[Productivity of teaching hospitals in the state of São Paulo,Brazil]

Teaching hospitals can be defined as hospitals whose mission is both to provide health care to the population and to train qualified professionals. This represents high costs that need to be balanced by higher productivity and quality. The aim of the present study was to identify the level of productivity in five teaching hospitals in the state of São Paulo, Brazil. For that, we measured indicators such as patient length of stay, patient turnover rate, substitution interval, and number of employees per hospital bed. For a better understanding of the reality of these teaching hospitals, data regarding morbidity and geographic range of influence were also analyzed. Results were compared with the results from a previous study which analyzed private tertiary and secondary hospitals and public secondary hospitals. Productivity was defined as inversely proportional to length of stay, patient turnover rate, substitution interval, and number of employees per hospital bed. We observed that private hospitals have a higher productivity in terms of most indicators, which suggests that these hospitals make a more efficient use of their human, material, and financial resources. Teaching hospitals have a higher length of stay than the other hospitals (median = 7 days); lower turnover rate than private hospitals and similar to public hospitals (median = 3.70 days); higher employee per bed ratio than the private hospitals, and smaller than public hospitals (median = 7 employee/hospital bed). Substitution interval was different for each type of hospital; only public hospitals had a lower substitution interval than teaching hospitals (median = 1.70 days).