
13
9
D369
DH407
S
195
1379647
14.13
34
34
1.00
61
90
0.68
94
42
2.24
9
7
11
D370
DH408
S
125
613192
20.39
32
34
0.94
54
90
0.60
90
42
2.14
9
11
9
D371
DH409
M
255
2519738
10.12
107
50
2.14
86
135
0.64
118
66
1.79
12
14
11
D372
DH410
S
135
1220946
11.06
24
34
0.71
46
90
0.51
69
42
1.64
6
7
7
D373
DH411
S
168
962789
17.45
20
34
0.59
34
90
0.38
25
42
0.60
13
11
8
D374
DH412
S
120
610382
19.66
16
34
0.47
50
90
0.56
69
42
1.64
6
11
9
D375
DH413
L
380
1698730
22.37
50
58
0.86
66
180
0.37
35
81
0.43
10
14
11
D376
DH414
S
99
967911
10.23
24
29
0.83
63
45
1.40
89
31
2.87
5
8
7
D377
DH415
M
225
1041099
21.61
33
50
0.66
37
135
0.27
44
66
0.67
9
12
10
D378
DH416
S
110
80775
136.18
19
34
0.56
22
90
0.24
32
42
0.76
7
5
6
D379
DH417
L
313
2093437
14.95
44
58
0.76
82
180
0.46
27
81
0.33
9
10
6 Annexures
146
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D379
DH418
S
197
2093437
9.41
28
34
0.82
53
90
0.59
79
42
1.88
10
10
9
D380
DH419
L
506
200222
252.72
58
68
0.85
166
225
0.74
562
100
5.62
10
14
11
D381
DH420
S
171
41816
408.93
19
34
0.56
74
90
0.82
105
42
2.50
9
14
9
D382
DH421
L
450
950289
47.35
88
68
1.29
199
225
0.88
149
100
1.49
9
6
8
D383
DH422
S
100
55626
179.77
29
29
1.00
61
45
1.36
62
31
2.00
9
11
9
D384
DH423
S
200
2490656
8.03
37
34
1.09
98
90
1.09
189
42
4.50
11
12
10
D385
DH424
S
160
595527
26.87
28
34
0.82
53
90
0.59
98
42
2.33
10
12
12
D386
DH425
S
200
1388525
14.40
49
34
1.44
59
90
0.66
133
42
3.17
10
13
12
D387
DH426
S
100
617508
16.19
31
29
1.07
44
45
0.98
87
31
2.81
11
11
10
D388
DH427
S
80
118100
67.74
32
29
1.10
42
45
0.93
25
31
0.81
10
12
12
D389
DH428
S
75
1180483
6.35
14
29
0.48
23
45
0.51
34
31
1.10
11
10
10
D390
DH429
S
120
2029074
5.91
27
34
0.79
56
90
0.62
54
42
1.29
11
11
11
D391
DH430
S
104
2298323
4.53
28
34
0.82
50
90
0.56
69
42
1.64
10
10
11
D392
DH431
S
200
1586625
12.61
32
34
0.94
59
90
0.66
21
42
0.50
9
13
12
D393
DH432
L
470
2193590
21.43
76
68
1.12
120
225
0.53
29
100
0.29
10
14
12
D394
DH433
S
120
815168
14.72
30
34
0.88
40
90
0.44
109
42
2.60
11
13
11
D395
DH434
M
270
3498739
7.72
46
50
0.92
58
135
0.43
37
66
0.56
9
13
13
D396
DH435
S
100
769751
12.99
26
29
0.90
42
45
0.93
140
31
4.52
10
13
12
D397
DH436
S
120
995746
12.05
25
34
0.74
77
90
0.86
57
42
1.36
10
12
11
D398
DH437
S
200
994628
20.11
37
34
1.09
64
90
0.71
145
42
3.45
11
12
12
D399
DH438
S
100
901896
11.09
16
29
0.55
40
45
0.89
111
31
3.58
11
8
10 Annexures
147
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D400
DH439
S
100
129500
77.22
22
29
0.76
40
45
0.89
85
31
2.74
10
13
11
D401
DH440
S
150
626154
23.96
34
34
1.00
60
90
0.67
88
42
2.10
10
12
11
D402
DH441
S
200
1895686
10.55
42
34
1.24
60
90
0.67
48
42
1.14
9
12
8
D403
DH442
S
100
684627
14.61
31
29
1.07
42
45
0.93
133
31
4.29
9
13
11
D404
DH443
S
100
1655169
6.04
29
29
1.00
45
45
1.00
61
31
1.97
10
13
12
D405
DH444
S
100
1119627
8.93
25
29
0.86
40
45
0.89
81
31
2.61
9
12
10
D406
DH445
L
400
2583052
15.49
33
58
0.57
105
180
0.58
151
81
1.86
14
13
12
D407
DH446
L
701
3674179
19.08
79
68
1.16
147
225
0.65
153
100
1.53
13
13
11
D408
DH447
L
454
1797485
25.26
57
68
0.84
169
225
0.75
17
100
0.17
12
13
12
D409
DH448
L
333
1222755
27.23
53
58
0.91
108
180
0.60
27
81
0.33
13
13
9
D410
DH449
M
285
2603751
10.95
43
50
0.86
83
135
0.61
106
66
1.61
13
13
11
D411
DH450
L
525
2548462
20.60
60
68
0.88
121
225
0.54
130
100
1.30
12
14
10
D412
DH451
L
525
2408523
21.80
54
68
0.79
186
225
0.83
223
100
2.23
12
13
14
D413
DH452
M
300
1110906
27.00
58
50
1.16
103
135
0.76
170
66
2.58
12
13
9
D414
DH453
L
551
1544338
35.68
48
68
0.71
119
225
0.53
55
100
0.55
14
13
8
D415
DH454
M
300
2039547
14.71
55
50
1.10
84
135
0.62
170
66
2.58
14
14
13
D416
DH455
M
250
1634409
15.30
50
50
1.00
72
135
0.53
40
66
0.61
14
11
10
D417
DH456
L
400
1206516
33.15
44
58
0.76
128
180
0.71
154
81
1.90
14
13
11
D418
DH457
M
256
1388552
18.44
30
50
0.60
97
135
0.72
9
66
0.14
13
13
8
D419
DH458
L
370
1969168
18.79
68
58
1.17
129
180
0.72
316
81
3.90
14
14
10
D420
DH459
L
307
1774692
17.30
45
58
0.78
90
180
0.50
246
81
3.04
14
14
10 Annexures
148
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D421
DH460
S
150
669919
22.39
32
34
0.94
26
90
0.29
52
42
1.24
14
13
12
D422
DH461
S
150
1828730
8.20
57
34
1.68
60
90
0.67
59
42
1.40
10
11
9
D423
DH462
S
200
2137045
9.36
60
34
1.76
73
90
0.81
49
42
1.17
14
14
11
D424
DH463
M
300
1458248
20.57
39
50
0.78
78
135
0.58
65
66
0.98
13
14
8
D425
DH464
M
296
3307743
8.95
30
50
0.60
84
135
0.62
78
66
1.18
12
12
6
D426
DH465
L
307
2037573
15.07
38
58
0.66
113
180
0.63
153
81
1.89
13
13
10
D427
DH466
S
150
867848
17.28
28
34
0.82
96
90
1.07
11
42
0.26
13
12
10
D428
DH467
M
220
1156597
19.02
27
50
0.54
64
135
0.47
14
66
0.21
14
14
9
D429
DH468
M
294
1335551
22.01
64
50
1.28
117
135
0.87
66
66
1.00
13
13
7
D430
DH469
L
400
2677333
14.94
72
58
1.24
127
180
0.71
185
81
2.28
13
14
11
D431
DH470
S
200
1036346
19.30
28
34
0.82
75
90
0.83
100
42
2.38
10
12
10
D432
DH471
S
200
1421326
14.07
44
34
1.29
117
90
1.30
153
42
3.64
13
14
11
D433
DH472
S
105
283583
37.03
31
34
0.91
26
90
0.29
96
42
2.29
9
11
11
D434
DH473
S
50
43709
114.39
17
29
0.59
23
45
0.51
57
31
1.84
9
5
8
D435
DH474
S
100
146850
68.10
34
29
1.17
20
45
0.44
44
31
1.42
13
12
9
D436
DH475
S
80
136435
58.64
16
29
0.55
28
45
0.62
66
31
2.13
10
10
11
D437
DH476
M
232
754894
30.73
42
50
0.84
64
135
0.47
21
66
0.32
14
14
11
D438
DH477
L
1098
4646732
23.63
231
68
3.40
199
225
0.88
272
100
2.72
12
14
14
D439
DH478
L
314
3458045
9.08
31
58
0.53
50
180
0.28
11
81
0.14
14
13
12
D440
DH479
L
750
2605914
28.78
78
68
1.15
132
225
0.59
198
100
1.98
10
14
12
D441
DH480
S
152
1506843
10.09
16
34
0.47
27
90
0.30
7
42
0.17
13
13
12 Annexures
149
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D442
DH481
L
645
2159775
29.86
73
68
1.07
132
225
0.59
100
100
1.00
14
14
12
D443
DH482
L
700
2251744
31.09
77
68
1.13
124
225
0.55
209
100
2.09
14
14
12
D444
DH483
L
543
3998252
13.58
65
68
0.96
128
225
0.57
57
100
0.57
13
14
12
D445
DH484
S
154
1870374
8.23
32
34
0.94
31
90
0.34
22
42
0.52
14
13
12
D446
DH485
S
103
1064493
9.68
13
34
0.38
31
90
0.34
10
42
0.24
13
14
11
D447
DH486
L
422
1879809
22.45
65
68
0.96
93
225
0.41
35
100
0.35
13
14
12
D448
DH487
S
185
3038252
6.09
27
34
0.79
60
90
0.67
88
42
2.10
14
13
11
D449
DH488
L
545
1616450
33.72
32
68
0.47
135
225
0.60
32
100
0.32
14
11
12
D450
DH489
L
468
1726601
27.11
69
68
1.01
120
225
0.53
158
100
1.58
14
14
13
D451
DH490
L
375
735394
50.99
43
58
0.74
114
180
0.63
196
81
2.42
14
13
10
D452
DH491
L
477
565223
84.39
63
68
0.93
109
225
0.48
40
100
0.40
12
13
11
D453
DH492
S
168
1618345
10.38
22
34
0.65
49
90
0.54
87
42
2.07
12
9
8
D454
DH493
L
613
1353445
45.29
63
68
0.93
122
225
0.54
51
100
0.51
14
14
12
D455
DH494
M
300
3482056
8.62
33
50
0.66
60
135
0.44
12
66
0.18
14
14
12
D456
DH495
M
222
1339101
16.58
19
50
0.38
55
135
0.41
77
66
1.17
13
14
12
D457
DH496
L
526
2405890
21.86
24
68
0.35
76
225
0.34
148
100
1.48
13
12
11
D458
DH497
M
296
1245899
23.76
18
50
0.36
66
135
0.49
153
66
2.32
14
9
9
D459
DH498
L
370
3728104
9.92
53
58
0.91
104
180
0.58
15
81
0.19
14
14
12
D460
DH499
L
354
1264277
28.00
23
58
0.40
54
180
0.30
47
81
0.58
14
13
12
D461
DH500
M
210
2722290
7.71
35
50
0.70
60
135
0.44
29
66
0.44
14
13
12
D462
DH501
M
256
3077233
8.32
34
50
0.68
68
135
0.50
34
66
0.52
14
12
10 Annexures
150
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D463
DH502
L
726
2479052
29.29
70
68
1.03
121
225
0.54
179
100
1.79
11
14
11
D464
DH503
M
226
2464875
9.17
19
50
0.38
47
135
0.35
23
66
0.35
12
12
11
D465
DH504
L
413
1750176
23.60
37
68
0.54
79
225
0.35
126
100
1.26
14
14
12
D466
DH505
M
300
3936331
7.62
23
50
0.46
64
135
0.47
53
66
0.80
12
14
10
D467
DH506
L
304
3458873
8.79
31
58
0.53
37
180
0.21
28
81
0.35
8
12
11
D468
DH507
L
386
1942288
19.87
35
58
0.60
109
180
0.61
154
81
1.90
14
14
12
D469
DH508
S
200
3943323
5.07
26
34
0.76
45
90
0.50
135
42
3.21
11
12
13
D470
DH509
L
500
3776269
13.24
41
68
0.60
107
225
0.48
11
100
0.11
12
14
14
D471
DH510
M
250
2797370
8.94
41
50
0.82
74
135
0.55
91
66
1.38
14
14
14
D472
DH511
L
450
3488809
12.90
26
68
0.38
110
225
0.49
108
100
1.08
14
13
13
D473
DH512
M
250
1235341
20.24
38
50
0.76
58
135
0.43
131
66
1.98
14
14
14
D474
DH513
S
0
927140
0.00
20
29
0.69
37
45
0.82
12
31
0.39
14
14
14
D475
DH514
S
150
378230
39.66
25
34
0.74
46
90
0.51
66
42
1.57
11
10
9
D476
DH515
S
150
441538
33.97
29
34
0.85
77
90
0.86
124
42
2.95
11
12
10
D477
DH516
S
100
327564
30.53
15
29
0.52
46
45
1.02
96
31
3.10
10
8
7
D478
DH517
S
100
693947
14.41
20
29
0.69
46
45
1.02
74
31
2.39
10
10
9
D479
DH518
S
100
876001
11.42
15
29
0.52
38
45
0.84
97
31
3.13
10
8
6
D480
DH519
S
150
298194
50.30
23
34
0.68
45
90
0.50
75
42
1.79
10
12
9
D481
DH520
S
128
1724409
7.42
46
34
1.35
59
90
0.66
121
42
2.88
10
11
9
D481
DH521
S
200
2694388
7.42
29
34
0.85
84
90
0.93
182
42
4.33
11
4
6
D482
DH522
S
100
870589.8
11.49
42
29
1.45
61
45
1.36
55
31
1.77
8
10
9 Annexures
151
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D482
DH523
S
90
783530.8
11.49
6
29
0.21
7
45
0.16
7
31
0.23
7
3
5
D482
DH524
M
232
2019768
11.49
20
50
0.40
10
135
0.07
24
66
0.36
9
8
8
D483
DH528
S
100
2397888
4.17
24
29
0.83
76
45
1.69
119
31
3.84
14
11
9
D484
DH529
S
50
459848.3
10.87
9
29
0.31
10
45
0.22
22
31
0.71
7
7
4
D484
DH530
S
100
919696.7
10.87
13
29
0.45
15
45
0.33
41
31
1.32
6
6
4
D485
DH531
S
100
1446368
6.91
14
29
0.48
55
45
1.22
15
31
0.48
9
5
5
D485
DH532
M
219
3167545
6.91
39
50
0.78
69
135
0.51
113
66
1.71
14
12
7
D486
DH533
S
100
1303048
7.67
33
29
1.14
19
45
0.42
105
31
3.39
11
12
8
D487
DH534
S
135
964843.6
13.99
13
34
0.38
21
90
0.23
42
42
1.00
5
4
4
D487
DH535
L
353
2522887
13.99
46
58
0.79
62
180
0.34
147
81
1.81
9
11
12
D488
DH536
S
176
2365976
7.44
23
34
0.68
23
90
0.26
28
42
0.67
13
10
8
D488
DH537
S
65
873798
7.44
3
29
0.10
13
45
0.29
19
31
0.61
11
3
4
D489
DH538
S
30
315980.1
9.49
5
29
0.17
14
45
0.31
5
31
0.16
6
3
1
D489
DH539
S
74
779417.7
9.49
14
29
0.48
3
45
0.07
29
31
0.94
6
10
7
D489
DH540
S
100
1053267
9.49
7
29
0.24
11
45
0.24
9
31
0.29
6
6
7
D490
DH541
S
30
405882
7.39
6
29
0.21
16
45
0.36
42
31
1.35
8
3
2
D490
DH542
S
103
1393528
7.39
18
34
0.53
42
90
0.47
119
42
2.83
12
10
9
D491
DH543
S
75
1137453
6.59
11
29
0.38
6
45
0.13
40
31
1.29
8
5
5
D491
DH544
S
140
2123246
6.59
26
34
0.76
15
90
0.17
65
42
1.55
9
10
10
D492
DH545
L
325
4448359
7.31
35
58
0.60
90
180
0.50
158
81
1.95
13
10
9
D492
DH546
S
114
4448359
2.56
15
34
0.44
23
90
0.26
81
42
1.93
13
3
3 Annexures
152
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D493
DH547
S
125
480589.7
26.01
8
34
0.24
19
90
0.21
3
42
0.07
8
4
4
D493
DH548
M
216
830459
26.01
33
50
0.66
13
135
0.10
49
66
0.74
9
12
9
D493
DH549
M
300
1153415
26.01
25
50
0.50
66
135
0.49
37
66
0.56
7
10
8
D494
DH550
S
100
2104407
4.75
15
29
0.52
19
45
0.42
72
31
2.32
8
10
8
D494
DH551
S
75
1578306
4.75
8
29
0.28
10
45
0.22
45
31
1.45
8
2
3
D495
DH552
S
79
929296.4
8.50
9
29
0.31
21
45
0.47
33
31
1.06
13
4
4
D495
DH553
M
234
2752600
8.50
34
50
0.68
49
135
0.36
79
66
1.20
14
11
8
D496
DH554
S
60
619322.3
9.69
9
29
0.31
6
45
0.13
10
31
0.32
13
5
5
D496
DH555
S
50
516101.9
9.69
10
29
0.34
8
45
0.18
37
31
1.19
9
5
7
D496
DH556
S
52
536746
9.69
14
29
0.48
6
45
0.13
11
31
0.35
8
6
6
D496
DH557
S
177
1827001
9.69
25
34
0.74
23
90
0.26
96
42
2.29
11
11
8
D497
DH558
S
100
849024.3
11.78
17
29
0.59
11
45
0.24
29
31
0.94
10
12
10
D497
DH559
S
30
254707.3
11.78
10
29
0.34
14
45
0.31
43
31
1.39
7
5
4
D497
DH560
S
100
849024.3
11.78
15
29
0.52
12
45
0.27
69
31
2.23
10
9
8
D498
DH561
S
100
991730
10.08
21
29
0.72
25
45
0.56
20
31
0.65
11
8
6
D499
DH562
S
191
1406842
13.58
8
34
0.24
24
90
0.27
16
42
0.38
9
4
4
D499
DH563
M
230
1694104
13.58
36
50
0.72
50
135
0.37
37
66
0.56
9
11
8
D500
DH564
S
100
1503797
6.65
18
29
0.62
18
45
0.40
103
31
3.32
9
8
10
D500
DH565
S
18
270683.4
6.65
4
29
0.14
6
45
0.13
21
31
0.68
10
3
3
D501
DH566
S
43
249149.6
17.26
6
29
0.21
17
45
0.38
15
31
0.48
9
4
2
D501
DH567
M
230
1332660
17.26
31
50
0.62
74
135
0.55
77
66
1.17
10
9
10 Annexures
153
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D502
DH568
S
114
685385.8
16.63
10
34
0.29
17
90
0.19
33
42
0.79
9
4
3
D502
DH569
S
85
511033.2
16.63
22
29
0.76
53
45
1.18
141
31
4.55
9
11
10
D502
DH570
M
212
1274577
16.63
37
50
0.74
67
135
0.50
107
66
1.62
11
9
7
D503
DH571
S
65
415383.9
15.65
11
29
0.38
20
45
0.44
3
31
0.10
10
5
3
D503
DH572
S
200
1278104
15.65
13
34
0.38
20
90
0.22
34
42
0.81
11
11
8
D503
DH573
S
30
191715.7
15.65
5
29
0.17
4
45
0.09
5
31
0.16
8
5
5
D504
DH574
S
72
869526.5
8.28
7
29
0.24
12
45
0.27
37
31
1.19
9
3
5
D504
DH575
S
146
1763207
8.28
27
34
0.79
64
90
0.71
38
42
0.90
9
9
8
D505
DH576
S
45
899336.2
5.00
5
29
0.17
6
45
0.13
13
31
0.42
6
2
5
D505
DH577
S
80
1598820
5.00
7
29
0.24
13
45
0.29
19
31
0.61
9
5
4
D506
DH578
S
137
1648115
8.31
53
34
1.56
85
90
0.94
31
42
0.74
10
11
10
D507
DH579
S
68
953149.3
7.13
14
29
0.48
28
45
0.62
12
31
0.39
7
3
4
D507
DH580
S
100
1401690
7.13
23
29
0.79
26
45
0.58
15
31
0.48
6
11
8
D507
DH581
S
166
2326806
7.13
30
34
0.88
54
90
0.60
29
42
0.69
11
12
8
D508
DH582
S
80
190144
42.07
6
29
0.21
22
45
0.49
51
31
1.65
9
4
5
D508
DH583
S
150
356520
42.07
17
34
0.50
32
90
0.36
68
42
1.62
12
11
10
D509
DH584
S
134
1493978
8.97
7
34
0.21
17
90
0.19
5
42
0.12
5
3
4
D509
DH585
S
174
1939941
8.97
28
34
0.82
19
90
0.21
35
42
0.83
13
10
7
D510
DH586
L
305
3036935
10.04
53
58
0.91
45
180
0.25
63
81
0.78
10
11
10
D510
DH587
S
141
1403960
10.04
20
34
0.59
43
90
0.48
78
42
1.86
8
4
5
D511
DH588
S
30
338046.4
8.87
4
29
0.14
5
45
0.11
9
31
0.29
10
4
2 Annexures
154
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D511
DH589
S
68
766238.6
8.87
16
29
0.55
20
45
0.44
26
31
0.84
11
9
6
D512
DH590
S
64
1056218
6.06
12
29
0.41
23
45
0.51
79
31
2.55
9
3
4
D512
DH591
S
184
3036627
6.06
25
34
0.74
17
90
0.19
68
42
1.62
10
10
9
D513
DH592
S
70
1095296
6.39
16
29
0.55
12
45
0.27
61
31
1.97
7
7
6
D513
DH593
S
30
469412.4
6.39
13
29
0.45
18
45
0.40
49
31
1.58
9
5
5
D514
DH594
S
60
618283.2
9.70
11
29
0.38
29
45
0.64
6
31
0.19
12
2
3
D514
DH595
S
104
1071691
9.70
26
34
0.76
12
90
0.13
21
42
0.50
9
9
