ARPOB (Average Revenue Per Occupied Bed) is inpatient revenue divided by occupied bed-days, usually quoted per day; ALOS (Average Length of Stay) is total inpatient days divided by the number of discharges; and the bed occupancy rate is occupied bed-days divided by available bed-days, multiplied by 100. Together they explain most of a hospital's inpatient economics: occupancy says how full the hospital is, ALOS how long each patient stays, and ARPOB how much each occupied bed earns. Listed Indian chains in 2026 report ARPOB between roughly ₹35,000 and ₹82,000 a day, occupancy of 50–77% and ALOS of 2.6–4.3 days, while ICRA put sector occupancy at 63.5% for FY26.
This guide is for hospital owners, CEOs, CFOs, medical superintendents and quality managers preparing for NABH. It gives the exact formula for each KPI, a worked example for a 50-bed hospital, the latest published benchmarks, and the traps that make two hospitals' "ARPOB" impossible to compare.
Key takeaways
- Count bed-days, not beds. Occupancy, ALOS and ARPOB all start from occupied bed-days — usually the sum of the midnight census for each day of the period.
- The three are linked. Occupied bed-days = discharges × ALOS. Cutting ALOS without more admissions lowers occupancy; ARPOB usually rises as ALOS falls, because the costliest days of a stay come first.
- Units differ. Max, Medanta, Jupiter and Rainbow quote ARPOB per day; Fortis quotes ₹ crore per annum and Narayana ₹ million per annum. Divide annual figures by 365 before comparing.
- Apollo stopped reporting ARPOB from Q1 FY26 and reports revenue per patient (ARPP) instead.
- "Ideal" occupancy is 80–85%, not 100%: the Indian Public Health Standards benchmark is 80%, and UK research found risks rising above about 85%.
- NABH asks for indicators, not a fixed list of numbers. The 6th edition, in force since 1 January 2025, requires hospitals to monitor managerial and clinical indicators and to set and monitor a discharge-time benchmark.
The core inpatient KPIs and their formulas
| KPI | Full form | Formula | What it tells you |
|---|---|---|---|
| BOR | Bed occupancy rate | Occupied bed-days ÷ (operational beds × days in period) × 100 | How full the hospital is |
| ALOS | Average length of stay | Total inpatient days of discharged patients ÷ number of discharges (including deaths) | How long a typical admission lasts |
| ARPOB | Average revenue per occupied bed (per day) | Inpatient revenue ÷ occupied bed-days | How much a filled bed earns each day |
| ARPP | Average revenue per patient | Inpatient revenue ÷ number of inpatients (discharges) | Revenue per admission; ARPP ≈ ARPOB × ALOS |
| BTR | Bed turnover rate | Discharges (including deaths) ÷ operational beds | How many patients each bed served in the period |
| TOI | Bed turnover interval | (Available bed-days − occupied bed-days) ÷ discharges | Average days a bed lies empty between patients |
Occupied bed-days are normally taken from the midnight census: the number of inpatients in beds at midnight, added up for every day of the month. A government scheme indicator list used in Maharashtra defines occupancy exactly this way — the sum of midnight census × 100 ÷ (operational beds × days in the month). Day-care patients are usually excluded or counted separately, and your definition should say which.
What goes into ARPOB
Definitions vary between hospitals, which is why ARPOB comparisons go wrong:
- Medanta defines it as hospital revenue excluding pharmacy and other income, divided by occupied bed-days.
- Manipal's disclosures use revenue from sale of healthcare services divided by occupied bed-days.
- Some hospitals include outpatient revenue in the numerator; most analysts exclude it, because OPD revenue is not earned by a bed.
Pick one definition, write it in your MIS policy, and keep it constant. A hospital that adds pharmacy to the numerator one quarter can "grow" ARPOB by 15% overnight.
