National Health Policy plays an important role in allocating National Resources to provide Healthcare Services which meet the needs of a defined Catchment Area and its Medical Charge.

World Health Organisation’s (WHO) Health Service Indicators are used to plan this region wise allocation of National Resources by the National Health Policy.  

These Health Service Indicators are also used to Monitor and Evaluate the impact of Healthcare Services provided. 

Diagnosis-Related-Grouping (DRG) indicators are functional indicators and are used for reimbursement of Hospital Charges as they tend to standardise the level of care to be provided. 

Complex, Resource-normalized indicators offer dynamic approach to utilise available resources like staff and equipment, during Emergencies like Epidemics, Pandemics and Disasters. 

The major Evaluation Indicator for assessing the physical infrastructure for Healthcare Services Delivery in a Country is the Hospital Bed Density. 

Hospital Bed Density refers to the number of Hospital Beds available per a specific unit of population, usually per 10,000 or per 1,000 people. It’s a key indicator of a country or region’s Healthcare Infrastructure and Capacity for providing Inpatient Care.  

World Health Organisation has recommended Hospital Bed Density to be 1 -2 Complement Beds per 1,000 people. 

This is also considered an indicator for General Standard of Living, the Economic and Social Status of the Country. 

It represents about 75% of the reach of the Healthcare Services in a Country in an Equitable manner. It is an easily measurable Indicator. It is used to compare National Health Systems and to compare the reach of the Healthcare Services in a Country. It is used for resource allocation. It is also used for other Healthcare Services Delivery Indicators like Number of Staff employed per bed per day, or average cost of care per bed per day, etc. for monitoring health status, risk factors, service coverage, and for evaluating the health systems performance. Bed Numbers also work well when designing and creating Healthcare Infrastructure Facilities. Hospital Bed Density remains the predominant metrics in any National Health System planning. 

The Hospital Operating License, in most countries is issued for approved Healthcare  facilities, as provided, and for a defined Bed Complement, the Hospital Provides for Patient Care. Hospitals usually have operational beds which are more than this number but are being utilised differently. The total number of Hospital Beds, as licensed, are also called the Bed Capacity of a Country or region. 

Therefore, it is important that the Hospital Bed is defined and categorised. 

1. A Licensed Complement Bed includes the following Hospital Beds. 
   • Adult Bed, which is occupied by a patient, for more than 24 hours, for custodian Care, when admitted to the Hospital. It is provided for all levels of Nursing Care including Intensive Care, Acute Care, Intermediate Care, Self Care and Urgent Care (Emergency Care in Ward or in Disaster Expansion Wards) in non-teaching Hospitals. 
   • It will be a fully Staffed and Equipped bed, ready to receive the Patient. 
   • It will include LDR beds, Eclampsia Room Beds, as provided irrespective of time of occupation. (Average occupation time of these beds is 48 – 72 Hours) 
2. A Non-complement Bed includes the following Hospital Beds. 
   • Adult Bed, which is occupied by a patient, for less than 24 hours, for custodian Care, when admitted to the Hospital. It is also called Daycare Bed. It is provided for all levels of Nursing Care, for a short time. It is provided in Daycare wards like Obstetric Suites, Surgical Suites, Endoscopy Suite, Dialysis Suite, Chemotherapy Suite, MTP Wards, Tubal Ligation Wards, etc. These beds may be occupied for less than 24 hours, for custodian Care, on direct admission or on moving a Patient from a Complement Ward. 
   • Adult Beds provided in any Treatment Room whether in Wards, OPD or elsewhere in Hospital Departments. 
   • Adult Beds provided in Emergency ward of teaching Hospitals where these are vacated at the start of the Morning Shift by moving the patients to departmental Wards. 
   • Adult Beds provided for Triage anywhere including Emergency & Trauma Department, Obstetrics, Cardiology Department, etc. 
   • Adult Beds provided anywhere in the Surgical Suites including Pre-operative Ward, Post-operative Ward, in Induction Room, in Recovery Room, in any  Operating Room, dressing Room or Procedure Room.  
   • Adult Beds provided for Obstetric Suites, in First Stage Ward, Delivery Rooms  Post-delivery Recovery Rooms or in Cardiotocography (CTG) monitoring Ward. 
   • Adult Beds provided for any Procedure Room like FNAC Room, Fracture Room, Plaster Room, TMT Room, ECT Room, etc. 
   • Adult Beds provided for observation in Diagnostic Services, Dental OPD, etc. 
   • Neonate Cribs, provided for any reason, where a new borne can be admitted and cared for. It includes all Cribs and incubators, provided for NICU, In-borne Nursery, Out borne Nursery or Phototherapy. 
   • The Non-complement Bed Count may be reported for administrative reasons but is not considered for determining the Bed Capacity of a Hospital. 

The Hospital Operating License, in most countries, needs to be revised if, at any time during the tenure of the  License, the Complement Bed Count increases or decreases by 10 or by 10% of total bed count, as specified.  

This is mandated so that Hospitals continuously meet their Fire Safety liability, Engineering Service Plants Capacity, Biomedical Engineering Service Plants Capacity, Staffing Levels, Consumable Resources, and Equipment Resources.