9
D515
DH596
S
100
1834369
5.45
12
29
0.41
30
45
0.67
65
31
2.10
8
4
4
D515
DH597
S
145
2659835
5.45
26
34
0.76
19
90
0.21
90
42
2.14
10
10
7
D516
DH598
S
47
428923.9
10.96
11
29
0.38
21
45
0.47
53
31
1.71
9
3
4
D516
DH599
S
172
1569679
10.96
46
34
1.35
22
90
0.24
81
42
1.93
13
11
10
D517
DH600
S
100
1840221
5.43
20
29
0.69
23
45
0.51
71
31
2.29
8
9
6
D518
DH601
S
100
1656616
6.04
36
29
1.24
55
45
1.22
188
31
6.06
10
11
10
D519
DH602
S
100
1796184
5.57
33
29
1.14
33
45
0.73
153
31
4.94
10
12
8
D520
DH603
L
423
2497263
16.94
69
68
1.01
149
225
0.66
283
100
2.83
12
11
11
D520
DH604
S
68
401451.3
16.94
19
29
0.66
13
45
0.29
65
31
2.10
10
9
7
D520
DH605
S
100
590369.6
16.94
34
29
1.17
32
45
0.71
52
31
1.68
9
11
8
D520
DH606
S
185
1092184
16.94
22
34
0.65
43
90
0.48
179
42
4.26
13
3
7
D521
DH607
S
30
1436719
2.09
7
29
0.24
4
45
0.09
41
31
1.32
9
6
3
D522
DH608
S
100
1599596
6.25
35
29
1.21
27
45
0.60
46
31
1.48
10
11
7
D523
DH609
S
100
3564544
2.81
42
29
1.45
71
45
1.58
126
31
4.06
9
13
9 Annexures
155
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D524
DH610
S
60
196936.7
30.47
17
29
0.59
24
45
0.53
8
31
0.26
12
5
4
D524
DH611
S
167
548140.3
30.47
28
34
0.82
51
90
0.57
112
42
2.67
9
11
9
D525
DH612
S
60
366477.6
16.37
9
29
0.31
25
45
0.56
19
31
0.61
9
4
3
D525
DH613
S
140
855114.4
16.37
25
34
0.74
20
90
0.22
52
42
1.24
10
9
6
D526
DH614
L
376
745155
50.46
95
58
1.64
79
180
0.44
340
81
4.20
12
11
13
D526
DH615
L
656
1300058
50.46
85
68
1.25
132
225
0.59
383
100
3.83
9
11
9
D526
DH616
L
326
646065.3
50.46
43
58
0.74
111
180
0.62
26
81
0.32
12
5
6
D526
DH617
L
466
923516.6
50.46
87
68
1.28
125
225
0.56
50
100
0.50
14
14
12
D526
DH618
S
110
217997.5
50.46
38
34
1.12
59
90
0.66
30
42
0.71
12
9
8
D526
DH619
S
100
198179.5
50.46
48
29
1.66
61
45
1.36
78
31
2.52
11
11
8
D526
DH620
S
82
162507.2
50.46
33
29
1.14
36
45
0.80
56
31
1.81
9
4
6
D526
DH621
S
100
198179.5
50.46
22
29
0.76
19
45
0.42
12
31
0.39
7
9
5
D526
DH622
S
100
198179.5
50.46
23
29
0.79
5
45
0.11
7
31
0.23
8
11
7
D527
DH623
S
100
2684703
3.72
28
29
0.97
56
45
1.24
77
31
2.48
14
11
6
D528
DH624
S
30
202144.2
14.84
7
29
0.24
12
45
0.27
38
31
1.23
9
3
4
D528
DH625
S
100
673813.8
14.84
20
29
0.69
26
45
0.58
63
31
2.03
10
10
9
D529
DH626
S
30
431199
6.96
5
29
0.17
11
45
0.24
9
31
0.29
9
4
4
D529
DH627
S
100
1437330
6.96
19
29
0.66
58
45
1.29
52
31
1.68
11
11
7
D530
DH628
S
54
603280.4
8.95
11
29
0.38
19
45
0.42
64
31
2.06
10
4
5
D530
DH629
S
100
1117186
8.95
22
29
0.76
40
45
0.89
89
31
2.87
10
11
10
D530
DH630
S
74
826717.6
8.95
19
29
0.66
9
45
0.20
79
31
2.55
11
11
9 Annexures
156
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D531
DH631
S
30
661551
4.53
6
29
0.21
13
45
0.29
17
31
0.55
11
4
4
D531
DH632
S
70
1543619
4.53
34
29
1.17
28
45
0.62
37
31
1.19
12
10
10
D532
DH633
S
116
1091442
10.63
18
34
0.53
30
90
0.33
41
42
0.98
9
5
4
D532
DH634
M
250
2352247
10.63
40
50
0.80
55
135
0.41
107
66
1.62
12
11
10
D533
DH635
S
88
904252.5
9.73
11
29
0.38
22
45
0.49
63
31
2.03
8
3
3
D533
DH636
S
155
1592717
9.73
44
34
1.29
53
90
0.59
82
42
1.95
11
12
11
D534
DH637
S
187
3367416
5.55
39
34
1.15
21
90
0.23
150
42
3.57
9
11
10
D534
DH638
S
78
1404590
5.55
6
29
0.21
9
45
0.20
6
31
0.19
8
3
6
D535
DH639
S
127
1742470
7.29
13
34
0.38
43
90
0.48
17
42
0.40
11
4
8
D535
DH640
S
175
2401042
7.29
28
34
0.82
26
90
0.29
51
42
1.21
12
11
10
D536
DH641
S
130
1320155
9.85
16
34
0.47
13
90
0.14
21
42
0.50
13
11
10
D536
DH642
S
70
710852.5
9.85
10
29
0.34
17
45
0.38
48
31
1.55
11
6
3
D537
DH643
S
62
822176.6
7.54
9
29
0.31
9
45
0.20
29
31
0.94
11
4
4
D537
DH644
S
180
2386964
7.54
22
34
0.65
20
90
0.22
22
42
0.52
13
9
6
D538
DH525
S
156
1789759
8.72
40
34
1.18
24
90
0.27
47
42
1.12
14
10
10
D538
DH526
S
164
1881542
8.72
22
34
0.65
18
90
0.20
3
42
0.07
10
4
6
D538
DH527
S
199
2283090
8.72
48
34
1.41
22
90
0.24
17
42
0.40
11
10
9
D539
DH645
S
121
1116728
10.84
14
34
0.41
18
90
0.20
34
42
0.81
11
5
8
D539
DH646
M
248
2288831
10.84
28
50
0.56
27
135
0.20
51
66
0.77
12
9
9
D540
DH647
S
150
1734519
8.65
15
34
0.44
45
90
0.50
15
42
0.36
14
9
11
D540
DH648
S
52
601299.9
8.65
10
29
0.34
12
45
0.27
34
31
1.10
5
5
5 Annexures
157
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D541
DH649
S
168
1193345
14.08
19
34
0.56
51
90
0.57
72
42
1.71
10
4
7
D541
DH650
L
320
2273037
14.08
40
58
0.69
55
180
0.31
49
81
0.60
12
11
9
D542
DH651
S
70
2192933
3.19
5
29
0.17
4
45
0.09
19
31
0.61
12
7
5
D543
DH652
S
100
1715183
5.83
35
29
1.21
46
45
1.02
16
31
0.52
14
12
8
D544
DH653
S
100
1052142
9.50
20
29
0.69
9
45
0.20
32
31
1.03
10
9
7
D544
DH654
S
50
526071
9.50
18
29
0.62
7
45
0.16
36
31
1.16
7
11
7
D545
DH655
S
108
1040725
10.38
14
34
0.41
29
90
0.32
80
42
1.90
9
4
4
D545
DH656
M
204
1965813
10.38
28
50
0.56
37
135
0.27
138
66
2.09
10
12
9
D546
DH657
S
100
1117361
8.95
14
29
0.48
12
45
0.27
48
31
1.55
12
9
10
D547
DH658
S
100
2559297
3.91
27
29
0.93
36
45
0.80
69
31
2.23
9
13
8
D548
DH659
S
144
1877020
7.67
14
34
0.41
34
90
0.38
100
42
2.38
8
4
4
D548
DH660
S
200
2606972
7.67
34
34
1.00
32
90
0.36
128
42
3.05
11
10
8
D549
DH661
S
100
1862559
5.37
20
29
0.69
5
45
0.11
26
31
0.84
7
12
7
D550
DH662
S
82
1066314
7.69
11
29
0.38
27
45
0.60
12
31
0.39
7
3
4
D550
DH663
M
210
2730803
7.69
34
50
0.68
73
135
0.54
40
66
0.61
7
12
10
D551
DH664
S
60
1097071
5.47
18
29
0.62
32
45
0.71
88
31
2.84
9
5
7
D551
DH665
S
110
2011296
5.47
31
34
0.91
14
90
0.16
37
42
0.88
9
9
10
D552
DH666
S
180
889558.3
20.23
18
34
0.53
38
90
0.42
50
42
1.19
10
4
3
D552
DH667
S
125
617748.8
20.23
29
34
0.85
28
90
0.31
21
42
0.50
14
9
10
D552
DH668
S
153
756124.6
20.23
25
34
0.74
14
90
0.16
68
42
1.62
13
11
8
D552
DH669
M
286
1413409
20.23
43
50
0.86
44
135
0.33
39
66
0.59
11
11
9 Annexures
158
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D553
DH670
S
36
235897
15.26
9
29
0.31
18
45
0.40
26
31
0.84
6
3
1
D553
DH671
S
59
386609
15.26
19
29
0.66
17
45
0.38
36
31
1.16
7
8
8
D554
DH672
S
45
58046
77.52
19
29
0.66
15
45
0.33
38
31
1.23
9
11
9
D555
DH673
S
68
391605
17.36
15
29
0.52
28
45
0.62
51
31
1.65
10
8
7
D556
DH674
S
45
259648
17.33
11
29
0.38
24
45
0.53
1
31
0.03
8
8
7
D557
DH675
S
132
553169.3
23.86
18
34
0.53
16
90
0.18
15
42
0.36
8
10
10
D557
DH676
S
32
134101.7
23.86
9
29
0.31
5
45
0.11
6
31
0.19
3
3
4
D558
DH677
S
38
665148.5
5.71
8
29
0.28
15
45
0.33
34
31
1.10
11
3
2
D558
DH678
S
70
1225274
5.71
17
29
0.59
22
45
0.49
23
31
0.74
12
8
8
D559
DH679
S
63
518449.3
12.15
22
29
0.76
16
45
0.36
39
31
1.26
10
11
10
D559
DH680
S
53
436155.7
12.15
7
29
0.24
8
45
0.18
15
31
0.48
10
2
0
D560
DH681
S
44
129703.1
33.92
8
29
0.28
18
45
0.40
18
31
0.58
6
3
0
D560
DH682
S
120
353735.9
33.92
26
34
0.76
29
90
0.32
25
42
0.60
8
11
9
D561
DH683
S
50
242285
20.64
16
29
0.55
13
45
0.29
33
31
1.06
4
8
5
D562
DH684
S
76
618931
12.28
18
29
0.62
28
45
0.62
61
31
1.97
8
11
9
D563
DH685
S
125
1648902
7.58
11
34
0.32
24
90
0.27
17
42
0.40
12
11
9
D564
DH686
S
108
225628.4
47.87
14
34
0.41
13
90
0.14
24
42
0.57
10
6
5
D564
DH687
S
50
104457.6
47.87
14
29
0.48
13
45
0.29
24
31
0.77
11
8
5
D565
DH688
M
282
1501983
18.78
55
50
1.10
84
135
0.62
34
66
0.52
14
13
7
D566
DH689
M
286
3502404
8.17
58
50
1.16
129
135
0.96
186
66
2.82
12
14
10
D567
DH690
L
430
1676276
25.65
49
68
0.72
226
225
1.00
37
100
0.37
14
13
11 Annexures
159
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Total
services available
Total
services available
Total
services available
KPI 1
KPI 2.1
KPI 2.2
KPI 2.3
KPI 3
KPI 4
KPI 5
D568
DH691
L
365
952105.1
38.34
61
58
1.05
136
180
0.76
141
81
1.74
13
14
9
D568
DH692
L
343
894717.9
38.34
37
58
0.64
156
180
0.87
93
81
1.15
13
14
10
D569
DH693
L
636
4850029
13.11
71
68
1.04
177
225
0.79
39
100
0.39
12
13
10
D570
DH694
L
625
5519145
11.32
72
68
1.06
168
225
0.75
41
100
0.41
13
14
10
D571
DH695
L
700
3872846
18.07
67
68
0.99
243
225
1.08
193
100
1.93
14
14
10
D572
DH696
L
460
1136548
40.47
73
68
1.07
172
225
0.76
208
100
2.08
13
14
11
D573
DH697
L
500
2819086
17.74
57
68
0.84
156
225
0.69
37
100
0.37
14
13
11
D574
DH698
L
849
5167600
16.43
76
68
1.12
254
225
1.13
33
100
0.33
14
13
8
D575
DH699
L
600
5227040
11.48
66
68
0.97
212
225
0.94
94
100
0.94
11
14
11
D575
DH700
L
549
4782741
11.48
34
68
0.50
132
225
0.59
52
100
0.52
8
13
9
D576
DH701
L
405
1159127
34.94
66
68
0.97
173
225
0.77
26
100
0.26
10
14
10
D577
DH702
L
415
4360388
9.52
62
68
0.91
166
225
0.74
373
100
3.73
14
14
11
D577
DH703
S
70
735487.1
9.52
35
29
1.21
44
45
0.98
65
31
2.10
9
10
4
D578
DH704
L
590
2930115
20.14
89
68
1.31
182
225
0.81
23
100
0.23
14
14
10
D579
DH705
L
625
4849074
12.89
104
68
1.53
339
225
1.51
53
100
0.53
13
14
12
D579
DH706
L
427
3312887
12.89
60
68
0.88
130
225
0.58
23
100
0.23
11
13
7
D580
DH707
L
436
3007134
14.50
51
68
0.75
162
225
0.72
44
100
0.44
14
13
9 Annexures
160
ANNEXURE 7 - TABLE 7B - KPI
s
6-10
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D1
DH1
S
363
126
0.79
0
206
0.00
0
0
0.00
59339
363
8
20.43
76
82
92.68
D2
DH2
S
5621
60
25.67
0
78
0.00
0
0
0.00
66105
362
12
15.22
305
305
100.00
D3
DH3
L
128472
476
73.94
918
2666
34.43
1134
6
189.00
532901
362
54
27.26
6629
4344
—
D4
DH4
L
345131
500
189.11
3498
9087
38.49
5619
30
187.30
592736
0
135
0.00
2982
13007
22.93
D5
DH5
M
108713
300
99.28
3472
12164
28.54
0
0
0.00
106521
313
35
9.72
0
2804
0.00
D5
DH6
L
252314
1098
62.96
0
0
0.00
6231
41
151.98
565377
313
157
11.51
75
6477
1.16
D6
DH7
L
84525
350
66.16
1107
2499
44.30
2050
6
341.67
284121
312
29
31.40
3440
3440
100.00
D7
DH8
M
134755
250
147.68
1658
4139
40.06
1238
4
309.50
318384
311
40
25.59
2522
4513
55.88
D8
DH9
M
93805
257
100.00
1320
2965
44.52
729
6
121.50
381316
313
38
32.06
1452
1452
100.00
D9
DH10
L
127750
350
100.00
4051
5523
73.35
938
6
156.33
250542
0
39
0.00
116
3548
3.27
D10
DH11
M
114340
300
104.42
2319
4565
50.80
588
4
147.00
425208
365
46
25.33
3760
3760
100.00
D11
DH12
L
40653
1077
10.34
2309
3603
64.09
1486
23
64.61
295151
0
103
0.00
2616
2616
100.00
D12
DH13
L
185556
500
101.67
1993
3859
51.65
1888
16
118.00
468617
365
93
13.81
0
3687
0.00
D13
DH14
L
148869
500
81.57
1227
3285
37.35
2370
21
112.86
189074
313
89
6.79
959
3657
26.22
D14
DH15
L
795990
2042
106.80
5168
13569
38.09
21675
66
328.41
1034198
313
320
10.33
7153
12068
59.27
D15
DH16
M
201220
300
183.76
2963
7460
39.72
779
9
86.56
453625
313
59
24.56
79
3033
2.60
D16
DH17
L
148306
350
116.09
2811
5932
47.39
2014
11
183.09
443873
365
43
28.28
641
2896
22.13
D17
DH18
S
17248
150
31.50
215
1256
17.12
311
10
31.10
65716
303
49
4.43
228
788
28.93
D18
DH19
S
1506
68
6.07
57
677
8.42
5
0
0.00
44325
0
21
0.00
144
144
100.00
Note: Hospital category - S: small (up to 200 beds); M: mid-sized (201-300 beds); L: large (more than 300 beds)
0
- data not provided/ error in submitted data Annexures
161
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D19
DH20
S
1451
72
5.52
0
434
0.00
0
0
0.00
39835
292
11
12.40
0
0
—
D20
DH21
M
59790
254
64.49
1148
2932
39.15
2539
19
133.63
181000
301
105
5.73
8
2688
0.30
D21
DH22
S
1052
38
7.58
43
272
15.81
0
2
0.00
30678
303
13
7.79
52
151
34.44
D22
DH23
S
3829
80
13.11
125
849
14.72
78
5
15.60
39282
303
22
5.89
0
188
0.00
D23
DH24
S
4046
70
15.84
46
1001
4.60
0
0
0.00
85638
365
21
11.17
0
0
—
D24
DH25
S
13637
45
83.03
594
3746
15.86
56
3
18.67
113896
299
22
17.31
0
0
—
D25
DH26
S
30502
160
52.23
1181
2282
51.75
320
6
53.33
69854
301
25
9.28
1327
2121
62.56
D26
DH27
S
13822
82
46.18
1068
3119
34.24
32
4
8.00
79894
313
21
12.15
0
0
—
D27
DH28
S
5345
100
14.64
311
1182
26.31
14
1
14.00
19192
301
15
4.25
0
0
—
D28
DH29
S
60100
200
82.33
498
5859
8.50
30
2
15.00
218748
301
29
25.06
2770
3576
77.46
D29
DH30
S
62830
160
107.59
2713
5502
49.31
567
1
567.00
91306
301
27
11.23
935
1749
53.46
D30
DH31
S
65147
200
89.24
1051
6145
17.10
373
4
93.25
160173
310
30
17.22
142
2994
4.74
D31
DH32
S
33085
136
66.65
585
1081
54.12
230
4
57.50
112460
305
20
18.44
573
1049
54.62
D32
DH33
S
53826
200
73.73
1833
5013
36.56
206
4
51.50
147722
301
29
16.92
2697
2734
98.65
D33
DH34
L
365
325
0.31
1442
6073
23.74
234
4
58.50
199736
301
31
21.41
825
7108
11.61
D34
DH35
S
23253
102
62.46
52
3759
1.38
0
2
0.00
78416
313
16
15.66
18
72
25.00
D35
DH36
S
9909
50
54.30
908
1538
59.04
22
2
11.00
63553
305
30
6.95
0
2
0.00
D36
DH37
S
5559
40
38.08
517
1357
38.10
8
1
8.00
66022
301
25
8.77
0
40
0.00
D37
DH38
S
47205
200
64.66
912
2065
44.16
360
6
60.00
48376
301
52
3.09
891
1554
57.34
D38
DH39
S
51962
169
84.24
600
2465
24.34
11
7
1.57
174399
300
32
18.17
774
1516
51.06
D39
DH40
S
43007
200
58.91
1401
4105
34.13
430
3
143.33
79603
300
29
9.15
3009
3020
99.64
D40
DH41
M
92295
220
114.94
3140
5763
54.49
417
3
139.00
204802
301
43
15.82
283
4754
5.95
D41
DH42
S
34132
150
62.34
—
—
—
787
4
196.75
162212
306
34
15.59
1246
1184
— Annexures
162
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D42
DH43
L
91444
302
82.96
1658
6947
23.87
506
4
126.50
248716
279
39
22.86
8167
9069
90.05
D43
DH44
M
76313
235
88.97
844
3890
21.70
19
2
9.50
154412
365
39
10.85
2368
3219
73.56
D44
DH45
L
58459
309
51.83
519
2983
17.40
288
5
57.60
144128
305
37
12.77
3334
3883
85.86
D45
DH46
M
52611
262
55.02
651
3449
18.88
136
2
68.00
197922
305
29
22.38
4806
5500
87.38
D46
DH47
S
46174
150
84.34
—
—
—
990
2
495.00
163443
306
31
17.23
583
3095
18.84
D47
DH48
S
9740
121
22.05
85
1121
7.58
2
3
0.67
55962
297
20
9.42
0
13
0.00
D48
DH49
S
14398
100
39.45
24
17372
0.14
0
2
0.00
193554
305
17
37.33
171
196
87.24
D49
DH50
S
14570
97
41.15
37
3353
1.10
11
0
0.00
154260
303
18
28.28
0
3
—
D50
DH51
S
19196
114
46.13
57
7360
0.77
49
1
49.00
357015
303
17
69.31
1397
663
—
D51
DH52
S
15730
124
34.75
62
5903
1.05
42
3
14.00
159737
303
16
32.95
0
13
—
D52
DH53
S
26494
108
67.21
63
8094
0.78
138
4
34.50
195005
303
22
29.25
1671
2181
76.62
D53
DH54
S
12291
30
112.25
525
5014
10.47
123
2
61.50
138404
303
22
20.76
0
13
—
D54
DH55
S
45468
150
83.05
1283
7189
17.85
179
3
59.67
31162
365
35
2.44
290
429
67.60
D55
DH56
S
5628
100
15.42
81
3666
2.21
0
2
0.00
130209
303
23
18.68
0
0
—
D56
DH57
S
18001
160
30.82
4089
11384
35.92
213
6
35.50
160824
303
33
16.08
0
0
—
D57
DH58
S
12524
60
57.19
514
2969
17.31
914
1
914.00
180083
303
12
49.53
0
