Glossary of hospital management and KPIs

Autorização de Internação Hospitalar: the document through which SUS authorizes and pays for an admission. Each AIH has a main procedure, with a value and an expected length of stay defined in the SUS procedure table.

The average number of days the hospital takes to receive what it billed. Usual formula: accounts receivable ÷ average daily billing. See average collection period.

The average time, in days, that patients stay admitted. Formula: patient-days ÷ discharges (including deaths and external transfers) for the period. See average length of stay.

The average number of days the hospital takes to pay suppliers. Usual formula: accounts payable ÷ average daily purchases.

Average value per encounter: revenue ÷ number of encounters. Supplies and physician-fee tickets are also calculated. See hospital average ticket.

A unit representing one bed available for one day. The sum of operational bed-days in the period is the denominator of the occupancy rate.

Also called the renewal index: number of discharges ÷ number of beds in the period. It shows how many patients, on average, passed through each bed.

The set of data, calculation rules and dashboards that turns system records into information for decisions. See hospital BI.

A comparison between the budget and the actual result, by income statement line and by cost center, in amount and percentage. See budget vs. actual.

Full or partial refusal by a payer or SUS to pay an account item, for technical or administrative reasons ("glosa" in Brazil). Denial rate = denied amount ÷ billed amount. See hospital claim denials.

Revenue minus deductions and variable costs (denials, supplies, drugs, physician fees passed through). It shows how much each payer, specialty or procedure leaves to cover fixed cost. It can be read in amount and as a percentage of revenue. See contribution margin by payer.

A unit that accumulates costs for analysis, such as the ICU, surgical center or laundry. Cost centers are productive (revenue-generating), support or administrative.

A screen that brings together the KPIs for one topic, with filters, comparisons and drill-down to detail. See hospital dashboard.

Clic Health's read agent installed at the hospital. It reads the Tasy database with a read-only user, brings only what changed and sends it to the Connection Environment over HTTPS. See how it works.

An amount billed and accepted that was not paid when due. Different from a denial, which is a refusal to pay.

Total discharges, deaths and external transfers in the period. It is the denominator of average length of stay.

Earnings before interest, taxes, depreciation and amortization. It shows the cash generated by operations, without the effect of the debt structure and equipment investment.

A cost that does not vary with patient volume in the short term, such as structure, fixed payroll, maintenance contracts and depreciation.

A projection of the result to the end of the period (usually the year), based on actuals to date and expected trends and events.

A comparison of an income statement line or KPI over time (month by month, year over year), in amount and percentage. It shows trend and seasonality.

The report showing a period's revenue, deductions, costs, expenses and result ("DRE" in Brazil). In hospital management, it is usually organized in a management format, with contribution margin and operating result. See how to analyze a hospital income statement.

Brazil's General Data Protection Law (Law No. 13,709/2018). It classifies health-related data as sensitive personal data. See security and LGPD.

The percentage of beds occupied in the period. Formula: patient-days ÷ operational bed-days × 100. See hospital occupancy rate.

The result of the hospital's core activity, before financial income and expenses and non-operating items.

Orthoses, prostheses and special materials: high-cost items used mainly in surgery, with their own authorization and billing rules with payers.

The record of everything delivered and consumed in an encounter (daily rates, fees, procedures, supplies, drugs, physician fees), which generates the charge to the payer.

A unit representing one patient admitted for one day, counted in the daily census. The period's sum is the basis of the occupancy rate and average length of stay.

A health plan operator or other payer with which the hospital has a contract and price table ("convênio" in Brazil). In management, payers are analyzed by billing, denials, collection period and margin.

Amounts paid to physicians for procedures performed, according to each contract's rules (fee, on-duty hours, on-call, volume) ("repasse médico" in Brazil). See physician fee management.

Checking the account before sending it to the payer: authorization, documentation, coding and amounts. It reduces administrative denials.

Processing that replaces data identifying a person with a code, so that identification is only possible with information kept separately. In Clic Health, patients travel to the cloud identified only by a code.

The average time a bed stays empty between one patient's discharge and the next admission. Usual formula: (100 − occupancy rate) × average length of stay ÷ occupancy rate.

The materials and medicines consumed in care and charged on the patient account ("mat/med" in Brazil). They are among the hospital's largest variable costs and revenue sources.

Sistema Único de Saúde, Brazil's public health system. For the hospital, it is a payer with its own billing rules (AIH for admissions) and values (procedure table).

Days of admission beyond the expected stay for the procedure in the SUS table. They create cost for the hospital without equivalent revenue. See SUS excess length of stay.

The supplementary health information exchange standard defined by ANS, Brazil's health plan regulator: rules for electronic data exchange between providers and health plan operators, including account submission and denial returns.

Accounts for completed encounters that have not yet been billed, also called open accounts. They should be tracked by value and age. See unbilled accounts.

A cost that varies with patient volume, such as supplies, drugs and volume-based physician fees.

Each income statement line's share of the same period's revenue. It shows, for example, how much of revenue goes to payroll or supplies.

A billed amount the hospital recognizes it will not collect, after appeals are exhausted or for other reasons.