A worked example: a 50-bed hospital in October
Take a 50-bed hospital in a tier-2 city, for October (31 days):
- Available bed-days = 50 × 31 = 1,550
- Midnight census added up over the month = 1,147 occupied bed-days
- Discharges, including 4 deaths = 310
- Inpatient revenue, excluding pharmacy = ₹1.03 crore
| KPI | Calculation | Result |
|---|---|---|
| Bed occupancy rate | 1,147 ÷ 1,550 × 100 | 74% |
| ALOS | 1,147 ÷ 310 | 3.7 days |
| ARPOB (per day) | ₹1,03,00,000 ÷ 1,147 | ₹8,980 |
| ARPP | ₹1,03,00,000 ÷ 310 | ₹33,226 |
| Bed turnover rate | 310 ÷ 50 | 6.2 patients per bed |
| Turnover interval | (1,550 − 1,147) ÷ 310 | 1.3 days |
Read together: the hospital is three-quarters full, each bed stays empty for about a day and a third between patients, and each occupied bed earns about ₹9,000 a day. If ALOS fell to 3.2 days with the same admissions, occupancy would drop to 64% — so ALOS improvements have to be matched by more admissions, which is the job of the OPD and referral desk.
Other KPIs management should track
| KPI | Formula | Why it matters |
|---|---|---|
| OPD-to-IPD conversion | Admissions from OPD ÷ OPD consultations × 100 | Shows whether OPD footfall feeds the wards |
| Payor mix | Revenue by cash, insurance/TPA, PM-JAY and other schemes, and corporate ÷ total | Scheme and insurance revenue settles later and at negotiated rates |
| LAMA / DAMA rate | Patients leaving against medical advice × 100 ÷ admissions | A quality and revenue-leakage signal; Indian studies report 3–5% in general settings and much higher in some ICUs |
| Gross mortality rate | Deaths × 100 ÷ discharges including deaths | Reviewed by department and case mix, not as one hospital number |
| Readmission rate | Readmissions for the same condition within a set period (often 30 days) × 100 ÷ discharges | Flags premature discharge or poor follow-up |
| Discharge turnaround time | Time from discharge order to patient leaving, averaged | NABH asks hospitals to set and monitor a benchmark; slow discharges block admissions. See how to speed up the discharge summary |
| OT utilisation | Minutes of OT time used ÷ minutes of OT time available × 100 | OTs are the most expensive rooms in the hospital |
| EBITDA per bed | EBITDA ÷ operational beds (annual) | The investor's measure of how well capacity converts to profit |
| Revenue per doctor and department | Revenue attributed to a doctor or department ÷ period | Shows which specialties carry the hospital |
2026 benchmarks: listed Indian hospital chains
The latest figures available on 5 November 2026, from company disclosures and broker notes. Large chains run tertiary and quaternary care in metros, so their ARPOB is several times a typical tier-2 or tier-3 hospital's — use them for direction, not as a target.
| Hospital group | Period | ARPOB (per day) | Occupancy | ALOS (days) |
|---|---|---|---|---|
| Max Healthcare | Q1 FY27 | ₹81,900 | ~75% (77% in Q2 FY27) | — |
| Fortis Healthcare | Q1 FY27 | ~₹74,300 (₹2.71 crore per annum) | 68.7% | 4.19 |
| Jupiter Life Line | Q2 FY27 | ₹71,800 | 59.5% (H1) | 3.79 |
| Medanta (Global Health) | Q1 FY27 | ₹70,244 | 62.6% | 2.87 |
| Manipal Hospitals | FY26 (IPO prospectus) | ₹68,958 | 64.5% | 2.78 |
| Rainbow Children's | Q2 FY27 | ₹63,400 | 49.2% | 2.64 |
| Narayana Health (India) | Q2 FY27 | ~₹53,400 (₹19.5 million per annum) | — | 4.3 (Q1) |
| KIMS Hospitals | Q1 FY27 | ₹47,200 | 49% of operational beds | 3.47 |
| Yatharth Hospital | Q1 FY27 | ₹34,758 | — | — |
| Apollo Hospitals | Q1 FY27 | Reports ARPP instead | 70% | — |
For the sector as a whole, ICRA's July 2026 update on 11 listed hospital companies put FY26 occupancy at 63.5% with ARPOB up 9.2%, and expects ARPOB to grow 6–8% in FY27. CRISIL Ratings, covering 98 hospitals, expects occupancy of about 65% and ARPOB of about ₹52,200 in FY27.
What is a good bed occupancy rate?