0
—
D58
DH59
S
26397
105
68.88
471
7980
5.90
1
4
0.25
159507
299
21
25.40
1439
1555
92.54
D59
DH60
S
0
100
0.00
552
8750
6.31
25
1
25.00
430959
303
12
118.53
429
1416
30.30
D60
DH61
S
18909
100
51.81
152
4465
3.40
87
1
87.00
210613
365
32
18.03
377
349
—
D61
DH62
S
35447
102
95.21
193
6490
2.97
45
3
15.00
230934
303
15
50.81
129
229
56.33
D62
DH63
S
26706
120
60.97
1041
9488
10.97
522
2
261.00
215006
303
19
37.35
2312
2663
86.82
D63
DH64
S
30795
100
84.37
51
9403
0.54
288
3
96.00
290076
303
14
68.38
147
1536
9.57
D64
DH65
S
34950
100
95.75
148
7105
2.08
0
3
0.00
129811
302
14
30.70
955
3683
25.93 Annexures
163
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D65
DH66
S
11594
75
42.35
13
4000
0.33
20
2
10.00
119934
303
16
24.74
0
0
—
D66
DH67
S
36992
80
126.68
254
6275
4.05
60
2
30.00
261787
303
14
61.71
896
896
100.00
D67
DH68
S
23119
110
57.58
58
6516
0.89
52
3
17.33
0
303
21
0.00
0
790
—
D68
DH69
S
37324
160
63.91
45
5930
0.76
3
3
1.00
262030
303
26
33.26
816
1292
63.16
D69
DH70
S
16976
164
28.36
147
4248
3.46
1305
1
1305.00
239715
365
20
32.84
1003
1285
78.05
D70
DH71
M
91367
300
83.44
1460
7718
18.92
11
1
11.00
279298
305
24
38.16
1365
1724
79.18
D71
DH72
S
76
82
0.25
185
6569
2.82
1067
3
355.67
171853
303
18
31.51
410
491
83.50
D72
DH73
M
84687
300
77.34
679
7759
8.75
63
9
7.00
317677
303
41
25.57
533
4992
10.68
D73
DH74
S
24481
100
67.07
48
3216
1.49
16
5
3.20
231656
303
22
34.75
43
137
31.39
D74
DH75
M
78461
281
76.50
326
7174
4.54
7174
2
3587.00
163844
303
16
33.80
1639
2082
78.72
D75
DH76
S
2296
98
6.42
352
9340
3.77
1702
2
851.00
166666
303
18
30.56
1250
1333
93.77
D76
DH77
S
43777
135
88.84
509
5957
8.54
1380
3
460.00
294508
303
24
40.50
1419
1706
83.18
D77
DH78
S
14801
83
48.86
32
6063
0.53
23
2
11.50
155032
303
23
22.25
0
0
—
D78
DH79
S
0
76
0.00
0
6928
0.00
0
0
0.00
95236
0
15
0.00
0
67
—
D79
DH80
S
20353
73
76.39
68
7638
0.89
0
0
0.00
241423
303
12
66.40
1092
1550
70.45
D80
DH81
S
34834
100
95.44
936
7983
11.72
24
7
3.43
187244
303
19
32.52
5320
5436
97.87
D81
DH82
S
20325
84
66.29
289
8560
3.38
3
1
3.00
199274
303
20
32.88
291
0
—
D82
DH83
S
72772
136
146.60
1738
12362
14.06
1234
3
411.33
418948
305
35
39.25
465
583
79.76
D83
DH84
L
36288
470
21.15
269
14625
1.84
0
0
0.00
182320
303
23
26.16
1781
1941
91.76
D84
DH85
L
197587
598
90.52
2879
8937
32.21
5090
21
242.38
1050839
294
94
38.02
20
3195
0.63
D85
DH86
S
10707
100
29.33
1
328
0.30
24
1
24.00
67664
305
22
10.08
0
0
—
D86
DH87
S
15377
100
42.13
3
1068
0.28
418
2
209.00
80894
264
12
25.53
0
0
—
D87
DH88
S
11556
60
52.77
20
632
3.16
17
1
17.00
54483
276
11
17.95
0
81
0.00 Annexures
164
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D88
DH89
S
43127
178
66.38
1042
3008
34.64
320
2
160.00
195069
365
40
13.36
2407
2588
93.01
D89
DH90
S
69391
175
108.64
131
1331
9.84
243
6
40.50
121210
297
54
7.56
0
1681
0.00
D90
DH91
M
48377
225
58.91
247
1352
18.27
162
2
81.00
117451
288
22
18.54
0
2344
0.00
D91
DH92
L
74848
410
50.02
1191
6054
19.67
339
3
113.00
219743
295
48
15.52
2235
6181
36.16
D92
DH93
S
12133
60
55.40
0
426
0.00
4
0
0.00
54211
303
12
14.91
334
334
100.00
D93
DH94
S
13256
93
39.05
366
1963
18.64
71
6
11.83
76847
365
28
7.52
4179
1347
—
D94
DH95
S
12540
126
27.27
27
1222
2.21
84
1
84.00
130829
0
20
0.00
893
1349
66.20
D95
DH96
S
160
160
0.27
84
1014
8.28
116
2
58.00
116299
0
21
0.00
2875
4765
60.34
D96
DH97
S
36500
100
100.00
30
1413
2.12
16
1
16.00
80948
365
21
10.56
1243
2030
61.23
D97
DH98
S
27766
163
46.67
19
1277
1.49
0
2
0.00
53995
297
20
9.09
0
2886
0.00
D98
DH99
S
40462
114
97.24
476
2168
21.96
69
3
23.00
114729
292
28
14.03
3564
4489
79.39
D99
DH100
S
41622
165
69.11
303
1760
17.22
10
3
3.33
95209
0
22
0.00
1240
1240
100.00
D100
DH101
S
21600
60
98.63
0
1089
0.00
0
1
0.00
52907
300
13
13.57
43
48
89.58
D101
DH102
S
297
100
0.81
79
775
10.19
7
1
7.00
55275
297
17
10.95
76
566
13.43
D102
DH103
S
20663
100
56.61
843
2501
33.71
151
10
15.10
150542
294
48
10.67
0
0
—
D103
DH104
S
15525
100
42.53
12
660
1.82
6
3
2.00
45954
297
19
8.14
328
631
51.98
D104
DH105
L
141638
316
122.80
2119
5330
39.76
3246
11
295.09
1164589
365
68
46.92
3041
11075
27.46
D105
DH106
S
36579
170
58.95
620
2102
29.50
833
5
166.60
261481
294
27
32.94
161
1031
15.62
D106
DH107
S
1698
60
7.75
128
188
68.09
22
1
22.00
102516
297
13
26.55
82
427
19.20
D107
DH108
S
41205
147
76.80
506
2403
21.06
2035
5
407.00
373202
345
111
9.75
526
404
—
D107
DH109
S
19632
97
55.45
460
2176
21.14
0
0
0.00
108297
293
28
13.20
0
0
—
D107
DH110
L
111108
450
67.65
3016
9058
33.30
94
1
94.00
257381
295
254
3.43
282
1682
16.77
D108
DH111
S
117863
188
171.76
1801
7485
24.06
1296
21
61.71
846053
348
163
14.92
1377
3788
36.35 Annexures
165
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D109
DH112
S
47455
100
130.01
256
3747
6.83
487
15
32.47
868455
345
131
19.22
167
167
100.00
D109
DH113
S
40823
150
74.56
67
945
7.09
1078
5
215.60
468675
313
34
44.04
29
87
33.33
D109
DH114
S
53480
200
73.26
90
1834
4.91
1077
3
359.00
712861
278
88
29.14
225
225
100.00
D110
DH115
M
62673
222
77.35
613
4579
13.39
758
0
0.00
1083995
302
117
30.68
146
414
35.27
D111
DH116
S
23107
200
31.65
0
0
0.00
0
3
0.00
654369
260
36
69.91
0
0
—
D111
DH117
M
157577
300
143.91
2179
10377
21.00
31661
7
4523.00
801401
292
58
47.32
68666
6866
—
D111
DH118
L
77
325
0.06
1687
5885
28.67
1453
3
484.33
678739
295
132
17.43
700
1545
45.31
D112
DH119
S
50207
103
133.55
508
3883
13.08
755
5
151.00
622791
297
31
67.64
650
650
100.00
D113
DH120
S
29209
100
80.02
282
3164
8.91
672
3
224.00
545522
295
91
20.32
295
295
100.00
D114
DH121
S
79964
100
219.08
1158
4841
23.92
859
3
286.33
588391
296
31
64.12
541
666
81.23
D114
DH122
S
56916
180
86.63
506
2156
23.47
827
4
206.75
1006471
294
108
31.70
400
400
100.00
D114
DH123
L
257294
640
110.14
3287
9854
33.36
6050
13
465.38
1333848
294
130
34.90
9317
40405
23.06
D115
DH124
S
85132
200
116.62
1773
5230
33.90
3646
2
1823.00
624308
273
128
17.87
1056
5493
19.22
D115
DH125
L
128596
370
95.22
2199
9237
23.81
1550
3
516.67
568895
273
198
10.52
850
3702
22.96
D116
DH126
M
57960
235
67.57
834
2293
36.37
1211
4
302.75
266627
295
74
12.21
47
457
10.28
D117
DH127
M
276
230
0.33
1055
2790
37.81
1014
8
126.75
303445
300
66
15.33
189
2457
7.69
D118
DH128
M
65297
220
81.32
741
2826
26.22
991
3
330.33
150792
0
11
0.00
0
0
—
D119
DH129
S
24069
119
55.41
140
1427
9.81
—
—
—
138644
300
13
35.55
0
0
—
D120
DH130
L
0
320
0.00
49
694
7.06
549
14
39.21
160632
365
37
11.89
919
919
100.00
D121
DH131
M
37235
210
48.58
309
1817
17.01
185
3
61.67
111445
306
31
11.75
0
0
—
D122
DH132
S
19629
64
84.03
373
2827
13.19
529
3
176.33
200675
300
5
133.78
130
0
—
D123
DH133
S
26702
100
73.16
9
1110
0.81
61
1
61.00
89396
300
14
21.28
0
107
0.00
D124
DH134
L
32121
363
24.24
775
5148
15.05
3091
10
309.10
204791
298
69
9.96
0
226
— Annexures
166
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D125
DH135
S
365
150
0.67
121
764
15.84
1004
3
334.67
271707
300
13
69.67
1656
1656
100.00
D126
DH136
S
43860
160
75.10
141
637
22.14
847
3
282.33
162637
310
30
17.49
0
0
—
D127
DH137
M
140
214
0.18
618
1458
42.39
3056
4
764.00
320167
299
32
33.46
4
1103
0.36
D128
DH138
S
11400
50
62.47
9
270
3.33
0
0
0.00
54945
307
5
35.79
0
9
—
D129
DH139
M
44324
206
58.95
126
1716
7.34
233
0
0.00
154964
304
19
26.83
175
2074
8.44
D130
DH140
S
32953
81
111.46
303
1045
29.00
323
2
161.50
76033
310
16
15.33
0
709
—
D131
DH141
M
78913
230
94.00
385
1574
24.46
601
3
200.33
248060
305
29
28.05
0
0
—
D132
DH142
M
301
264
0.31
401
1468
27.32
1487
3
495.67
184987
301
21
29.27
934
1121
83.32
D133
DH143
M
365
241
0.41
625
2831
22.08
103
2
51.50
130822
307
33
12.91
1625
1625
100.00
D134
DH144
S
71161
115
169.53
477
3022
15.78
239
3
79.67
395407
304
24
54.20
0
201
0.00
D135
DH145
S
15489
110
38.58
178
1198
14.86
779
7
111.29
140498
290
17
28.50
108
916
11.79
D136
DH146
M
88632
235
103.33
623
2854
21.83
1003
2
501.50
177249
310
29
19.72
0
165
0.00
D137
DH147
S
41366
200
56.67
102
1100
9.27
1189
3
396.33
97402
300
23
14.12
0
432
0.00
D138
DH148
S
644
200
0.88
563
2490
22.61
1315
6
219.17
266364
365
13
56.14
205
205
100.00
D139
DH149
S
74458
200
102.00
1173
4432
26.47
292
14
20.86
417620
270
72
21.48
325
5093
6.38
D140
DH150
M
169845
300
155.11
294
3603
8.16
4179
6
696.50
704880
284
42
59.09
4
6244
0.06
D141
DH151
S
75011
200
102.75
1580
6419
24.61
1664
2
832.00
553086
284
48
40.57
0
3135
0.00
D142
DH152
S
29572
100
81.02
841
3312
25.39
347
4
86.75
302606
292
22
47.11
0
2930
0.00
D143
DH153
S
57252
176
89.12
395
2377
16.62
744
7
106.29
358717
270
47
28.27
0
8672
0.00
D144
DH154
S
21307
100
58.38
111
2313
4.80
580
10
58.00
310339
280
54
20.53
0
2725
0.00
D145
DH155
S
25830
90
78.63
436
4419
9.87
563
4
140.75
384381
287
35
38.27
0
6483
0.00
D146
DH156
S
62040
175
97.13
1364
4765
28.63
1361
7
194.43
384898
270
36
39.60
0
6434
0.00
D147
DH157
S
86796
92
258.48
1201
4193
28.64
537
2
268.50
353825
292
41
29.55
0
6640
0.00 Annexures
167
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D148
DH158
S
0
100
0.00
1507
7938
18.98
1502
1
1502.00
0
0
36
0.00
0
3594
0.00
D149
DH159
S
0
48
0.00
36
2361
1.52
206
7
29.43
205734
283
47
15.47
27
304
8.88
D150
DH160
S
29787
100
81.61
64
949
6.74
249
1
249.00
399887
282
44
32.23
0
5300
0.00
D151
DH161
M
47848
300
43.70
914
2334
39.16
2028
13
156.00
248235
288
51
16.90
0
4556
0.00
D152
DH162
S
31565
83
104.19
940
10893
8.63
225
8
28.13
223319
274
47
17.34
0
0
—
D153
DH163
S
32962
109
82.85
452
3462
13.06
1244
6
207.33
332599
282
62
19.02
12
7407
0.16
D154
DH164
S
70737
100
193.80
601
4183
14.37
493
14
35.21
490757
290
55
30.77
0
183
0.00
D155
DH165
S
69216
120
158.03
1391
5368
25.91
2014
2
1007.00
244015
272
47
19.09
503
5160
9.75
D156
DH166
S
54677
200
74.90
633
5587
11.33
256
6
42.67
238313
286
47
17.73
316
3481
9.08
D157
DH167
M
42268
270
42.89
164
1617
10.14
228
7
32.57
236678
293
20
40.39
247
2407
10.26
D158
DH168
M
0
300
0.00
364
2628
13.85
1294
4
323.50
189029
280
8
84.39
810
1226
66.07
D159
DH169
M
3
216
0.00
301
2885
10.43
721
1
721.00
283410
292
25
38.82
36
2678
1.34
D160
DH170
M
27007
215
34.41
123
887
13.87
321
4
80.25
218390
292
26
28.77
21
1040
2.02
D161
DH171
M
119121
300
108.79
416
2590
16.06
995
3
331.67
209144
289
28
25.85
206
1650
12.48
D162
DH172
S
1290
20
17.67
0
9
0.00
0
1
0.00
16108
291
7
7.91
0
0
—
D163
DH173
M
3
300
0.00
1476
5540
26.64
1424
1
1424.00
310246
292
25
42.50
52
3692
1.41
D164
DH174
M
46759
261
49.08
277
1856
14.92
875
8
109.38
274632
289
39
24.37
16
401
3.99
D165
DH175
M
39532
250
43.32
497
1836
27.07
1388
16
86.75
215119
280
67
11.47
77
957
8.05
D166
DH176
S
54954
180
83.64
341
2533
13.46
699
6
116.50
303652
284
22
48.60
77
1365
5.64
D167
DH177
S
3
200
0.00
1273
3665
34.73
158
3
52.67
135824
292
18
25.84
267
2454
10.88
D168
DH178
S
35176
110
87.61
4729
9107
51.93
0
0
0.00
260457
365
20
35.68
511
570
89.65
D168
DH179
S
32115
178
49.43
0
0
0.00
1941
3
647.00
528536
313
67
25.20
770
1368
56.29
D169
DH180
S
7332
64
31.39
644
1188
54.21
996
5
199.20
37550
313
50
2.40
133
191
69.63 Annexures
168
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D170
DH181
S
7300
20
100.00
258
1385
18.63
283
1
283.00
194084
365
23
23.12
0
4
0.00
D171
DH182
S
66425
200
90.99
1982
3871
51.20
1987
15
132.47
575577
312
66
27.95
339
1256
26.99
D172
DH183
S
15998
160
27.39
889
2610
34.06
838
4
209.50
147363
303
23
21.15
436
504
86.51
D173
DH184
S
4252
40
29.12
134
517
25.92
454
2
227.00
313160
313
31
32.27
0
0
—
D174
DH185
S
20587
135
41.78
1628
3322
49.01
1074
6
179.00
423980
309
56
24.50
1144
1536
74.48
D174
DH186
S
0
58
0.00
562
1027
54.72
359
5
71.80
216114
295
38
19.28
0
152
—
D175
DH187
S
7427
160
12.72
1421
3196
44.46
878
3
292.67
235665
308
28
27.33
853
988
86.34
D176
DH188
S
25295
36
192.50
1055
3625
29.10
702
6
117.00
359705
313
36
31.92
24
221
10.86
D177
DH189
S
9980
50
54.68
478
2142
22.32
873
6
145.50
266977
313
38
22.45
205
299
68.56
D178
DH190
S
16885
54
85.67
1059
1582
66.94
1058
12
88.17
682934
0
55
0.00
151
409
36.92
D179
DH191
S
6471
40
44.32
88
1379
6.38
60
4
15.00
93161
302
17
18.15
8
12
66.67
D180
DH192
S
576
50
3.16
25
941
2.66
1919
2
959.50
80778
270
11
27.20
0
0
—
D181
DH193
S
5706
70
22.33
198
1215
16.30
345
5
69.00
210203
305
23
29.96
0
0
—
D182
DH194
S
4082
32
34.95
212
694
30.55
735
2
367.50
246627
313
22
35.82
0
0
—
D183
DH195
S
36530
150
66.72
1985
2184
90.89
1623
5
324.60
560469
313
61
29.35
371
762
48.69
D184
DH196
S
37215
200
50.98
1210
4005
30.21
1644
7
234.86
332695
302
35
31.48
607
1018
59.63
D185
DH197
S
865
100
2.37
138
1227
11.25
0
0
0.00
93599
302
22
14.09
0
0
—
D186
DH198
S
6418
27
65.12
4
2617
0.15
7
1
7.00
57164
302
11
17.21
36
58
62.07
D187
DH199
S
18506
100
50.70
301
4914
6.13
48
2
24.00
142282
307
24
19.31
4869
5298
91.90
D188
DH200
S
15306
103
40.71
81
2976
2.72
14
2
7.00
110291
303
23
15.83
462
736
62.77
D189
DH201
S
13204
100
36.18
383
5703
6.72
383
2
191.50
132630
0
20
0.00
1810
2158
83.87
D190
DH202
S
12512
100
34.28
218
6496
3.36
8
3
2.67
102688
303
17
19.94
626
3333
18.78
D191
DH203
S
19676
100
53.91
235
6323
3.72
0
1
0.00
111040
303
17
21.56
0
0
— Annexures
169
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D192
DH204
S
14068
182
21.18
401
3805
10.54
95
2
47.50
91964
303
19
15.97
296
2370
12.49
D193
DH205
L
26087
326
21.92
2367
8655
27.35
0
5
0.00
13964
303
22
2.09
0
0
—
D194
DH206
S
4910
100
13.45
64
3051
2.10
0
3
0.00
48829
0
12
0.00
0
4
0.00
D195
DH207
S
4416
60
20.16
182
1673
10.88
0
1
0.00
73685
0
15
0.00
0
62
—
D196
DH208
S
3312
100
9.07
473
3333
14.19
0
3
0.00
76578
303
12
21.06
1312
1663
78.89
D197
DH209
S
7098
60
32.41
92
1461
6.30
12
1
12.00
90357
302
12
24.93
136
179
75.98
D198
DH210
S
16807
50
92.09
250
2316
10.79
36
1
36.00
86895
302
19
15.14
1241
1484
83.63
D199
DH211
S
6526
100
17.88
42
3554
1.18
42
2
21.00
47125
330
9
15.87
0
0
—
D200
DH212
S
22499
200
30.82
856
6403
13.37
532
5
106.40
231613
0
25
0.00
8803
10066
87.45
D201
DH213
S
31589
100
86.55
112
2007
5.58
10
3
3.33
119530
355
23
14.64
2419
4462
54.21
D202
DH214
S
18389
100
50.38
349
1239
28.17
167
1
167.00
126722
301
20
21.05
0
602
—
D203
DH215
S
13171
40
90.21
285
3130
9.11
0
2
0.00
83081
0
19
0.00
31
31
100.00
D204
DH216
S
25371
200
34.75
2101
6260
33.56
75
2
37.50
359753
301
44
27.16
79
431
18.33
D205
DH217
S
0
60
0.00
997
3183
31.32
2
1
2.00
57862
303
15
12.73
265
876
30.25
D206
DH218
S
16891
80
57.85
131
1255
10.44
0
0
0.00
68993
0
14
0.00
0
0
—
D207
DH219
S
4870
100
13.34
96
1420
6.76
26
2
13.00
58728
303
17
11.40
495
636
77.83
D208
DH220
M
20145
300
18.40
627
3122
20.08
317
5
63.40
161035
365
19
23.22
194
1000
19.40
D209
DH221
S
6485
120
14.81
1199
3455
34.70
0
0
0.00
38198
365
11
9.51
0
256
0.00
D209
DH222
S
1150115
200
0
.00
566
764
74.08
790
6
131.67
105594
365
44
6.57
0
345
—
D209
DH223
M
58491
285
56.23
1995
4246
46.99
807
10
80.70
302302
365
53
15.63
0
0
—
D209
DH224
L
195884
536
100.12
10488
307517
3.41
0
0
0.00
139527
365
167
2.29
0
0
—
D209
DH225
L
219985
764
78.89
0
0
0.00
6929
78
88.83
432513
0
285
0.00
1241
10366
11.97
D209
DH226
L
99825
360
75.97
1935
4084
47.38
2224
8
278.00
264771
365
46
15.77
0
3904
0.00 Annexures
170
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D209
DH227
L
139953
1030
37.23
786
2332
33.70
5469
28
195.32
461095
365
114
11.08
0
3432
0.00
D210
DH228
L
266222
740
98.56
2450
8554
28.64
3199
11
290.82
402032
365
131
8.41
0
6811
0.00
D211
DH229
M
26538
210
34.62
2521
5604
44.99
160
4
40.00
294749
365
43
18.78
0
421
0.00
D211
DH230
L
298375
1017
80.38
2957
7290
40.56
8332
15
555.47
337131
365
170
5.43
0
22074
0.00
D212
DH231
L
0
450
0.00
2623
7660
34.24
2695
0
0.00
336430
365
179
5.15
6831
1854
—
D213
DH232
M
250
250
0.27
2476
2476
100.00
3063
17
180.18
320865
365
17
51.71
0
1977
0.00
D214
DH233
M
105850
300
96.67
1375
3597
38.23
1849
15
123.27
327360
365
58
15.46
1588
2541
62.50
D215
DH234
S
45373
140
88.79
2110
3527
59.82
795
6
132.50
454292
250
29
62.66
0
0
—
D216
DH235
L
96622
400
66.18
1652
3248
50.86
2236
1
2236.00
—
—
—
—
66
1895
3.48
D217
DH236
L
145314
450
88.47
4529
7839
57.78
950
6
158.33
333137
365
33
27.66
664
1210
54.88
D218
DH237
M
100775
272
101.51
2829
5946
47.58
0
0
0.00
38612
365
33
3.21
0
14590
0.00
D218
DH238
L
211765
905
64.11
0
0
0.00
4685
55
85.18
293712
365
117
6.88
106
18237
0.58
D219
DH239
S
7016
100
19.22
1947
4979
39.10
0
0
0.00
39198
365
8
13.42
0
382
—
D219
DH240
L
45645
930
13.45
3564
10032
35.53
11040
9
1226.67
512047
365
38
36.92
378
2444
15.47
D220
DH241
M
62894
250
68.92
1086
3447
31.51
1338
4
334.50
291813
365
20
39.97
0
1361
0.00
D220
DH242
L
309513
1200
70.67
3786
10731
35.28
5352
35
152.91
484139
365
284
4.67
161
8472
1.90
D221
DH243
M
101973
250
111.75
2287
4393
52.06
671
2
335.50
188480
365
9
57.38
400
3260
12.27
D222
DH244
L
37863
560
18.52
4642
10709
43.35
1303
20
65.15
397346
365
106
10.27
3679
1779
—
D223
DH245
L
750
750
0.27
3300
8550
38.60
820
26
31.54
556463
365
176
8.66
1310
6472
20.24
D224
DH246
M
29458
300
26.90
1707
4578
37.29
398
2
199.00
237529
365
31
20.99
74
2655
2.79
D225
DH247
L
96211
410
64.29
942
3125
30.14
1465
17
86.18
269350
365
80
9.22
0
1597
0.00
D226
DH248
L
99445
400
68.11
2727
5456
49.98
326
8
40.75
472743
365
43
30.12
0
1867
—
D227
DH249
M
93946
300
85.80
1827
5071
36.03
655
1
655.00
170267
365
8
58.31
0
1905
0.00 Annexures
171
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D228
DH250
L
198281
650
83.57
2648
6846
38.68
978
25
39.12
751845
365
197
10.46
9527
15642
60.91
D229
DH251
L
128686
410
85.99
3329
11443
29.09
0
1
0.00
163552
365
83
5.40
581
6683
8.69
D229
DH252
L
229601
1020
61.67
0
0
0.00
9207
15
613.80
457213
365
45
27.84
10202
14416
70.77
D230
DH253
L
147693
640
63.22
1554
5639
27.56
1869
12
155.75
340126
365
124
7.51
9507
9507
100.00
D231
DH254
S
7949
100
21.78
632
1098
57.56
411
2
205.50
249122
0
16
0.00
0
1411
0.00
D232
DH255
L
323998
950
93.44
4122
10111
40.77
6316
34
185.76
731871
0
148
0.00
322
12568
2.56
D233
DH256
L
114322
400
78.30
3669
6132
59.83
1967
11
178.82
481730
365
43
30.69
164
3395
4.83
D234
DH257
M
78377
250
85.89
917
1924
47.66
311
3
103.67
171359
365
28
16.77
0
8271
—
D235
DH258
L
40923
316
35.48
449
982
45.72
544
4
136.00
274290
365
9
83.50
0
1021
0.00
D236
DH259
S
100
100
0.27
464
3313
14.01
12
2
6.00
146455
365
19
21.12
1457
1370
—
D237
DH260
M
38557
255
41.43
767
1538
49.87
0
0
0.00
99872
313
24
13.29
274
326
84.05
D237
DH261
L
58495
400
40.07
0
0
0.00
494
7
70.57
621672
313
54
36.78
0
0
—
D238
DH262
M
42024
227
50.72
761
1135
67.05
656
4
164.00
392327
365
32
33.59
6373
6373
100.00
D238
DH263
L
154476
639
66.23
1033
2511
41.14
3331
6
555.17
683100
365
91
20.57
0
168
0.00
D239
DH264
S
36121
144
68.72
478
878
54.44
382
5
76.40
317913
313
32
31.74
0
0
—
D240
DH265
L
152615
541
77.29
1818
3906
46.54
2367
11
215.18
393053
315
56
22.28
0
7463
0.00
D241
DH266
L
70710
364
53.22
511
1594
32.06
681
8
85.13
305597
365
52
16.10
2413
3139
76.87
D242
DH267
M
66312
273
66.55
2975
5788
51.40
0
0
0.00
268579
0
31
0.00
160
160
100.00
D242
DH268
L
145410
537
74.19
0
0
0.00
—
—
—
781154
0
63
0.00
6599
6599
100.00
D243
DH269
L
13897
360
10.58
645
1213
53.17
422
8
52.75
674648
313
61
35.33
187
666
28.08
D244
DH270
L
96791
525
50.51
222
729
30.45
762
11
69.27
756556
0
60
0.00
36
1097
3.28
D245
DH271
S
43425
164
72.54
304
783
38.83
369
5
73.80
529530
365
34
42.67
0
1356
0.00
D245
DH272
L
189007
501
103.36
1569
5161
30.40
6600
52
126.92
915886
0
48
0.00
0
5885
0.00 Annexures
172
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D246
DH273
M
78800
250
86.36
2091
5695
36.72
0
0
0.00
175030
365
21
22.83
0
0
—
D246
DH274
L
173269
544
87.26
0
0
0.00
1328
2
664.00
459276
303
47
32.25
70
27366
0.26
D247
DH275
L
0
403
0.00
399
808
49.38
589
9
65.44
306254
365
55
15.26
1072
1842
58.20
D248
DH276
M
41156
300
37.59
241
760
31.71
137
7
19.57
535748
0
54
0.00
2
78
2.56
D248
DH277
L
174295
747
63.93
0
0
0.00
5872
7
838.86
747663
0
77
0.00
0
3812
0.00
D248
DH278
L
88529
428
56.67
2210
5719
38.64
0
0
0.00
300097
365
38
21.64
0
399
—
D249
DH279
M
68340
240
78.01
1011
3049
33.16
383
5
76.60
569318
0
48
0.00
2
1110
0.18
D250
DH280
M
119712
296
110.80
521
2284
22.81
685
10
68.50
514537
365
63
22.38
82
3170
2.59
D251
DH281
S
23744
160
40.66
337
1697
19.86
9
9
1.00
96949
303
34
9.41
65
622
10.45
D252
DH282
M
19490
250
21.36
424
1506
28.15
766
9
85.11
158443
303
38
13.76
321
902
35.59
D253
DH283
S
4148
50
22.73
130
294
44.22
24
1
24.00
109214
305
21
17.05
0
0
—
D254
DH284
S
16945
100
46.42
18
3666
0.49
0
2
0.00
189090
285
22
30.16
0
186
0.00
D255
DH285
S
50900
110
126.77
5
2158
0.23
43
3
14.33
118537
285
34
12.23
20
839
2.38
D256
DH286
S
15870
100
43.48
489
2514
19.45
568
2
284.00
128420
285
20
22.53
490
2131
22.99
D257
DH287
S
45823
100
125.54
122
4514
2.70
58
4
14.50
200375
285
27
26.04
0
444
—
D258
DH288
M
59949
300
54.75
2819
7842
35.95
393
5
78.60
173104
285
31
19.59
5364
6444
83.24
D259
DH289
M
204139
300
186.43
700
6337
11.05
849
11
77.18
231702
285
35
23.23
6796
11094
61.26
D260
DH290
M
128654
300
117.49
688
5766
11.93
497
3
165.67
253899
285
28
31.82
4823
6574
73.36
D261
DH291
L
159
350
0.12
250
9431
2.65
1300
8
162.50
4459695
285
50
312.96
2127
1896
—
D262
DH292
L
120450
330
100.00
1391
5176
26.87
3602
15
240.13
622046
285
76
28.72
284
1083
26.22
D263
DH293
S
33788
200
46.28
808
5736
14.09
187
3
62.33
251784
285
23
38.41
1508
4110
36.69
D264
DH294
M
109284
300
99.80
1302
8722
14.93
1773
8
221.63
317164
285
57
19.52
477
5227
9.13
D265
DH295
L
184378
400
126.29
2574
10384
24.79
689
7
98.43
304038
285
53
20.13
1164
11042
10.54 Annexures
173
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D266
DH296
M
87948
300
80.32
983
6869
14.31
40
6
6.67
37150
285
32
4.07
920
2678
34.35
D267
DH297
L
36868
350
28.86
277
4536
6.11
329
6
54.83
283382
285
44
22.60
1398
1530
91.37
D268
DH298
L
89166
400
61.07
1362
7424
18.35
146
2
73.00
332644
285
43
27.14
1356
2274
59.63
D269
DH299
M
236193
300
215.70
661
5474
12.08
464
3
154.67
242924
285
46
18.53
470
3762
12.49
D270
DH300
S
29765
100
81.55
100
1798
5.56
0
1
0.00
69992
285
21
11.69
101
744
13.58
D271
DH301
L
148410
400
101.65
643
6942
9.26
1005
7
143.57
240827
285
35
24.14
649
6687
9.71
D272
DH302
S
23169
200
31.74
833
6653
12.52
2562
4
640.50
329651
285
45
25.70
1069
1862
57.41
D273
DH303
S
51359
100
140.71
768
4055
18.94
275
5
55.00
146567
289
31
16.36
1564
2629
59.49
D274
DH304
M
97271
300
88.83
2060
5812
35.44
686
6
114.33
213590
285
38
19.72
3352
3461
96.85
D275
DH305
S
27285
100
74.75
339
2818
12.03
37
4
9.25
259014
285
37
24.56
0
170
—
D276
DH306
L
84856
500
46.50
0
0
0.00
2044
11
185.82
211527
285
48
15.46
66
6249
1.06
D277
DH307
S
54082
200
74.08
67
1508
4.44
378
2
189.00
126351
285
27
16.42
319
2542
12.55
D278
DH308
S
83541
200
114.44
586
4707
12.45
163
6
27.17
212244
285
24
31.03
109
6668
1.63
D279
DH309
L
99381
400
68.07
2290
7639
29.98
154
1
154.00
384022
285
28
48.12
5509
6491
84.87
D280
DH310
M
0
300
0.00
1982
8475
23.39
1408
5
281.60
236631
285
41
20.25
990
10786
9.18
D281
DH311
M
147
300
0.13
139
3556
3.91
236
4
59.00
164828
285
25
23.13
3500
3927
89.13
D282
DH312
L
76833
500
42.10
2207
6545
33.72
459
6
76.50
243198
285
34
25.10
0
5400
0.00
D283
DH313
M
214736
300
196.11
415
11269
3.68
346
7
49.43
355643
285
42
29.71
346
3657
9.46
D284
DH314
M
62635
300
57.20
1147
4454
25.75
423
3
141.00
21638
285
22
3.45
479
4383
10.93
D285
DH315
S
38305
200
52.47
302
4952
6.10
296
4
74.00
192440
285
28
24.12
1360
1360
100.00
D286
DH316
S
58286
200
79.84
561
3113
18.02
58
3
19.33
153203
285
21
25.60
779
1598
48.75
D287
DH317
S
46355
200
63.50
861
3727
23.10
1201
4
300.25
229350
285
32
25.15
979
989
98.99
D288
DH318
M
128578
300
117.42
274
4636
5.91
19
2
9.50
177508
285
21
29.66
3316
4048
81.92 Annexures
174
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D289
DH319
L
170333
500
93.33
1170
8199
14.27
899
7
128.43
514658
285
45
40.13
7839
8640
90.73
D290
DH320
S
6995
100
19.16
158
2294
6.89
82
5
16.40
227589
285
35
22.82
0
11
0.00
D291
DH321
M
49375
300
45.09
2036
8457
24.07
112
4
28.00
103368
285
37
9.80
0
8903
0.00
D292
DH322
L
190174
400
130.26
2561
10949
23.39
1740
6
290.00
374867
285
50
26.31
10370
13611
76.19
D293
DH323
M
88637
240
101.18
740
5364
13.80
288
4
72.00
361531
285
29
43.74
3763
4275
88.02
D294
DH324
L
97344
400
66.67
1830
5905
30.99
149
1
149.00
294692
365
27
29.90
3220
4267
75.46
D295
DH325
M
75558
300
69.00
1995
6775
29.45
453
2
226.50
186280
285
38
17.20
6432
7045
91.30
D296
DH326
S
63161
200
86.52
173
4347
3.98
76
4
19.00
195526
285
20
34.30
204
3555
5.74
D297
DH327
S
35
100
0.10
402
3697
10.87
258
2
129.00
230887
285
31
26.13
1860
118
—
D298
DH328
M
124056
300
113.29
1514
8120
18.65
648
7
92.57
375821
285
45
29.30
2365
2430
97.33
D299
DH329
M
0
300
0.00
31
4073
0.76
0
0
0.00
140723
285
26
18.99
1403
1403
100.00
D300
DH330
S
15516
120
35.42
33
2622
1.26
174
3
58.00
82432
285
24
12.05
1349
504
—
D301
DH331
S
98570
200
135.03
345
6260
5.51
497
1
497.00
191668
285
27
24.91
115
2165
5.31
D302
DH332
L
161423
700
63.18
2457
6970
35.25
988
11
89.82
353147
285
54
22.95
1842
6261
29.42
D303
DH333
S
45394
100
124.37
302
2350
12.85
310
3
103.33
103685
285
18
20.21
109
1258
8.66
D304
DH334
M
109500
300
100.00
733
5109
14.35
130
7
18.57
301549
285
39
27.13
4593
4711
97.50
D305
DH335
M
135956
274
135.94
2341
6085
38.47
1410
10
141.00
250899
290
54
16.02
3372
742
—
D306
DH336
L
125607
379
90.80
0
2
0.00
1185
3
395.00
290785
306
50
19.01
775
5974
12.97
D306
DH337
S
109889
189
159.29
3591
10945
32.81
0
1
0.00
48611
297
34
4.81
1
2072
0.05
D307
DH338
L
171625
320
146.94
2646
10394
25.46
1076
10
107.60
417435
305
62
22.07
0
12300
0.00
D308
DH339
L
160937
482
91.48
4023
7530
53.43
899
4
224.75
228078
300
61
12.46
532
6448
8.25
D309
DH340
L
83070
306
74.38
374
3278
11.41
455
4
113.75
191901
298
71
9.07
0
2725
0.00
D310
DH341
M
119294
252
129.70
1822
5359
34.00
1239
9
137.67
156122
294
33
16.09
0
6529
0.00 Annexures
175
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D311
DH342
S
72912
100
199.76
1009
4814
20.96
94
5
18.80
195141
305
52
12.30
3695
3695
100.00
D312
DH343
L
144217
356
110.99
1932
6984
27.66
3148
15
209.87
284152
283
25
40.16
0
5757
—
D313
DH344
S
34701
60
158.45
501
6001
8.35
0
0
0.00
101684
294
18
19.21
0
0
—
D313
DH345
S
60503
200
82.88
0
0
0.00
395
3
131.67
262620
305
47
18.32
0
667
—
D314
DH346
S
102739
200
140.74
1130
4410
25.62
1028
3
342.67
38000
298
37
3.45
3348
3469
96.51
D315
DH347
L
174819
541
88.53
2525
6899
36.60
2580
9
286.67
326407
296
66
16.71
0
8891
0.00
D316
DH348
M
57108
236
66.30
0
0
0.00
1024
6
170.67
392122
296
42
31.54
0
2736
0.00
D316
DH349
S
51688
60
236.02
1555
6082
25.57
0
0
0.00
31963
300
16
6.66
0
0
—
D317
DH350
L
148190
406
100.00
0
0
0.00
0
4
0.00
354788
300
44
26.88
0
7535
0.00
D317
DH351
S
58122
60
265.40
3735
8702
42.92
0
0
0.00
24184
305
7
11.33
0
0
—
D318
DH352
L
64071
333
52.71
448
1486
30.15
201
9
22.33
352239
294
80
14.98
0
996
0.00
D319
DH353
M
82391
272
82.99
1461
3532
41.36
968
3
322.67
160327
312
47
10.93
0
4955
0.00
D320
DH354
S
76996
200
105.47
921
2863
32.17
561
4
140.25
193781
0
35
0.00
0
6357
0.00
D321
DH355
M
124770
242
141.25
1748
4678
37.37
781
3
260.33
267652
297
41
21.98
0
2351
0.00
D322
DH356
S
34320
200
47.01
93
151
61.59
1655
4
413.75
111075
300
40
9.26
4692
4692
100.00
D323
DH357
M
88451
278
87.17
1045
4031
25.92
525
4
131.25
262251
312
40
21.01
0
1796
0.00
D324
DH358
M
86274
282
83.82
626
2772
22.58
356
4
89.00
497556
0
50
0.00
1
1713
0.06
D325
DH359
S
50816
200
69.61
76
2876
2.64
22
2
11.00
181764
313
28
20.74
1767
1767
100.00
D326
DH360
S
4288
50
23.50
128
731
17.51
14
4
3.50
46775
276
39
4.35
0
90
0.00
D327
DH361
S
803
29
7.59
0
70
0.00
0
1
0.00
14504
268
28
1.93
0
0
—
D328
DH362
S
33385
141
64.87
426
2573
16.56
972
9
108.00
131566
280
72
6.53
1110
1482
74.90
D329
DH363
S
2333
50
12.78
78
654
11.93
0
3
0.00
21426
283
17
4.45
0
0
—
D330
DH364
S
3486
36
26.53
5
245
2.04
22
1
22.00
14490
267
11
4.93
0
11
— Annexures
176
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D331
DH365
S
4075
64
17.44
422
1623
26.00
24
6
4.00
108220
278
59
6.60
28
75
37.33
D332
DH366
S
2759
50
15.12
0
336
0.00
20
3
6.67
28767
276
21
4.96
0
0
—
D333
DH367
S
43
100
0.12
4
782
0.51
0
0
0.00
39742
0
13
0.00
0
0
—
D334
DH368
L
146596
386
104.05
1690
10272
16.45
230
3
76.67
121084
313
53
7.30
0
0
—
D334
DH369
L
2629
600
1.20
0
0
0.00
942
3
314.00
177502
308
62
9.30
0
0
—
D335
DH370
S
17177
74
63.59
0
578
0.00
0
5
0.00
40974
282
17
8.55
0
0
—
D336
DH371
S
26606
50
145.79
221
1558
14.18
0
0
0.00
28362
0
19
0.00
0
0
—
D336
DH372
S
49966
200
68.45
0
0
0.00
950
5
190.00
55320
307
50
3.60
2294
2819
81.38
D337
DH373
S
38323
108
97.22
119
2726
4.37
42
1
42.00
51632
307
23
7.31
532
70
—
D338
DH374
S
30978
100
84.87
58
1726
3.36
50
5
10.00
48162
306
20
7.87
0
0
—
D338
DH375
S
18262
100
50.03
85
1159
7.33
29
4
7.25
44961
304
12
12.32
0
0
—
D339
DH376
M
79709
280
77.99
1093
4264
25.63
3847
17
226.29
389784
290
83
16.19
4532
24373
18.59
D340
DH377
S
9901
73
37.16
78
714
10.92
139
3
46.33
31692
288
14
7.86
213
1248
17.07
D341
DH378
S
16291
60
74.39
62
677
9.16
242
2
121.00
43387
283
10
15.33
128
745
17.18
D342
DH379
S
8935
34
72.00
32
442
7.24
5
2
2.50
33214
277
12
9.99
369
1037
35.58
D343
DH380
S
36257
143
69.46
207
264
78.41
406
6
67.67
92013
277
31
10.72
530
1778
29.81
D344
DH381
S
4442
26
46.81
16
255
6.27
0
2
0.00
556
284
10
0.20
12
165
7.27
D345
DH382
S
13052
45
79.46
106
648
16.36
86
2
43.00
20928
277
11
6.87
288
792
36.36
D346
DH383
S
18266
51
98.13
13
370
3.51
224
3
74.67
30794
265
14
8.30
175
1067
16.40
D347
DH384
S
14488
150
26.46
827
3680
22.47
580
7
82.86
144945
0
36
0.00
8037
2048
—
D348
DH385
S
23487
150
42.90
179
663
27.00
231
5
46.20
44830
269
18
9.26
168
841
19.98
D349
DH386
S
1789
50
9.80
41
294
13.95
47
4
11.75
17458
280
14
4.45
0
61
0.00
D350
DH387
S
365
163
0.61
1202
6048
19.87
34
3
11.33
224152
365
31
19.81
6968
7171
97.17 Annexures
177
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D351
DH388
M
86140
236
100.00
2821
9467
29.80
34
9
3.78
285313
365
113
6.92
1696
7408
22.89
D352
DH389
L
147358
360
112.14
5012
12101
41.42
776
20
38.80
364475
365
73
13.68
854
17430
4.90
D353
DH390
S
20682
160
35.41
1294
4318
29.97
156
2
78.00
319057
365
22
39.73
2958
14079
21.01
D354
DH391
S
13434
93
39.58
545
2913
18.71
158
4
39.50
133655
365
28
13.08
547
2536
21.57
D355
DH392
M
108352
269
110.35
1486
6487
22.91
391
6
65.17
321839
365
38
23.20
1042
10960
9.51
D356
DH393
S
19764
130
41.65
604
2232
27.06
1156
3
385.33
385875
365
33
32.04
0
0
—
D357
DH394
S
46720
128
100.00
150
1507
9.95
31
2
15.50
107452
365
16
18.40
107
2431
4.40
D358
DH395
M
80566
288
76.64
2013
5911
34.06
614
3
204.67
343295
365
29
32.43
447
6004
7.45
D359
DH396
S
40515
111
100.00
1445
2920
49.49
82
4
20.50
166102
365
25
18.20
1527
3807
40.11
D360
DH397
S
11700
137
23.40
633
3636
17.41
259
7
37.00
354693
365
33
29.45
0
3
—
D361
DH398
S
45800
126
99.59
1208
4447
27.16
1332
3
444.00
201204
0
25
0.00
1999
2042
97.89
D362
DH399
L
51110
305
45.91
572
8045
7.11
273
4
68.25
320541
365
30
29.27
1226
4620
26.54
D363
DH400
S
44414
116
104.90
319
2833
11.26
49
49
1.00
219040
0
25
0.00
1495
7308
20.46
D364
DH401
S
93203
165
154.76
1335
6960
19.18
83
6
13.83
195800
365
33
16.26
7204
9956
72.36
D365
DH402
S
56890
186
83.80
646
2967
21.77
173
6
28.83
179387
365
39
12.60
2761
5128
53.84
D366
DH403
S
42408
195
59.58
567
6539
8.67
275
3
91.67
274472
365
25
30.08
825
3672
22.47
D367
DH404
S
91126
162
154.11
1936
5720
33.85
162
4
40.50
224787
365
40
15.40
3544
7142
49.62
D368
DH405
L
196993
675
79.96
4691
10872
43.15
6951
11
631.91
786996
365
129
16.71
5491
23034
23.84
D368
DH406
S
66
146
0.12
1205
4862
24.78
959
5
191.80
420643
365
43
26.80
307
2903
10.58
D369
DH407
S
30404
195
42.72
1340
4299
31.17
680
3
226.67
186479
365
34
15.03
722
6234
11.58
D370
DH408
S
66040
125
144.75
678
3480
19.48
104
5
20.80
98505
365
32
8.43
1972
2870
68.71
D371
DH409
M
223497
255
240.13
3001
11021
27.23
3844
24
160.17
333746
365
107
8.55
138
7468
1.85
D372
DH410
S
66739
135
135.44
541
3186
16.98
24
6
4.00
84965
365
24
9.70
6321
7238
87.33 Annexures
178
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D373
DH411
S
65574
168
106.94
271
4107
6.60
350
3
116.67
361145
365
20
49.47
625
4932
12.67
D374
DH412
S
39643
120
90.51
1112
5266
21.12
32
5
6.40
86878
365
16
14.88
3326
3779
88.01
D375
DH413
L
117423
380
84.66
2101
5399
38.91
191
10
19.10
344011
365
50
18.85
1183
5131
23.06
D376
DH414
S
61754
99
170.90
769
4017
19.14
47
6
7.83
151858
365
24
17.34
1793
3601
49.79
D377
DH415
M
0
225
0.00
0
0
0.00
0
0
0.00
0
365
33
0.00
0
0
—
D378
DH416
S
29433
110
73.31
342
2916
11.73
22
3
7.33
198855
365
19
28.67
391
3891
10.05
D379
DH417
L
22768
313
19.93
1979
7661
25.83
953
6
158.83
229487
365
44
14.29
8902
13295
66.96
D379
DH418
S
31984
197
44.48
1278
4713
27.12
12
3
4.00
219304
308
28
25.43
3252
4493
72.38
D380
DH419
L
1107
506
0.60
1433
2387
60.03
3256
2
1628.00
535784
365
58
25.31
451
1935
23.31
D381
DH420
S
24031
171
38.50
180
338
53.25
228
2
114.00
287927
365
19
41.52
76
238
31.93
D382
DH421
L
144258
450
87.83
4312
9927
43.44
0
0
0.00
276970
313
88
10.06
143
1935
7.39
D383
DH422
S
17992
100
49.29
51
298
17.11
366
2
183.00
338164
365
29
31.95
0
0
—
D384
DH423
S
47990
200
65.74
1183
2901
40.78
818
6
136.33
293228
275
37
28.82
0
5748
0.00
D385
DH424
S
27104
160
46.41
1598
5302
30.14
973
4
243.25
286655
262
28
39.08
23
5832
0.39
D386
DH425
S
75645
200
103.62
2139
4961
43.12
1923
7
274.71
368815
276
49
27.27
1208
7953
15.19
D387
DH426
S
38260
100
104.82
607
1691
35.90
670
4
167.50
137678
275
31
16.15
0
443
0.00
D388
DH427
S
23323
80
79.87
267
967
27.61
288
4
72.00
236812
365
32
20.28
0
1365
0.00
D389
DH428
S
16641
75
60.79
527
2514
20.96
202
3
67.33
122286
279
14
31.31
0
3919
0.00
D390
DH429
S
47948
120
109.47
914
2334
39.16
167
2
83.50
227557
276
27
30.54
0
4566
0.00
D391
DH430
S
77370
104
203.82
1306
3130
41.73
1470
5
294.00
186044
294
28
22.60
0
5427
0.00
D392
DH431
S
56718
200
77.70
677
2787
24.29
1323
2
661.50
290966
283
32
32.13
0
4887
0.00
D393
DH432
L
167650
470
97.73
2617
7074
36.99
2279
9
253.22
406878
286
76
18.72
382
9886
3.86
D394
DH433
S
50773
120
115.92
586
1932
30.33
1179
4
294.75
254491
292
30
29.05
0
2810
0.00 Annexures
179
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D395
DH434
M
95941
270
97.35
2758
8063
34.21
956
8
119.50
254208
286
46
19.32
318
8688
3.66
D396
DH435
S
11676
100
31.99
1135
2974
38.16
758
4
189.50
197398
282
26
26.92
0
5215
0.00
D397
DH436
S
74137
120
169.26
2074
5152
40.26
797
8
99.63
207424
277
25
29.95
0
11224
0.00
D398
DH437
S
41790
200
57.25
678
2324
29.17
1092
7
156.00
324213
290
37
30.22
0
988
0.00
D399
DH438
S
18451
100
50.55
393
2162
18.18
220
2
110.00
147481
275
16
33.52
362
7040
5.14
D400
DH439
S
24140
100
66.14
500
1479
33.81
798
4
199.50
176042
291
22
27.50
0
71
—
D401
DH440
S
36852
150
67.31
1840
4330
42.49
1181
6
196.83
226775
292
34
22.84
3178
14921
21.30
D402
DH441
S
65666
200
89.95
1446
3714
38.93
3918
7
559.71
374200
281
42
31.71
0
233
—
D403
DH442
S
23323
100
63.90
296
1488
19.89
442
5
88.40
249808
287
31
28.08
0
4144
0.00
D404
DH443
S
48886
100
133.93
2637
5106
51.65
673
1
673.00
267851
287
29
32.18
0
6459
0.00
D405
DH444
S
32799
100
89.86
755
1869
40.40
457
5
91.40
279836
282
25
39.69
2984
4767
62.60
D406
DH445
L
146000
400
100.00
1068
8542
12.50
1046
7
149.43
493680
365
33
40.99
187
6629
2.82
D407
DH446
L
205585
701
80.35
2419
12311
19.65
1752
19
92.21
804745
365
79
27.91
7430
7430
100.00
D408
DH447
L
52374
454
31.61
2180
7068
30.84
4186
6
697.67
351520
365
57
16.90
1514
3055
49.56
D409
DH448
L
124182
333
102.17
1195
7072
16.90
674
8
84.25
439988
0
53
0.00
1198
12608
9.50
D410
DH449
M
77998
285
74.98
624
9525
6.55
1843
2
921.50
474102
0
43
0.00
1334
4623
28.86
D411
DH450
L
63139
525
32.95
1097
10402
10.55
834
2
417.00
468812
365
60
21.41
7431
11388
65.25
D412
DH451
L
164060
525
85.62
2381
15126
15.74
2310
9
256.67
491397
365
54
24.93
308
7330
4.20
D413
DH452
M
91010
300
83.11
567
6952
8.16
739
6
123.17
500909
0
58
0.00
4736
4914
96.38
D414
DH453
L
115569
551
57.46
2022
10396
19.45
1248
3
416.00
508249
365
48
29.01
1056
12658
8.34
D415
DH454
M
82475
300
75.32
563
5445
10.34
1283
6
213.83
509663
350
55
26.48
1594
9436
16.89
D416
DH455
M
0
250
0.00
760
10811
7.03
1218
10
121.80
533282
365
50
29.22
1471
3199
45.98
D417
DH456
L
56912
400
38.98
1062
13402
7.92
956
13
73.54
509447
365
44
31.72
2313
5194
44.53 Annexures
180
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D418
DH457
M
38822
256
41.55
442
5485
8.06
587
2
293.50
212668
365
30
19.42
61
1898
3.21
D419
DH458
L
131485
370
97.36
886
4968
17.83
1792
9
199.11
548789
365
68
22.11
405
7771
5.21
D420
DH459
L
37592
307
33.55
1430
6390
22.38
583
9
64.78
43063
365
45
2.62
6593
9297
70.92
D421
DH460
S
3739
150
6.83
118
3378
3.49
256
2
128.00
264491
365
32
22.64
625
1870
33.42
D422
DH461
S
12167
150
22.22
82
2450
3.35
1911
3
637.00
216637
365
57
10.41
301
2721
11.06
D423
DH462
S
87099
200
119.31
108
3643
2.96
2204
16
137.75
559785
362
60
25.77
3813
6375
59.81
D424
DH463
M
365
300
0.33
210
7646
2.75
640
8
80.00
470538
365
39
33.06
3903
4306
90.64
D425
DH464
M
79384
296
73.48
1131
6884
16.43
1374
0
0.00
319800
365
30
29.21
2486
3310
75.11
D426
DH465
L
91027
307
81.23
1018
7543
13.50
2408
3
802.67
456109
0
38
0.00
1488
5863
25.38
D427
DH466
S
27484
150
50.20
48
6040
0.79
959
2
479.50
204839
0
28
0.00
398
2755
14.45
D428
DH467
M
65822
220
81.97
290
4994
5.81
1332
24
55.50
353894
365
27
35.91
1155
4187
27.59
D429
DH468
M
365
294
0.34
1115
8178
13.63
501
15
33.40
385307
365
64
16.49
1970
4725
41.69
D430
DH469
L
146000
400
100.00
1875
7081
26.48
2024
15
134.93
506782
365
72
19.28
2655
8409
31.57
D431
DH470
S
39743
200
54.44
429
3555
12.07
1140
4
285.00
287315
0
28
0.00
746
2213
33.71
D432
DH471
S
119036
200
163.06
1239
8555
14.48
3464
12
288.67
527432
365
44
32.84
587
4077
14.40
D433
DH472
S
19381
105
50.57
89
525
16.95
0
7
0.00
106635
365
31
9.42
0
227
0.00
D434
DH473
S
9665
50
52.96
0
105
0.00
0
0
0.00
17617
274
17
3.78
0
0
—
D435
DH474
S
40437
100
110.79
265
883
30.01
59
7
8.43
130306
274
34
13.99
52
1067
4.87
D436
DH475
S
13097
80
44.85
9
326
2.76
0
0
0.00
56454
275
16
12.83
0
0
—
D437
DH476
M
62160
232
73.41
1146
1986
57.70
1034
9
114.89
503366
365
42
32.84
2
1715
0.12
D438
DH477
L
338008
1098
84.34
3052
5861
52.07
—
—
—
1110122
365
231
13.17
15373
16002
96.07
D439
DH478
L
100080
314
87.32
1666
2509
66.40
855
10
85.50
693322
365
31
61.27
0
3309
—
D440
DH479
L
217048
750
79.29
3804
5657
67.24
761
19
40.05
1019267
365
78
35.80
0
4459
0.00 Annexures
181
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D441
DH480
S
42088
152
75.86
380
890
42.70
306
4
76.50
435354
365
16
74.55
0
190
0.00
D442
DH481
L
199382
645
84.69
2447
5990
40.85
1708
22
77.64
1151416
365
73
43.21
0
4391
—
D443
DH482
L
64955
700
25.42
1764
3210
54.95
955
12
79.58
984783
365
77
35.04
0
5889
0.00
D444
DH483
L
168079
543
84.80
2321
4039
57.46
883
13
67.92
969857
365
65
40.88
0
1750
0.00
D445
DH484
S
50850
154
90.46
1001
1292
77.48
565
2
282.50
404529
365
32
34.63
0
1033
0.00
D446
DH485
S
32352
103
86.05
404
558
72.40
60
4
15.00
217674
0
13
0.00
0
496
—
D447
DH486
L
181493
422
117.83
3042
5261
57.82
792
19
41.68
770441
365
65
32.47
0
3971
0.00
D448
DH487
S
55483
185
82.17
1398
2862
48.85
386
3
128.67
458109
365
27
46.48
0
1624
0.00
D449
DH488
L
112210
545
56.41
1220
1774
68.77
543
7
77.57
725117
365
32
62.08
0
1513
0.00
D450
DH489
L
117579
468
68.83
1146
1944
58.95
922
8
115.25
696372
365
69
27.65
0
4212
0.00
D451
DH490
L
62655
375
45.78
1090
1912
57.01
2329
5
465.80
243393
365
43
15.51
0
1247
0.00
D452
DH491
L
161906
477
92.99
2439
4825
50.55
5859
11
532.64
531554
0
63
0.00
0
2808
0.00
D453
DH492
S
52300
168
85.29
1242
2128
58.36
2011
2
1005.50
337424
365
22
42.02
0
1047
0.00
D454
DH493
L
198232
613
88.60
2657
4133
64.29
1603
12
133.58
672462
365
63
29.24
0
3590
0.00
D455
DH494
M
77414
300
70.70
955
1759
54.29
481
2
240.50
476128
365
33
39.53
0
1651
0.00
D456
DH495
M
62337
222
76.93
1472
2943
50.02
362
4
90.50
302276
365
19
43.59
0
2209
—
D457
DH496
L
148070
526
77.12
1779
4217
42.19
729
5
145.80
567703
365
24
64.81
0
3068
—
D458
DH497
M
58716
296
54.35
722
1365
52.89
1326
3
442.00
679311
365
18
103.40
0
1541
0.00
D459
DH498
L
143140
370
105.99
2179
4704
46.32
2065
2
1032.50
917421
365
53
47.42
0
4360
0.00
D460
DH499
L
129210
354
100.00
1063
1566
67.88
190
6
31.67
421782
365
23
50.24
0
216
—
D461
DH500
M
51325
210
66.96
1100
2623
41.94
160
1
160.00
381669
0
35
0.00
0
781
0.00
D462
DH501
M
256
256
0.27
1510
3893
38.79
6991
5
1398.20
529197
365
34
42.64
0
1703
0.00
D463
DH502
L
194982
726
73.58
2685
5519
48.65
1850
9
205.56
917021
365
70
35.89
0
3327
— Annexures
182
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D464
DH503
M
56516
226
68.51
594
974
60.99
68
1
68.00
432989
365
19
62.44
0
124
—
D465
DH504
L
116519
413
77.30
1872
2890
64.78
720
8
90.00
427940
365
37
31.69
0
2728
0.00
D466
DH505
M
57100
300
52.15
456
905
50.39
513
6
85.50
1092100
365
23
130.09
76
949
8.01
D467
DH506
L
112376
304
101.28
1336
3910
34.17
346
13
26.62
518746
365
31
45.85
0
1630
0.00
D468
DH507
L
113743
386
80.73
2275
3955
57.52
715
6
119.17
500521
365
35
39.18
0
4483
0.00
D469
DH508
S
78117
200
107.01
1971
3295
59.82
871
6
145.17
259090
365
26
27.30
0
0
—
D470
DH509
L
162202
500
88.88
4527
6473
69.94
4913
4
1228.25
324617
0
41
0.00
82
4745
1.73
D471
DH510
M
128450
250
140.77
4272
6530
65.42
461
7
65.86
648194
312
41
50.67
426
3054
13.95
D472
DH511
L
140510
450
85.55
4140
6025
68.71
3240
7
462.86
257916
0
26
0.00
20
1761
1.14
D473
DH512
M
122033
250
133.73
2383
7352
32.41
2282
4
570.50
361168
308
38
30.86
3369
3369
100.00
D474
DH513
S
1189
0
0.00
1151
4644
24.78
943
2
471.50
320626
310
20
51.71
100
673
14.86
D475
DH514
S
27367
150
49.99
25
1031
2.42
0
3
0.00
43345
269
25
6.45
106
319
33.23
D476
DH515
S
61211
150
111.80
836
3427
24.39
105
6
17.50
83390
0
29
0.00
180
3200
5.63
D477
DH516
S
25178
100
68.98
315
1524
20.67
0
2
0.00
47463
253
15
12.51
144
915
15.74
D478
DH517
S
18590
100
50.93
187
1673
11.18
0
1
0.00
63725
267
20
11.93
489
2390
20.46
D479
DH518
S
16126
100
44.18
67
700
9.57
0
0
0.00
47025
265
15
11.83
84
416
20.19
D480
DH519
S
19123
150
34.93
318
1655
19.21
96
4
24.00
37138
275
23
5.87
0
1415
—
D481
DH520
S
26040
128
55.74
0
0
0.00
5276
8
659.50
636399
310
46
44.63
0
1166
0.00
D481
DH521
S
24380
200
33.40
1245
6937
17.95
0
0
0.00
160140
309
29
17.87
0
0
—
D482
DH522
S
37253
100
102.06
57
1907
2.99
2282
6
380.33
536714
0
42
0.00
0
0
—
D482
DH523
S
0
90
0.00
368
10167
3.62
0
0
0.00
151832
365
6
69.33
0
0
—
D482
DH524
M
240000
232
283.42
0
0
0.00
1330
6
221.67
644502
310
20
103.95
219
5094
4.30
D483
DH528
S
60635
100
166.12
820
2853
28.74
1416
5
283.20
308654
286
24
44.97
1481
1656
89.43 Annexures
183
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D484
DH529
S
4861
50
26.64
0
0
0.00
0
1
0.00
170614
310
9
61.15
0
0
—
D484
DH530
S
6603
100
18.09
0
386
0.00
0
0
0.00
66724
310
13
16.56
0
0
—
D485
DH531
S
36500
100
100.00
1941
7638
25.41
0
0
0.00
157496
270
14
41.67
0
0
—
D485
DH532
M
2558
219
3.20
0
0
0.00
4252
8
531.50
571443
365
39
40.14
12440
12440
100.00
D486
DH533
S
3870
100
10.60
209
1820
11.48
200
3
66.67
272803
282
33
29.31
502
1006
49.90
D487
DH534
S
30801
135
62.51
2032
10861
18.71
0
0
0.00
155829
0
13
0.00
0
0
—
D487
DH535
L
125301
353
97.25
0
0
0.00
0
8
0.00
626695
310
46
43.95
6358
6358
100.00
D488
DH536
S
41616
176
64.78
0
0
0.00
1327
6
221.17
672215
313
23
93.38
2477
2819
87.87
D488
DH537
S
13937
65
58.74
341
7209
4.73
98
0
0.00
108778
310
3
116.97
0
0
—
D489
DH538
S
10800
30
98.63
56
2549
2.20
0
0
0.00
48550
308
5
31.53
206
206
100.00
D489
DH539
S
200
74
0.74
0
0
0.00
20
9
2.22
184800
308
14
42.86
0
0
—
D489
DH540
S
0
100
0.00
50
201
24.88
660
1
660.00
25506
0
7
0.00
1800
2190
82.19
D490
DH541
S
0
30
0.00
19
5864
0.32
0
0
0.00
68562
313
6
36.51
0
0
—
D490
DH542
S
0
103
0.00
0
0
0.00
175
6
29.17
354303
313
18
62.89
134
1517
8.83
D491
DH543
S
29780
75
108.79
2784
6541
42.56
3612
0
0.00
142990
305
11
42.62
0
0
—
D491
DH544
S
1695
140
3.32
0
0
0.00
2044
4
511.00
584986
304
26
74.01
1286
2679
48.00
D492
DH545
L
28890
325
24.35
0
0
0.00
5880
7
840.00
677555
310
35
62.45
1657
1381
—
D492
DH546
S
35864
114
86.19
1406
6327
22.22
0
0
0.00
109656
0
15
0.00
0
0
—
D493
DH547
S
7814
125
17.13
1166
7202
16.19
0
0
0.00
139700
310
8
56.33
0
0
—
D493
DH548
M
15279
216
19.38
0
0
0.00
0
5
0.00
0
0
33
0.00
1040
1040
100.00
D493
DH549
M
310
300
0.28
0
0
0.00
1225
7
175.00
0
310
25
0.00
627
808
77.60
D494
DH550
S
28837
100
79.01
0
0
0.00
673
0
0.00
398929
290
15
91.71
3904
3904
100.00
D494
DH551
S
981
75
3.58
1121
4028
27.83
0
0
0.00
78407
280
8
35.00
0
0
— Annexures
184
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D495
DH552
S
14520
79
50.36
297
4820
6.16
0
0
0.00
93414
309
9
33.59
0
0
—
D495
DH553
M
20729
234
24.27
0
0
0.00
550
9
61.11
319494
300
34
31.32
2368
171
—
D496
DH554
S
23529
60
107.44
413
8074
5.12
0
0
0.00
129158
310
9
46.29
0
0
—
D496
DH555
S
6983
50
38.26
2
2155
0.09
0
0
0.00
188188
310
10
60.71
0
0
—
D496
DH556
S
5479
52
28.87
0
0
0.00
250
4
62.50
137288
309
14
31.74
0
0
—
D496
DH557
S
16674
177
25.81
0
0
0.00
489
5
97.80
493420
307
25
64.29
250
2641
9.47
D497
DH558
S
2953
100
8.09
39
521
7.49
501
7
71.57
278888
310
17
52.92
1170
1645
71.12
D497
DH559
S
724
30
6.61
91
1147
7.93
0
0
0.00
49167
310
10
15.86
0
0
—
D497
DH560
S
990
100
2.71
50
1067
4.69
501
5
100.20
99683
310
15
21.44
0
0
—
D498
DH561
S
32460
100
88.93
9
3806
0.24
158
4
39.50
283768
265
21
50.99
188
225
83.56
D499
DH562
S
10594
191
15.20
1090
6511
16.74
0
0
0.00
86193
309
8
34.87
0
0
—
D499
DH563
M
66189
230
78.84
0
0
0.00
3124
4
781.00
387865
317
36
33.99
666
5867
11.35
D500
DH564
S
30212
100
82.77
0
0
0.00
0
0
0.00
412620
305
18
75.16
682
967
70.53
D500
DH565
S
360
18
5.48
64
3449
1.86
0
0
0.00
53058
308
4
43.07
0
0
—
D501
DH566
S
7925
43
50.49
386
5439
7.10
0
0
0.00
92241
310
6
49.59
0
0
—
D501
DH567
M
58869
230
70.12
0
0
0.00
1048
7
149.71
688337
310
31
71.63
1985
2301
86.27
D502
DH568
S
48017
114
115.40
920
5466
16.83
0
1
0.00
96009
312
10
30.77
390
390
100.00
D502
DH569
S
8996
85
29.00
0
0
0.00
661
5
132.20
344306
310
22
50.48
0
0
—
D502
DH570
M
20000
212
25.85
0
0
0.00
2149
10
214.90
544409
311
37
47.31
2120
7639
27.75
D503
DH571
S
14721
65
62.05
122
4501
2.71
0
0
0.00
73868
308
11
21.80
0
0
—
D503
DH572
S
11645
200
15.95
0
0
0.00
350
0
0.00
384559
288
13
102.71
3651
4426
82.49
D503
DH573
S
78
30
0.71
0
594
0.00
594
0
0.00
67645
308
5
43.93
0
0
—
D504
DH574
S
27214
72
103.55
157
5955
2.64
0
0
0.00
88615
309
7
40.97
0
0
— Annexures
185
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D504
DH575
S
13166
146
24.71
0
0
0.00
1083
8
135.38
457781
308
27
55.05
738
911
81.01
D505
DH576
S
20206
45
123.02
53
6987
0.76
0
0
0.00
14869
294
5
10.11
0
0
—
D505
DH577
S
12977
80
44.44
0
4621
0.00
0
0
0.00
267646
310
7
123.34
0
0
—
D506
DH578
S
24223
137
48.44
840
7596
11.06
1921
5
384.20
811035
0
53
0.00
218
1254
17.38
D507
DH579
S
27340
68
110.15
812
5938
13.67
0
0
0.00
144405
309
14
33.38
0
0
—
D507
DH580
S
27900
100
76.44
406
1286
31.57
1271
6
211.83
192238
0
23
0.00
0
0
—
D507
DH581
S
15209
166
25.10
0
0
0.00
1649
4
412.25
527133
312
30
56.32
1071
3739
28.64
D508
DH582
S
29200
80
100.00
568
3808
14.92
0
0
0.00
58790
307
6
31.92
0
0
—
D508
DH583
S
53250
150
97.26
0
0
0.00
344
3
114.67
276116
307
17
52.91
2582
1995
—
D509
DH584
S
38467
134
78.65
2419
13490
17.93
0
0
0.00
120659
307
7
56.15
0
0
—
D509
DH585
S
0
174
0.00
0
0
0.00
920
12
76.67
520269
309
28
60.13
521
4904
10.62
D510
DH586
L
83533
305
75.04
0
0
0.00
753
5
150.60
574362
309
53
35.07
9
1496
0.60
D510
DH587
S
19557
141
38.00
1075
5499
19.55
0
0
0.00
116578
310
20
18.80
0
0
—
D511
DH588
S
10800
30
98.63
509
3369
15.11
0
2
0.00
54957
309
4
44.46
0
0
—
D511
DH589
S
309
68
1.24
0
0
0.00
543
5
108.60
239011
309
16
48.34
119
611
19.48
D512
DH590
S
365
64
1.56
464
11306
4.10
0
0
0.00
117027
310
12
31.46
0
0
—
D512
DH591
S
365
184
0.54
0
0
0.00
555
5
111.00
461762
310
25
59.58
3717
4554
81.62
D513
DH592
S
17629
70
69.00
0
0
0.00
129
4
32.25
344829
310
16
69.52
98
1180
8.31
D513
DH593
S
4622
30
42.21
234
4591
5.10
0
0
0.00
69989
310
13
17.37
0
0
—
D514
DH594
S
13134
60
59.97
201
5580
3.60
0
0
0.00
85010
0
11
0.00
0
0
—
D514
DH595
S
5704
104
15.03
0
0
0.00
764
4
191.00
540567
309
26
67.28
56
119
47.06
D515
DH596
S
26680
100
73.10
1408
7163
19.66
0
0
0.00
72306
311
12
19.37
533
533
100.00
D515
DH597
S
16537
145
31.25
0
0
0.00
1720
8
215.00
328070
309
26
40.84
2235
5495
40.67 Annexures
186
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D516
DH598
S
16249
47
94.72
577
4647
12.42
0
0
0.00
88146
278
11
28.82
98
182
53.85
D516
DH599
S
54672
172
87.09
0
0
0.00
10464
13
804.92
886104
313
46
61.54
424
1598
26.53
D517
DH600
S
16217
100
44.43
26
823
3.16
501
2
250.50
266846
290
20
46.01
949
2936
32.32
D518
DH601
S
36876
100
101.03
65
3670
1.77
1121
3
373.67
223398
309
36
20.08
349
610
57.21
D519
DH602
S
30802
100
84.39
91
5171
1.76
267
2
133.50
79475
309
33
7.79
340
340
100.00
D520
DH603
L
348
423
0.23
0
0
0.00
4603
7
657.57
501898
0
69
0.00
5778
9078
63.65
D520
DH604
S
15355
68
61.87
0
0
0.00
519
6
86.50
160656
310
19
27.28
0
0
—
D520
DH605
S
20482
100
56.12
415
2886
14.38
869
5
173.80
294497
291
34
29.77
0
0
—
D520
DH606
S
23673
185
35.06
3650
8871
41.15
0
0
0.00
204826
310
22
30.03
0
0
—
D521
DH607
S
0
30
0.00
0
0
0.00
0
3
0.00
0
0
7
0.00
0
0
—
D522
DH608
S
29880
100
81.86
155
2921
5.31
677
5
135.40
269436
309
35
24.91
908
1047
86.72
D523
DH609
S
0
100
0.00
128
3178
4.03
1156
7
165.14
329861
313
42
25.09
1373
1412
97.24
D524
DH610
S
18906
60
86.33
557
8965
6.21
557
1
557.00
156219
0
17
0.00
0
0
—
D524
DH611
S
365
167
0.60
0
0
0.00
1956
6
326.00
386230
310
28
44.50
4821
11052
43.62
D525
DH612
S
28540
60
130.32
978
8134
12.02
0
0
0.00
106904
310
9
38.32
0
0
—
D525
DH613
S
0
140
0.00
0
0
0.00
846
8
105.75
8298
0
25
0.00
475
4094
11.60
D526
DH614
L
113477
376
82.69
0
0
0.00
2979
18
165.50
878968
309
95
29.94
4522
4736
95.48
D526
DH615
L
48855
656
20.40
0
0
0.00
8422
24
350.92
5068250
309
85
192.97
383
4964
7.72
D526
DH616
L
20555
326
17.27
2720
7029
38.70
0
0
0.00
197911
310
43
14.85
0
0
—
D526
DH617
L
0
466
0.00
1876
6471
28.99
5661
16
353.81
1271496
308
87
47.45
1047
12252
8.55
D526
DH618
S
40105
110
99.89
567
1675
33.85
4474
5
894.80
326605
310
38
27.73
0
0
—
D526
DH619
S
24278
100
66.52
2344
4488
52.23
1182
6
197.00
529766
308
48
35.83
0
0
—
D526
DH620
S
9415
82
31.46
1266
2681
47.22
0
0
0.00
86014
310
33
8.41
0
0
— Annexures
187
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D526
DH621
S
5202
100
14.25
45
286
15.73
220
4
55.00
199303
306
22
29.61
0
0
—
D526
DH622
S
1442
100
3.95
10
27
37.04
329
5
65.80
137726
310
23
19.32
0
0
—
D527
DH623
S
28020
100
76.77
94
2888
3.25
993
2
496.50
338665
306
28
39.53
803
194
—
D528
DH624
S
8028
30
73.32
92
4033
2.28
0
0
0.00
97962
310
7
45.14
0
0
—
D528
DH625
S
130
100
0.36
0
0
0.00
385
6
64.17
376642
310
20
60.75
145
333
43.54
D529
DH626
S
39990
30
365.21
6
4332
0.14
0
0
0.00
76292
305
5
50.03
0
0
—
D529
DH627
S
19813
100
54.28
0
0
0.00
195
2
97.50
393738
308
19
67.28
960
157
—
D530
DH628
S
14598
54
74.06
407
4855
8.38
0
0
0.00
82725
0
11
0.00
0
0
—
D530
DH629
S
25408
100
69.61
129
710
18.17
502
6
83.67
278530
363
22
34.88
0
0
—
D530
DH630
S
8749
74
32.39
0
0
0.00
1079
7
154.14
439258
325
19
71.13
3140
2852
—
D531
DH631
S
2742
30
25.04
14
850
1.65
0
0
0.00
387070
313
6
206.11
0
0
—
D531
DH632
S
0
70
0.00
0
0
0.00
1656
11
150.55
283618
312
34
26.74
535
801
66.79
D532
DH633
S
20477
116
48.36
1574
4919
32.00
0
0
0.00
313
313
18
0.06
0
0
—
D532
DH634
M
2
250
0.00
0
0
0.00
1787
3
595.67
535315
309
40
43.31
5047
8889
56.78
D533
DH635
S
310
88
0.97
1806
8611
20.97
0
1
0.00
112179
310
11
32.90
0
0
—
D533
DH636
S
0
155
0.00
0
0
0.00
2189
6
364.83
708998
300
44
53.71
0
0
—
D534
DH637
S
60337
187
88.40
0
0
0.00
633
5
126.60
625532
309
39
51.91
3235
4237
76.35
D534
DH638
S
24748
78
86.93
1272
5067
25.10
0
0
0.00
89299
310
6
48.01
0
0
—
D535
DH639
S
43193
127
93.18
3707
11312
32.77
0
0
0.00
186486
312
13
45.98
5881
5881
100.00
D535
DH640
S
56170
175
87.94
0
0
0.00
4361
5
872.20
741875
312
28
84.92
18393
19448
94.58
D536
DH641
S
41444
130
87.34
0
0
0.00
467
1
467.00
347425
310
16
70.05
1549
2199
70.44
D536
DH642
S
10183
70
39.86
246
3105
7.92
246
2
123.00
100024
308
10
32.48
0
0
—
D537
DH643
S
21996
62
97.20
2510
7451
33.69
3197
0
0.00
104087
308
9
37.55
0
0
— Annexures
188
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D537
DH644
S
662
180
1.01
0
0
0.00
2878
6
479.67
305395
308
22
45.07
978
2443
40.03
D538
DH525
S
56940
156
100.00
0
0
0.00
3390
10
339.00
942139
308
40
76.47
5276
5608
94.08
D538
DH526
S
39550
164
66.07
1534
4581
33.49
0
0
0.00
165166
309
22
24.30
0
0
—
D538
DH527
S
0
199
0.00
0
0
0.00
5059
3
1686.33
934306
309
48
62.99
4283
5148
83.20
D539
DH645
S
0
121
0.00
1928
8295
23.24
518
0
0.00
140464
297
14
33.78
0
0
—
D539
DH646
M
0
248
0.00
0
0
0.00
0
5
0.00
89283
0
28
0.00
617
8320
7.42
D540
DH647
S
69671
150
127.25
0
0
0.00
828
2
414.00
424945
309
15
91.68
3740
4414
84.73
D540
DH648
S
15847
52
83.49
485
3153
15.38
0
0
0.00
123961
304
10
40.78
0
0
—
D541
DH649
S
0
168
0.00
3567
13305
26.81
140
1
140.00
196747
312
19
33.19
0
0
—
D541
DH650
L
104595
320
89.55
0
0
0.00
2788
6
464.67
641890
309
40
51.93
2119
4791
44.23
D542
DH651
S
2723
70
10.66
1
5552
0.02
0
1
0.00
156902
308
5
101.88
0
0
—
D543
DH652
S
23351
100
63.98
112
1250
8.96
514
8
64.25
349220
308
35
32.40
684
761
89.88
D544
DH653
S
15287
100
41.88
0
503
0.00
190
3
63.33
257192
310
20
41.48
247
345
71.59
D544
DH654
S
1550
50
8.49
4
3114
0.13
135
4
33.75
222033
310
18
39.79
0
0
—
D545
DH655
S
365
108
0.93
322
7662
4.20
0
0
0.00
78390
310
14
18.06
0
0
—
D545
DH656
M
365
204
0.49
0
0
0.00
1291
6
215.17
405903
310
28
46.76
4861
5886
82.59
D546
DH657
S
0
100
0.00
16
3117
0.51
50
2
25.00
0
313
14
0.00
102
102
100.00
D547
DH658
S
62081
100
170.08
246
1327
18.54
306
3
102.00
232954
312
27
27.65
2032
2164
93.90
D548
DH659
S
38430
144
73.12
727
13377
5.43
0
0
0.00
202367
295
14
49.00
0
0
—
D548
DH660
S
0
200
0.00
0
0
0.00
1554
5
310.80
769240
295
34
76.69
1673
2870
58.29
D549
DH661
S
16338
100
44.76
61
1341
4.55
606
3
202.00
0
0
20
0.00
4059
4622
87.82
D550
DH662
S
30832
82
103.01
1911
10227
18.69
0
0
0.00
161238
308
11
47.59
0
0
—
D550
DH663
M
61288
210
79.96
0
0
0.00
2074
8
259.25
395428
304
34
38.26
1613
9435
17.10 Annexures
189
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D551
DH664
S
21971
60
100.32
981
6458
15.19
0
0
0.00
108555
292
18
20.65
0
0
—
D551
DH665
S
9888
110
24.63
0
0
0.00
470
5
94.00
569267
305
31
60.21
726
726
100.00
D552
DH666
S
53088
180
80.80
2381
5874
40.53
0
0
0.00
12042
349
18
1.92
0
0
—
D552
DH667
S
13462
125
29.51
0
0
0.00
2578
3
859.33
428391
310
29
47.65
2469
2469
100.00
D552
DH668
S
2901
153
5.19
70
798
8.77
465
3
155.00
247740
310
25
31.97
0
0
—
D552
DH669
M
77252
286
74.00
0
0
0.00
3999
9
444.33
1301539
309
43
97.96
2732
3433
79.58
D553
DH670
S
9560
36
72.75
160
1121
14.27
0
0
0.00
22335
310
9
8.01
0
0
—
D553
DH671
S
5296
59
24.59
0
0
0.00
0
2
0.00
104506
310
19
17.74
66
858
7.69
D554
DH672
S
17286
45
105.24
68
1349
5.04
97
1
97.00
111905
295
19
19.97
0
21
—
D555
DH673
S
7026
68
28.31
0
643
0.00
10
1
10.00
68279
315
15
14.45
200
230
86.96
D556
DH674
S
2341
45
14.25
0
483
0.00
0
1
0.00
55190
313
11
16.03
0
153
0.00
D557
DH675
S
36500
132
75.76
0
0
0.00
37
3
12.33
169603
310
18
30.39
13
13
100.00
D557
DH676
S
2081
32
17.82
19
637
2.98
0
0
0.00
18085
310
9
6.48
0
0
—
D558
DH677
S
15523
38
111.92
606
4561
13.29
0
0
0.00
82694
308
8
33.56
189
641
29.49
D558
DH678
S
13857
70
54.23
0
0
0.00
288
2
144.00
104393
312
17
19.68
1722
8440
20.40
D559
DH679
S
8744
63
38.03
0
0
0.00
200
5
40.00
132994
0
22
0.00
0
350
0.00
D559
DH680
S
5350
53
27.66
126
718
17.55
0
0
0.00
35538
313
7
16.22
0
0
—
D560
DH681
S
40290
44
250.87
837
3087
27.11
0
0
0.00
74584
309
8
30.17
0
0
—
D560
DH682
S
40290
120
91.99
0
0
0.00
1664
5
332.80
200600
309
26
24.97
113
2176
5.19
D561
DH683
S
298
50
1.63
144
1210
11.90
128
4
32.00
70381
330
16
13.33
0
0
—
D562
DH684
S
485
76
1.75
3
546
0.55
10
4
2.50
99756
270
18
20.53
293
293
100.00
D563
DH685
S
21338
125
46.77
11
3579
0.31
180
3
60.00
287784
310
11
84.39
707
5976
11.83
D564
DH686
S
12000
108
30.44
0
0
0.00
1521
2
760.50
93000
300
14
22.14
0
491
0.00 Annexures
190
Dist Code
DH Code
Hospital category
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
Raw Score
Num.
Den.
(i)
Den.
(ii)
Raw Score
Num.
Den.
Raw Score
KPI 6
KPI 7
KPI 8
KPI 9
KPI 10
D564
DH687
S
1200
50
6.58
69
1996
3.46
1521
2
760.50
93000
300
14
22.14
578
491
—
D565
DH688
M
161555
282
156.96
3316
7528
44.05
2001
8
250.13
385619
0
55
0.00
2699
14721
18.33
D566
DH689
M
140897
286
134.97
1633
8002
20.41
202
5
40.40
0
0
58
0.00
0
8100
0.00
D567
DH690
L
147737
430
94.13
1865
5742
32.48
595
7
85.00
371794
0
49
0.00
1056
4411
23.94
D568
DH691
L
126870
365
95.23
1408
5919
23.79
2437
7
348.14
488431
303
61
26.43
25
3046
0.82
D568
DH692
L
65276
343
52.14
511
1975
25.87
337
4
84.25
113941
300
37
10.26
2213
2213
100.00
D569
DH693
L
230368
636
99.24
2458
5936
41.41
851
9
94.56
325454
0
71
0.00
0
9259
—
D570
DH694
L
261906
625
114.81
4668
9188
50.81
978
4
244.50
362606
303
72
16.62
0
9692
0.00
D571
DH695
L
161724
700
63.30
3636
11004
33.04
1626
11
147.82
396491
305
67
19.40
4217
14917
28.27
D572
DH696
L
137160
460
81.69
2056
6604
31.13
499
8
62.38
266792
355
73
10.29
193
5070
3.81
D573
DH697
L
136903
500
75.02
3129
9036
34.63
863
8
107.88
524329
0
57
0.00
3345
13957
23.97
D574
DH698
L
267421
849
86.30
7819
14223
54.97
860
10
86.00
408158
303
76
17.72
266
16911
1.57
D575
DH699
L
253662
600
115.83
2766
10959
25.24
1552
13
119.38
1143611
299
66
57.95
15
10077
0.15
D575
DH700
L
120435
549
60.10
1733
7231
23.97
578
10
57.80
246332
301
34
24.07
357
6202
5.76
D576
DH701
L
181133
405
122.53
2837
9004
31.51
1160
10
116.00
245859
303
66
12.29
2051
86831
2.36
D577
DH702
L
184288
415
121.66
4387
10160
43.18
598
8
74.75
371714
303
62
19.79
461
21550
2.14
D577
DH703
S
23116
70
90.47
32
1700
1.88
2
3
0.67
192266
303
35
18.13
0
0
—
D578
DH704
L
280144
590
130.09
3615
13243
27.30
2129
7
304.14
453160
302
89
16.86
1884
8012
23.51
D579
DH705
L
226293
625
99.20
3409
5571
61.19
4578
6
763.00
645275
303
104
20.48
5069
32
—
D579
DH706
L
186232
427
119.49
3769
9996
37.71
596
9
66.22
540280
0
60
0.00
0
14841
0.00
D580
DH707
L
118549
436
74.49
1697
9747
17.41
584
8
73.00
273373
0
51
0.00
3955
12801
30.90 Annexures
191
ANNEXURE 7 - TABLE 7C - DISTRICT AND DISTRICT HOSPITAL CODES
District
Code
DistrictDH CodeDistrict Hospital (DH)
Andaman and Nicobar Islands
D1 NicobarDH1 BJR Hospital
D2 North and Middle Andaman DH2 Dr R.P. Hospital
D3 South AndamanDH3 G.B. Pant Hospital
Andhra Pradesh
D4 AnantapurDH4 Ggh Anantapur
D5 ChittoorDH5 GovernmentMaternity Hospl.Th
D5 ChittoorDH6
Sri.Venkateshwara Ram Narayana Ruia Gen.
Hospl.Th
D6 CuddapahDH7 DH Proddutur
D7 East GodavariDH8 DH Rajahmundry
D8 GunturDH9 DH Tenali
D9 KrishnaDH10 DH Machilipatnam
D10 KurnoolDH11 DH Nandyal
D11 NelloreDH12 Government General Hospital Nellore
D12 PrakasamDH13 Rims Ongole Th
D13 SrikakulamDH14 Rims Srikakulam Th
D14 VishakapatnamDH15 King George Hospital Th
D15 VizianagaramDH16 DH Vizianagaram
D16 West GodavariDH17 DH Eluru
Arunachal Pradesh
D17 East SiangDH18 GH Pasighat
D18 LohitDH19 GH Tezu
D19 Lower Dibang ValleyDH20 DH Roing
D20 Papum PareDH21
Tomo Riba Institute Of Medical Science &
Hospital
D21 TawangDH22 DH Tawang
D22 West SiangDH23 General Hospital Aalo
Assam
D23 BaksaDH24 Dr Ravi Boro Civil Hospital Baksa
D24 BarpetaDH25 Barpeta Civil Hospital Kalgachia
D25 BongaigaonDH26 Bongaigaon Ch
D26 CacharDH27 S.M.Deb Civil Hospital Silchar
D27 ChirangDH28 J.S.B Civil Hospital Chirang
D28 DarrangDH29 Mangaldai Civil Hospital
D29 DhemajiDH30 DHemaji Civil Hospital
D30 DhubriDH31 DHubri Civil Hospital Annexures
192
District
Code
DistrictDH CodeDistrict Hospital (DH)
D31 Dima HasaoDH32 Haflong Civil Hospital
D32 GoalparaDH33 200 Bedded Civil Hospital
D33 GolaghatDH34 Kushal Konwar Civil Hospital
D34 HailakandiDH35 S.K.Roy Civil Hospital
D35 Kamrup MDH36 Sonapur District Hospital
D36 Kamrup RDH37 Trb Civil Hospital
D37 Karbi AnglongDH38 Diphu Civil Hospital
D38 KarimganjDH39 Karimganj Civil Hospital
D39 KokrajharDH40 Rnb Civil Hospital Kokrajhar
D40 LakhimpurDH41 North Lakhimpur Civil Hospital
D41 MarigaonDH42 Morigaon Civil Hospital
D42 NagaonDH43 B.P. Civil Hospital
D43 NalbariDH44 Smk Civil Hospital
D44 SibsagarDH45 Sivasagar Civil Hospital
D45 SonitpurDH46 Kanaklata Civil Hospital
D46 TinsukiaDH47 LGB Civil Hospital
D47 UdalguriDH48 Udalguri Civil Hospital
Bihar
D48 ArariaDH49 Sardar Hospital Araria
D49 ArwalDH50 Sadar Hospital Arwal
D50 AurangabadDH51 Sadar Hospital Aurangabad
D51 BankaDH52 Sadar Hospital Banka
D52 BegusaraiDH53 Sadar Hospital Begusarai
D53 BhagalpurDH54 LNJP Sadar Hospital Bhagalpur
D54 BhojpurDH55 Sadar Hospital Ara Bhojpur
D55 BuxarDH56 Sadar Hospital Buxar
D56 East ChamparanDH57 Sadar Hospital Motihari Purbi Champaran
D57 GayaDH58 Sadar Hospital Pilgrim Gaya
D58 GopalganjDH59 Sadar Hospital Gopalganj
D59 JamuiDH60 Sadar Hospital Jamui
D60 JehanabadDH61 Sadar Hospital Jehanabad
D61 Kaimur BhabuaDH62 Sadar Hospital Bhabua Kaimur
D62 KatiharDH63 Sadar Hospital Katihar
D63 KhagariaDH64 Sadar Hospital Khagaria
D64 KishanganjDH65 Sadar Hospital Kishanganj
D65 LakhisaraiDH66 Sadar Hospital Lakhisarai
D66 MadhepuraDH67 Sadar Hospital Madhepura
D67 MadhubaniDH68 Sadar Hospital Madhubani
D68 MungerDH69 Sadar Hospital Munger Annexures
193
District
Code
DistrictDH CodeDistrict Hospital (DH)
D69 MuzaffarpurDH70 Sadar Hospital Muzaffarpur
D70 NalandaDH71 Sadar Hospital Biharsharif Nalanda
D71 NawadaDH72 Sadar Hospital Nawada
D72 PurniaDH73 Sadar Hospital Purnia
D73 RohtasDH74 Sadar Hospital Rohtas Sasaram
D74 SaharsaDH75 Sadar Hospital Saharsa
D75 SamastipurDH76 Sadar Hospital Samastipur
D76 SaranDH77 Sadar Hospital Saran
D77 SheikhpuraDH78 Sadar Hospital Sheikhpura
D78 SheoharDH79 Sadar Hospital Sheohar
D79 SitamarhiDH80 Sadar Hospital Sitamarhi
D80 SiwanDH81 Sadar Hospital Siwan
D81 SupaulDH82 Sadar Hospital Supaul
D82 VaishaliDH83 Sadar Hospital Hajipur Vaishali
D83 West ChamparanDH84
Sadar Hospital M.J.K Bettiah Paschim
Champaran
Chandigarh
D84 ChandigarhDH85 GMSH 16
Chhattisgarh
D85 BalodDH86 DH Balod
D86 Baloda BazarDH87 DH Baloda Bazar
D87 BemetraDH88 DH Bemetara
D88 BilaspurDH89 Bilaspur DH
D89 DantewadaDH90 Dantewada
D90 DhamtariDH91 DHamtari
D91 DurgDH92 District Hospital Durg
D92 GariyabandDH93 DH Gariaband
D93 Janjgir ChampaDH94 District Hospital
D94 JashpurDH95 Jashpur
D95 KankerDH96 Kanker DH
D96 KawardhaDH97 District Hospital Kawardha
D97 KondagaonDH98 Ravindra Tagore DH Kondagaon
D98 KorbaDH99 Indira Gandhi Dstt Hospital Korba
D99 MahasamundDH100 Mahasamund
D100 MungeliDH101 DH Mungeli
D101 NarayanpurDH102 Narayanpur
D102 RaipurDH103 Raipur
D103 SukmaDH104 DH Sukma Annexures
194
District
Code
DistrictDH CodeDistrict Hospital (DH)
Dadra and Nagar Haveli
D104 Dadra and Nagar Haveli DH105 Shri Vinoba Bhave Civil Hospital
Daman and Diu
D105 DamanDH106 Government Hospital Daman
D106 DiuDH107 Government Hospital Diu
Delhi
D107 Delhi CentralDH108 Aruna Asaf Ali Hospital
D107 Delhi CentralDH109 Girdhari Lal Maternity Hospital
D107 Delhi CentralDH110 Kasturba Hospital
D108 Delhi EastDH111 Lal Bahadur Shastri Hospital
D109 Delhi NorthDH112
Babu Jagjeevan Ram Memorial Hospital
Jahgirpuri
D109 Delhi NorthDH113 Maharishi Valmiki Hospital
D109 Delhi NorthDH114 Satyawati Raja Harishchandra Hospital
D110 Delhi North EastDH115 DH Jpc Hospital
D111 Delhi North WestDH116 Deep Chand Bandhu Hospital
D111 Delhi North WestDH117 Sanjay Gandhi Memorial Hospital Mangolpuri
D111 Delhi North WestDH118 Bhagwan Mahavir Hospital Pitampura
D112 Delhi SouthDH119 Pt. Madan Mohan Malviya Hospital
D113 Delhi South WestDH120 Rao Tula Ram Hospital
D114 Delhi WestDH121 Guru Govind Singh Govt Hospital
D114 Delhi WestDH122 Acharya Shree Bhikshu Hospital
D114 Delhi WestDH123 Deendayal Upadhyay Hospital
D115 ShahdaraDH124 Hedgewar Hospital
D115 ShahdaraDH125 DH SDN Hospital
Goa
D116 North GoaDH126 North Goa District Hospital
D117 South GoaDH127 South Goa District Hospital
Gujarat
D118 AmreliDH128 General Hospital Amreli
D119 AnandDH129 S.S.Hospital Petlad
D120 Banas KanthaDH130 General Hospital Palanpur
D121 BharuchDH131 General Hospital Bahruch
D122 BotadDH132 Botad
D123 ChhotaudepurDH133 Chhotaudepur
D124 DahodDH134 General Hospital Dahod
D125 Devbhumi DwarkaDH135 Jam Khambhalia
D126 KhedaDH136 General Hospital Nadiad
D127 MahesanaDH137 General Hospital Mehsana Annexures
195
District
Code
DistrictDH CodeDistrict Hospital (DH)
D128 MahisagarDH138 Lunawada
D129 MorbiDH139 Morbi
D130 NarmadaDH140 General Hospital Rajpipla
D131 NavsariDH141 M.G.G.Hospital Navsari
D132 Panch MahalsDH142 General Hospital Godhra
D133 PorbandarDH143 Bhavsinhji General Hospital
D134 RajkotDH144 PK General Hospital
D135 SurendranagarDH145 M.G. General Hospital
D136 TapiDH146 General Hospital Vyara
D137 The DangsDH147 General Hospital Dang
D138 VadodaraDH148 Jamnabai General Hospital
Haryana
D139 AmbalaDH149 Civil Hospital
D140 BhiwaniDH150 Civil Hospital
D141 FaridabadDH151 B.K. Civil Hospital
D142 FatehabadDH152 Civil Hospital Fatehabad
D143 HisarDH153 Civil Hospital
D144 JhajjarDH154 Civil Hospital Jhajjar
D145 JindDH155 Civil Hospital Jind
D146 KaithalDH156 IGMS Civil Hospital
D147 KurukshetraDH157 LNJP Civil Hospital
D148 MahendragarhDH158 Civil Hospital
D149 MewatDH159 Civil Hospital Mandikhera
D150 PalwalDH160 Civil Hospital
D151 PanchkulaDH161 Civil Hospital
D152 PanipatDH162 Civil Hospital
D153 RewariDH163 Civil Hospital Rewari
D154 RohtakDH164 Civil Hospital
D155 SirsaDH165 Civil Hospital Sirsa
D156 SonipatDH166 Civil Hospital Sonepat
Himachal Pradesh
D157 BilaspurDH167 Bilaspur RH
D158 ChambaDH168 Chamba RH MCH Centre
D159 HamirpurDH169 Hamirpur RH
D160 KangraDH170 DHaramshala ZH
D161 KulluDH171 Kullu RH
D162 Lahul SpitiDH172 Keylong RH
D163 MandiDH173 Mandi ZH
D164 ShimlaDH174 DDU ZH Annexures
196
District
Code
DistrictDH CodeDistrict Hospital (DH)
D165 SirmaurDH175 Nahan RH
D166 SolanDH176 Solan RH
D167 UnaDH177 Una RH
Jammu and Kashmir
D168 AnantnagDH178 MCH Anantnag
D168 AnantnagDH179 DH Anantnag
D169 BadgamDH180 District Hospital Budgam
D170 BandiporaDH181 Bandipora
D171 BaramulaDH182 Baramula
D172 DodaDH183 Doda
D173 GanderbalDH184 District Hospital
D174 JammuDH185 Gandhinagar Hospital
D174 JammuDH186 Sarwal Hospital
D175 KathuaDH187 Kathua
D176 KulgamDH188 Kulgam
D177 KupwaraDH189 DH Handwara
D178 PulwamaDH190 Pulwama DH
D179 RambanDH191 Ramban
D180 ReasiDH192 DH Reasi
D181 SambaDH193 Samba
D182 ShopianDH194 Shopain
D183 SrinagarDH195 District Hospital Jnlm
D184 UdhampurDH196 Udhampur
Jharkhand
D185 BokaroDH197 Bokaro Sadar Hospital
D186 ChatraDH198 Chatra Sadar Hospital
D187 DeogharDH199 Deoghar Sadar Hospital
D188 DumkaDH200 Dumka Sadar Hospital
D189 GarhwaDH201 Garhwa Sadar Hospital
D190 GiridihDH202 Giridih Sadar Hospital
D191 GoddaDH203 Godda Sadar Hospital
D192 GumlaDH204 Gumla Sadar Hospital
D193 HazaribaghDH205 Hazaribagh Sadar Hospital
D194 JamtaraDH206 Jamtara Sadar Hospital
D195 KhuntiDH207 Khunti Sadar Hospital
D196 KodarmaDH208 Kodrma Sadar Hospital
D197 LateharDH209 Latehar Sadar Hospital
D198 LohardagaDH210 Lohardaga Sadar Hospital
D199 PakurDH211 Pakur Sadar Hospital Annexures
197
District
Code
DistrictDH CodeDistrict Hospital (DH)
D200 PalamuDH212 Palamau Sadar Hospital
D201 Pashchimi SinghbhumDH213 Pashchimi Singhbhum Sadar Hospital
D202 Purbi SinghbhumDH214 Purbi Singhbhum Sadar Hospital
D203 RamgarhDH215 Ramgarh Sadar Hospital
D204 RanchiDH216 Ranchi Sadar Hospital
D205 SahibganjDH217 Sahibganj Sadar Hospital
D206 SaraikelaDH218 Saraikela Sadar Hospital
D207 SimdegaDH219 Simdega Sadar Hospital
Karnataka
D208 BagalkoteDH220 Bagalkote District Hospital FRU
D209 Bangalore UrbanDH221 HSIS Goshiya
D209 Bangalore UrbanDH222 Indiranagar General Hospital
D209 Bangalore UrbanDH223 Jayanagar General Hospital
D209 Bangalore UrbanDH224 Vanivilas Hospital
D209 Bangalore UrbanDH225 Victoria Hospital
D209 Bangalore UrbanDH226 Kc General Hospital
D209 Bangalore UrbanDH227 Bowring Lady Curzon
D210 BelgaumDH228 Belgaum District Hospital
D211 BellaryDH229 Bellary District Hospital FRU
D211 BellaryDH230 Vims Bellary Medical College
D212 BidarDH231 Bidar District Hospital
D213 BijapurDH232 Bijapur District Hospital FRU
D214 ChamrajnagarDH233 Chamarajnagar District Hospital FRU
D215 ChikkaballapurDH234 Chikkaballapur District Hospital FRU
D216 ChikmagalurDH235 Chickmagalur District Hospital FRU
D217 ChitradurgaDH236 Chitradurga District Hospital FRU
D218 Dakshina KannadaDH237 Lady Goshan Hospital Mangalore DH FRU
D218 Dakshina KannadaDH238 Wenlock Hospital Mangalore DH
D219 DavanagereDH239 Davangere Women And Children DH FRU
D219 DavanagereDH240 Davanagere District Hospital
D220 DharwadDH241 DHarwad District Hospital FRU
D220 DharwadDH242 Hubli Kims District Hospital
D221 GadagDH243 Gadag District Hospital FRU
D222 GulbargaDH244 Gulbarga District Hospital FRU
D223 HassanDH245 Hassan District Hospital
D224 HaveriDH246 Haveri District Hospital FRU
D225 KodaguDH247 Kodagu District Hospital FRU
D226 KolarDH248 Kolar District Hospital FRU
D227 KoppalDH249 Koppal District Hospital FRU Annexures
198
District
Code
DistrictDH CodeDistrict Hospital (DH)
D228 MandyaDH250 Mandya District Hospital
D229 MysoreDH251 Cheluvamba Hospital Mysore DH
D229 MysoreDH252 KR Hospital Mysore DH
D230 RaichurDH253 Raichur District Hospital
D231 RamanagarDH254 Ramanagara District Hospital FRU
D232 ShimogaDH255 Shimoga District Hospital
D233 TumkurDH256 Tumkur District Hospital FRU
D234 UdupiDH257 Udupi District Hospital FRU
D235 Uttara KannadaDH258 Uttara Kannada District Hospital FRU
D236 YadgirDH259 Yadgir District Hospital FRU
Kerala
D237 AlappuzhaDH260 W And C Hospital Alappuzha
D237 AlappuzhaDH261 General Hospital Alappuzha
D238 ErnakulamDH262 DH Aluva
D238 ErnakulamDH263 GH Ernakulam
D239 IdukkiDH264 District Hospital Thodupuzha
D240 KannurDH265 GH Thalassery
D241 KasaragodDH266 DH Kanhangad
D242 KollamDH267 W&C Hospital Kollam
D242 KollamDH268 DH Kollam
D243 KottayamDH269 General Hospital Kottayam
D244 KozhikodeDH270 General Hospital Calicut
D245 MalappuramDH271 DH Tirur
D245 MalappuramDH272 GH Manjeri
D246 PalakkadDH273 W & C Palakkad
D246 PalakkadDH274 District Hospital Palakkad
D247 PathanamthittaDH275 General Hosp Pathanamthitta
D248 ThiruvananthapuramDH276 District Model Hospital Peroorkada
D248 ThiruvananthapuramDH277 General Hospital Thiruvananthapuram
D248 ThiruvananthapuramDH278 W&C Hospital Thiruvananthapuram
D249 ThrissurDH279 GH Thrissur
D250 WayanadDH280 DH Mananthavady
Ladakh
D251 KargilDH281 Kargil
D252 LehDH282 Leh DH
Lakshadweep
D253 LakshadweepDH283 Indira Gandhi Hospital
Madhya Pradesh
D254 Agar MalwaDH284 DH Agar Annexures
199
District
Code
DistrictDH CodeDistrict Hospital (DH)
D255 AlirajpurDH285 DH Alirajpur
D256 AnuppurDH286 DH Anuppur
D257 Ashok NagarDH287 DH Ashoknagar
D258 BalaghatDH288 DH Balaghat
D259 BarwaniDH289 DH Barwani
D260 BetulDH290 DH Betul
D261 BhindDH291 DH Bhind
D262 BhopalDH292 DH Bhopal J.P
D263 BurhanpurDH293 DH Burhanpur
D264 ChhatarpurDH294 DH Chhatarpur
D265 ChhindwadaDH295 DH Chhindwara
D266 DamohDH296 DH Damoh
D267 DatiaDH297 DH Datia
D268 DewasDH298 DH Dewas
D269 DharDH299 DH DHar
D270 DindoriDH300 DH Dindori
D271 GunaDH301 DH Guna
D272 GwaliorDH302 DH Gwalior
D273 HardaDH303 DH Harda
D274 HoshangabadDH304 DH Hoshangabad
D275 IndoreDH305 DH Indore
D276 JabalpurDH306 DH Jabalpur
D277 JhabuaDH307 DH Jhabua
D278 KatniDH308 DH Katni
D279 KhandwaDH309 DH Khandwa
D280 KhargoneDH310 DH Khargone
D281 MandlaDH311 DH Mandla
D282 MandsaurDH312 DH Mandsaur
D283 MorenaDH313 DH Morena
D284 NarsinghpurDH314 DH Narsinghpur
D285 NeemuchDH315 DH Neemuch
D286 PannaDH316 DH Panna
D287 RaisenDH317 DH Raisen
D288 RajgarhDH318 DH Rajgarh
D289 RatlamDH319 DH Ratlam
D290 RewaDH320 DH Rewa
D291 SagarDH321 DH Sagar
D292 SatnaDH322 DH Satna
D293 SehoreDH323 DH Sehore Annexures
200
District
Code
DistrictDH CodeDistrict Hospital (DH)
D294 SeoniDH324 DH Seoni
D295 ShahdolDH325 DH Shahdol
D296 ShajapurDH326 DH Shajapur
D297 SheopurDH327 DH Sheopur
D298 ShivpuriDH328 DH Shivpuri
D299 SidhiDH329 DH Sidhi
D300 SingroliDH330 DH Singrauli
D301 TikamgarhDH331 DH Tikamgarh
D302 UjjainDH332 DH Ujjain
D303 UmariaDH333 DH Umaria
D304 VidishaDH334 DH Vidisha
Maharashtra
D305 AhmednagarDH335 Ahmednagar
D306 AmravatiDH336 District General Hospital Amravati
D306 AmravatiDH337 District Women Hospital Amravati
D307 BeedDH338 District Hospital Beed
D308 BhandaraDH339 Bhandara
D309 BuldanaDH340 DH Buldana
D310 GadchiroliDH341 District Hospital Gadchiroli
D311 HingoliDH342 DH Hingoli
D312 JalgaonDH343 District Hospital Jalgaon
D313 JalnaDH344 Women Hospital Jalna
D313 JalnaDH345 District Hospital Jalna
D314 NandurbarDH346 Nandurbar
D315 NashikDH347 District Hospital Nashik
D316 OsmanabadDH348 District Hospital Osmanabad
D316 OsmanabadDH349 WH Osmanabad
D317 ParbhaniDH350 General Hospital Parbhani
D317 ParbhaniDH351 Women Hospital Parbhani
D318 PuneDH352 Aundh
D319 RaigarhDH353 Alibag
D320 RatnagiriDH354 District Hospital Ratnagiri
D321 SataraDH355 Lt Karntisigh Nana Patil Civil Hospital Satara
D322 SindhudurgDH356 Sindhudurg
D323 ThaneDH357 District Hospital Thane
D324 WardhaDH358 Wardha
D325 WashimDH359 Washim
Manipur
D326 BishnupurDH360 Bishnupur District Hospital Annexures
201
District
Code
DistrictDH CodeDistrict Hospital (DH)
D327 ChandelDH361 Chandel District Hospital
D328 ChurachandpurDH362 Churachandpur District Hospital
D329 SenapatiDH363 Senapati District Hospital
D330 TamenglongDH364 Tamenglong District Hospital
D331 ThoubalDH365 Thoubal District Hospital
D332 UkhrulDH366 Ukhrul District Hospital
Meghalaya
D333 East Garo HillsDH367 Williamnagar Civil Hospital
D334 East Khasi HillsDH368 Ganesh Das Hospital
D334 East Khasi HillsDH369 Shillong Civil Hospital
D335 Ri BhoiDH370 Nongpoh DH
D336 West Garo HillsDH371 Tura Maternity And Child Hospital
D336 West Garo HillsDH372 Tura Civil Hospital
D337 West Jaintia HillsDH373 Jowai Civil Hospital
D338 West Khasi HillsDH374 Nongstoin DH
D338 West Khasi HillsDH375 Mairang DH
Mizoram
D339 Aizawl WestDH376 Aizawl Civil Hospital
D340 ChamphaiDH377 Champhai DH
D341 KolasibDH378 Kolasib DH
D342 LawngtlaiDH379 Lawngtlai DH
D343 LungleiDH380 Lunglei DH
D344 MamitDH381 Mamit DistrictHospital
D345 SaihaDH382 Saiha DH
D346 SerchhipDH383 Serchhip DH
Nagaland
D347 DimapurDH384 District Hospital
D348 MokokchungDH385 Ongpangkong DH
D349 WokhaDH386 Wokha DH
Odisha
D350 AnugulDH387 Angul
D351 BalangirDH388 Balangir
D352 BaleshwarDH389 Balasore
D353 BargarhDH390 Bargarh
D354 BaudhDH391 Boudh
D355 BhadrakDH392 Bhadrak
D356 CuttackDH393 City Hospital
D357 DeogarhDH394 Deogarh
D358 DhenkanalDH395 DHenkanal Annexures
202
District
Code
DistrictDH CodeDistrict Hospital (DH)
D359 GajapatiDH396 Paralakhemundi
D360 GanjamDH397 City Hospital
D361 JagatsinghpurDH398 Jagatsinghpur
D362 JajapurDH399 Jajpur
D363 JharsugudaDH400 Jharsuguda
D364 KalahandiDH401 Bhawanipatna
D365 KandhamalDH402 Phulbani
D366 KendraparaDH403 Kendrapada
D367 KeonjharDH404 Keonjhar
D368 KhordhaDH405 Capital Hospital
D368 KhordhaDH406 Khordha
D369 KoraputDH407 DHh Koraput
D370 MalkangiriDH408 Malkangiri
D371 MayurbhanjDH409 Baripada
D372 NabarangapurDH410 Nabarangpur
D373 NayagarhDH411 Nayagarh
D374 NuapadaDH412 Nuapada
D375 PuriDH413 Puri
D376 RayagadaDH414 Rayagada
D377 SambalpurDH415 Sambalpur
D378 SonapurDH416 Subarnapur
D379 SundargarhDH417 Rgh Rourkela
D379 SundargarhDH418 Sundargarh
Puducherry
D380 KaraikalDH419 Government General Hospital
D381 MaheDH420 Government General Hospital
D382 PondicherryDH421 RGGW & CH
D383 YanamDH422 Government General Hospital
Punjab
D384 AmritsarDH423 Amritsar DH
D385 BarnalaDH424 Barnala DH
D386 BathindaDH425 Bathinda DH
D387 FaridkotDH426 Faridkot DH
D388 Fatehgarh SahibDH427 Fatehgarh Sahib DH
D389 FazilkaDH428 Fazilka DH
D390 FirozpurDH429 Ferozepur DH
D391 GurdaspurDH430 Gurdaspur DH
D392 HoshiarpurDH431 Hoshiarpur DH
D393 JalandharDH432 Jalandhar DH Annexures
203
District
Code
DistrictDH CodeDistrict Hospital (DH)
D394 KapurthalaDH433 Kapurthala DH
D395 LudhianaDH434 Ludhiana DH
D396 MansaDH435 Mansa DH
D397 MogaDH436 Moga DH
D398 Mohali SAS NagarDH437 Mohali DH
D399 MuktsarDH438 Muktsar DH
D400 NawanshahrDH439 Nawanshahar DH
D401 PathankotDH440 Pathankot DH
D402 PatialaDH441 M.K.H. Patiala DH
D403 RupnagarDH442 Rupnagar DH
D404 SangrurDH443 Sangrur DH
D405 Tarn TaranDH444 Tarn Taran DH
Rajasthan
D406 AjmerDH445 A K Hospital Beawar Ajmer
D407 AlwarDH446 Rajeev Gandhi Govt Genaral Hospital Alwar
D408 BanswaraDH447 District Hospital Banswara
D409 BaranDH448 District Hospital Baran
D410 BarmerDH449 District Hospital Barmar
D411 BharatpurDH450 RBM Hospital, Bharatpur
D412 BhilwaraDH451 M G Hospital Bhilwara
D413 BundiDH452
Pandit Briz Sundar Sharma General Hospital
Bundi
D414 ChittaurgarhDH453 District Hospital Chittaurgarh
D415 ChuruDH454 D B Government Hospital Churu
D416 DausaDH455 District Hospital Dausa
D417 DhaulpurDH456 Sadar Hospital DHolpur
D418 DungarpurDH457 Shri Hari Dev Joshi Genaral Hospital Dungarpur
D419 GanganagarDH458 Govt Hospitls Sriganganagar
D420 HanumangarhDH459 DH Hanumangarh Town
D421 JaisalmerDH460 Jawahar Hospital Jaisalmer
D422 JalorDH461 District Hospital Jalor
D423 JhunjhununDH462 B.D.K. Hospital Jhunjhunun
D424 KarauliDH463 General Hospital Karauli
D425 NagaurDH464 District Hospital Nagaur
D426 PaliDH465 Govt Bangur Hopital Pali
D427 PratapgarhDH466 District Hospital Pratapgarh
D428 RajsamandDH467 RK District Hospital Rajsamand
D429 Sawai MadhopurDH468 General Hospital Sawai Madhopur
D430 SikarDH469 S K Hospital, Sikar Annexures
204
District
Code
DistrictDH CodeDistrict Hospital (DH)
D431 SirohiDH470 General Hospital Sirohi
D432 TonkDH471 District Sahadat Hospital Tonk
Sikkim
D433 Sikkim EastDH472 Singtam Hospital
D434 Sikkim NorthDH473 Mangan Hospital
D435 Sikkim SouthDH474 Namchi District Hospital
D436 Sikkim WestDH475 District Hospital Gyalshing
Tamil Nadu
D437 AriyalurDH476 Ariyalur
D438 ChennaiDH477 Kilpauk Hospital
D439 CoimbatoreDH478 Pollachi
D440 CuddaloreDH479 Cuddalore
D441 DharmapuriDH480 Pennagaram
D442 DindigulDH481 Dindigul
D443 ErodeDH482 Erode
D444 KancheepuramDH483 Kancheepuram
D445 KanniyakumariDH484 Padhmanabapuram
D446 KarurDH485 Kulithalai
D447 KrishnagiriDH486 Krishnagiri
D448 MaduraiDH487 Usilampatti
D449 NagapattinamDH488 Nagapattinam
D450 NamakkalDH489 Namakkal
D451 NilgirisDH490 Uthagamandalam
D452 PerambalurDH491 Perambalur
D453 PudukkottaiDH492 Aranthangi
D454 RamanathapuramDH493 Ramanathapuram
D455 SalemDH494 Mettur Dam
D456 SivagangaDH495 Karaikudi
D457 ThanjavurDH496 Kumbakonam
D458 TheniDH497 Periakulam
D459 ThiruvallurDH498 Thiruvallur
D460 ThiruvarurDH499 Mannargudi
D461 TiruchirappalliDH500 Manapparai
D462 TirunelveliDH501 Tenkasi
D463 TirupurDH502 Tiruppur
D464 TiruvanamalaiDH503 Cheyyar
D465 ToothukudiDH504 Kovilpatti
D466 VelloreDH505 Walajapet
D467 ViluppuramDH506 Kallakurichi Annexures
205
District
Code
DistrictDH CodeDistrict Hospital (DH)
D468 VirudhunagarDH507 Virudhunagar
Telangana
D469 HyderabadDH508 Kingkoti
D470 Karim NagarDH509 Karimnagar
D471 KhammamDH510 DH Khammam
D472 NalgondaDH511 Nalgonda
D473 SangareddyDH512 DH Sangareddy
D474 VikarabadDH513 Tandur
Tripura
D475 DhalaiDH514 DHalai District Hospital
D476 GomatiDH515 District Hospital Gomati District
D477 KhowaiDH516 Khowai District Hospital
D478 North TripuraDH517 District Hospital North Tripura
D479 South TripuraDH518 District Hospital South
D480 UnakotiDH519 District Hospital Unakoti District
Uttar Pradesh
D481 AgraDH520 DH Male
D481 AgraDH521 DH Female
D482 AligarhDH522 Pt Deen Dayal District Combined Hospital
D482 AligarhDH523 Mohan Lal Gautam District Female Hospital
D482 AligarhDH524 Malkhan Singh District Hospital
D483 Ambedkar NagarDH528 Mahatma Jyotiba Phule District Hospital
D484 AuraiyaDH529 District Combined Hospital Auraiya
D484 AuraiyaDH530 District Combined Hospital Chicholi
D485 AzamgarhDH531 District Women Hospital
D485 AzamgarhDH532 District Hospital Azamgarh
D486 BagpatDH533 District Combined Hospital
D487 BahraichDH534 District Women Hosp
D487 BahraichDH535 District Male Hosp
D488 BalliaDH536 District Male Hospitol Ballia
D488 BalliaDH537 District Fimale Hospitol Ballia
D489 BalrampurDH538 District Women Hospital
D489 BalrampurDH539 District Memeorial Male Hospital
D489 BalrampurDH540 District Combined Hospital
D490 BandaDH541 DWH Banda
D490 BandaDH542 DH Banda
D491 BarabankiDH543 DWH Barabanki
D491 BarabankiDH544 DH Barabanki
D492 BareillyDH545 District Male Hospital Annexures
206
District
Code
DistrictDH CodeDistrict Hospital (DH)
D492 BareillyDH546 District Female Hospital
D493 BastiDH547 District Female Hospital
D493 BastiDH548 District Male Hospital
D493 BastiDH549 Opec Hospital Kaily
D494 BijnorDH550
Pandit Deendayal Upadyaya District Combined
Hospital Bijnor Male
D494 BijnorDH551
Pandit Deendayal Upadyaya District Combined
Hospital Bijnor Female
D495 BudaunDH552 District Female Hospital Budaun
D495 BudaunDH553 District Hospital Badaun
D496 BulandshaharDH554 K.M.C Bulandshahr
D496 BulandshaharDH555 Joint Hospital Sikandrabad
D496 BulandshaharDH556 Ssmj Hospital Khurja
D496 BulandshaharDH557 B.B.D.Government Hospital
D497 ChandauliDH558 Pt K P T DistrictCombined Hospital Chandauli
D497 ChandauliDH559 Rajkiya Mahila Chikitsalaya Mughalsarai
D497 ChandauliDH560 Combined Hospital Chakiya Chandauli
D498 ChitrakootDH561 District Combined Hospital
D499 DeoriaDH562 District Hospital Female
D499 DeoriaDH563 District Hospital Male
D500 EtahDH564 Distt Male Hospital
D500 EtahDH565 District Women Hospital
D501 EtawahDH566 District Women Hospital F
D501 EtawahDH567 District Male Hospital
D502 FaizabadDH568 DistrictFemale Hospital
D502 FaizabadDH569 Sri Ram Ayodya
D502 FaizabadDH570 Distt Male Hospital
D503 FarrukhabadDH571 Dr Ram Manohar Lohiya Female
D503 FarrukhabadDH572 Dr Ram Manohar Lohiya Male
D503 FarrukhabadDH573 Civil Hospital Linziganj
D504 FatehpurDH574 District Hospital Female
D504 FatehpurDH575 District Hospital Male
D505 FirozabadDH576 District Women Hospital
D505 FirozabadDH577 Rnm District Joint Hospital
D506 Gautam Buddha NagarDH578 Combined Distt Hospital Noida
D507 GhaziabadDH579 District Women Hospital
D507 GhaziabadDH580 District Combined Hospital Sanjay Nagar
D507 GhaziabadDH581 District Mmg Male Hospital
D508 GhazipurDH582 District Woman Hospital Annexures
207
District
Code
DistrictDH CodeDistrict Hospital (DH)
D508 GhazipurDH583 District Hospital
D509 GondaDH584 DWH
D509 GondaDH585 DH
D510 GorakhpurDH586 Neta Ji Subhash Chandra Bose District Hospital
D510 GorakhpurDH587 District Women Hospital
D511 HamirpurDH588 District Women Hospital
D511 HamirpurDH589 District Men Hospital
D512 HardoiDH590 District Women Hospital
D512 HardoiDH591 District Male Hospita
D513 HathrasDH592 Bagala Joint District Hospital, Hathras
D513 HathrasDH593 District Female Hospital Hathras
D514 JalaunDH594 District Women Hospital
D514 JalaunDH595 District Hospital
D515 JaunpurDH596 District Femail Hospital
D515 JaunpurDH597 District Male Hospital
D516 JhansiDH598 District Women Hospital
D516 JhansiDH599 District Hospital
D517 Jyotiba Phule NagarDH600 Amroha
D518 KannaujDH601 Combined District Hospital Kannauj
D519 Kanpur DehatDH602 District Combined Hospital
D520 Kanpur NagarDH603 UHM Male Hospital
D520 Kanpur NagarDH604 Kpm Hospital Kanpur Nagar
D520 Kanpur NagarDH605 Manyawar Kashiram Hospital
D520 Kanpur NagarDH606 Distric Women Hospital
D521 Kashi Ram NagarDH607 WH
D522 KaushambiDH608 District Combined Hospital
D523 KushinagarDH609 District Combined Hospital Kushinagar
D524 Lakhimpur KheriDH610 DFH
D524 Lakhimpur KheriDH611 DH
D525 LalitpurDH612 District Female Hospital
D525 LalitpurDH613 District Male Hospital
D526 LucknowDH614 Shyama Prasad Mukherjee
D526 LucknowDH615 Balrampur Hospital Lucknow
D526 LucknowDH616 Awanti Bai Mahila Hospitals
D526 LucknowDH617 Ram Manohar Lohiya
D526 LucknowDH618 Rani Laxmi Bai Combined Hospital
D526 LucknowDH619 Lokbandhu Raj Narain
D526 LucknowDH620 Jhalkari Bai Mahila Hospitals
D526 LucknowDH621 RSM Combined Hospital Annexures
208
District
Code
DistrictDH CodeDistrict Hospital (DH)
D526 LucknowDH622 Bhau Rao Devras Hospital Mahanagar
D527 MaharajganjDH623 District Combined Hospital
D528 MahobaDH624 DWH Mahoba
D528 MahobaDH625 DH Mahoba
D529 MainpuriDH626 District Female Hospital
D529 MainpuriDH627 District Male Hospital
D530 MathuraDH628 District Women Hospital
D530 MathuraDH629 District Combined Hospital
D530 MathuraDH630 District Male Hospital
D531 MaunathbhanjanDH631 District Women Hospital
D531 MaunathbhanjanDH632 District Hospital
D532 MeerutDH633 District Women Hospital
D532 MeerutDH634 P.L. Sharma Hospital
D533 MirzapurDH635 DistrictWoman Hospital Mzp
D533 MirzapurDH636 District Hospital Mirzapur
D534 MoradabadDH637 Male District Hospital
D534 MoradabadDH638 Female District Hospital
D535 MuzaffarnagarDH639 Female District Hospital Muzaffar Nagar
D535 MuzaffarnagarDH640
Swami Kalyan Dev District Hospital Muzaffar
Nagar
D536 PilibhitDH641 District Male Hospital
D536 PilibhitDH642 District Women Hospital
D537 PratapgarhDH643 District Women Hospital
D537 PratapgarhDH644 District Male Hospital
D538 PrayagrajDH525 Moti Lal Nehru District Hospital
D538 PrayagrajDH526 District Women Hospital
D538 PrayagrajDH527 Tej Bahadur Sapru Hospital
D539 Rae BareliDH645 District Female Hospital
D539 Rae BareliDH646 District Hospital
D540 RampurDH647 District Male Hospital
D540 RampurDH648 District Woman Hospital
D541 SaharanpurDH649 District Women Hospital
D541 SaharanpurDH650 SBD District Hospital
D542 SambhalDH651 District Combined Hospital
D543 Sant Kabir NagarDH652 District Combined Hospital Sant Kabir Nagar
D544 Sant Ravidas NagarDH653 Maharaja Chet Singh District Hospital
D544 Sant Ravidas NagarDH654 Maharaja Balavant Singh Distric Hospital
D545 ShahjahanpurDH655 District Women Hospital
D545 ShahjahanpurDH656 District Male Hospital Annexures
209
District
Code
DistrictDH CodeDistrict Hospital (DH)
D546 ShrawastiDH657 Combined District Hospital
D547 Siddharth NagarDH658 District Combined Hospital
D548 SitapurDH659 District Women Hospital
D548 SitapurDH660 District Hospital Male Sitapur
D549 SonbhadraDH661 District Combined Hospital Robertsganj
D550 SultanpurDH662 District Women Hospital
D550 SultanpurDH663 District Hospital
D551 UnnavDH664 Uma Shankar Female Hospital
D551 UnnavDH665 Uma Shanker Male Hospital
D552 VaranasiDH666 District Women Hospital Varanasi
D552 VaranasiDH667 Pt. Deen Dayal Upadhyay Govt Hospital
D552 VaranasiDH668 Lbs Ramnagar Hospital
D552 VaranasiDH669 S.S.P.G. Div. Dist. Hospital
Uttarakhand
D553 AlmoraDH670 Distt Female Hosptial
D553 AlmoraDH671 Distt Hosptial Almora
D554 BageshwarDH672 Shyam Lal Shah DH
D555 ChamoliDH673 District Hospital
D556 ChampawatDH674 DH Champawat
D557 GarhwalDH675 DH Pauri
D557 GarhwalDH676 DH Female Pauri
D558 HardwarDH677 Cr Women Govt Hospital
D558 HardwarDH678 Hmg Hospital Hardwar
D559 NainitalDH679 B.D.Pandey Male Hospital
D559 NainitalDH680 B.D.Pandey Female Hospital
D560 PithoragarhDH681 H G Pant District Female Hospital
D560 PithoragarhDH682 B D Pandey District Male Hospital
D561 RudraprayagDH683 District Hospital Rudraprayag
D562 Tehri GarhwalDH684 DH Bauradi
D563 Udham Singh NagarDH685 J.L.N. District Hospital
D564 UttarkashiDH686 District Hospital
D564 UttarkashiDH687 District Female Hospital
West Bengal
D565 AlipurduarDH688 Alipurduar District Hospital
D566 BirbhumDH689 Rampuhat DH & SSH
D567 Dakshin DinajpurDH690 Balurghat DH & SSH
D568 DarjilingDH691 Siliguri DH
D568 DarjilingDH692 Darjeeling DH
D569 HowrahDH693 Howrah District Hospital Annexures
210
District
Code
DistrictDH CodeDistrict Hospital (DH)
D570 HugliDH694 Imambara District Hospital
D571 JalpaiguriDH695 Jalpaiguri DH & SSH
D572 JhargramDH696 Jhargram DH & SSH
D573 Koch BiharDH697 Mjn District Hospital
D574 NadiaDH698 District Hospital Nadia
D575 North Twenty Four Parganas DH699 Barasat DH
D575 North Twenty Four Parganas DH700 Basirhat DH & SSH
D576 Paschim BarddhamanDH701 Asansol DH & SSH
D577 Purba MedinipurDH702 Tamluk District Hospital
D577 Purba MedinipurDH703 Nandigram DH & SSH
D578 PuruliyaDH704 D.M.Sadar DH & SSH
D579 South Twenty Four Parganas DH705 M. R. Bangur DH & SSH
D579 South Twenty Four Parganas DH706 Diamond Harbour DH & SSH
D580 Uttar DinajpurDH707 Raiganj DH & SSH
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