Around 80–85% for most hospitals. The Indian Public Health Standards benchmark for district hospitals is 80%, as cited by the CAG. A study of hospital bed capacity in the BMJ found that risks become noticeable above about 85% and bed crises regular at 90% and above, because there is no slack for emergencies. Very low occupancy is a cost problem; sustained occupancy above 90% is a safety problem — admissions get refused, and patients wait on trolleys.
NABH and hospital KPIs
The NABH 6th edition standards for hospitals were released on 17 September 2024 and became effective on 1 January 2025. Under the Patient Safety and Quality chapter, the hospital identifies key indicators to monitor structures, processes and outcomes, including managerial indicators — bed occupancy and ALOS are the usual examples. The access and continuity of care chapter requires the hospital to monitor discharge time, set benchmarks and improve on them. NABH runs a separate training programme on the mandatory organisational and department-specific KPIs of the 6th edition.
Two practical points for assessments: define every indicator in writing (numerator, denominator, source, frequency, owner), and show the trend and the action taken, not just the number. Our guide to NABH accreditation and hospital software covers the documentation side.
Common mistakes that distort hospital KPIs
- Licensed beds instead of operational beds. A hospital licensed for 100 beds with 70 staffed has a very different occupancy depending on which it uses. Use operational beds and say so.
- Counting day-care as inpatients. Day-care patients inflate admissions and depress ALOS. Report them separately.
- Mixing gross and net revenue. Scheme and TPA bills are often settled below the billed amount. ARPOB on billed revenue overstates what the hospital earns.
- Annual figures compared with daily ones. Divide per-annum ARPOB by 365.
- Midnight census taken from memory. If admissions and discharges are not entered in real time, the census — and every KPI built on it — is wrong.
- One hospital-wide number. Occupancy and ALOS mean little across ICU, wards and day-care combined. Track them by ward and specialty.
Getting the numbers out of your HMS
Every KPI above depends on four facts being recorded on time: when a patient was admitted, where they were bedded, when they left and how, and what was billed. With those in the HMS, the KPIs are arithmetic. Healthixio records them as part of the normal workflow:
- Live bed position: the dashboard shows live occupancy and a ward-wise occupancy chart, with today's admissions and discharges, and the Bed Status screen shows every bed.
- Admission and discharge records: the IPD report lists admissions for any period, and every discharge records its type — routine, LAMA, DAMA, referred, transfer, absconded, death and others — so LAMA and mortality counts come from data, not memory.
- Revenue by doctor and billing type: the MIS report breaks down OPD consultations by doctor, OPD billing by type such as lab and radiology, and IPD payments, refunds and expenses; the Daily Report and Day Wise Summary give the day's collections.
- Referral business through doctor commission and referral management.
Healthixio does not yet calculate ARPOB, ALOS or occupancy rate as a single report, so most hospitals compute them monthly from these reports with the formulas above. See the MIS and reporting module and our list of MIS reports every hospital administrator needs.
Frequently Asked Questions
What is the full form of ARPOB?
ARPOB stands for Average Revenue Per Occupied Bed. It is inpatient revenue divided by occupied bed-days, and Indian hospitals usually quote it per day.
How is ARPOB calculated?
Divide inpatient revenue for the period by occupied bed-days for the same period. A hospital with ₹1.03 crore of inpatient revenue and 1,147 occupied bed-days in a month has an ARPOB of about ₹8,980 a day. State whether pharmacy and other income are included.
What is the formula for bed occupancy rate?
Bed occupancy rate = occupied bed-days ÷ (operational beds × number of days) × 100. Occupied bed-days are usually the sum of the daily midnight census.
What is ALOS in a hospital and how is it calculated?
ALOS is Average Length of Stay: total inpatient days of discharged patients divided by the number of discharges, including deaths. Listed Indian chains report 2.6–4.3 days in 2026.
What is a good bed occupancy rate for a hospital in India?
About 80–85%. The IPHS benchmark for district hospitals is 80%, and research shows safety risks rising above about 85%. Listed chains averaged 63.5% in FY26 according to ICRA.
Why did Apollo stop reporting ARPOB?
From Q1 FY26 Apollo Hospitals reports average revenue per patient (ARPP) instead of ARPOB. The two measure the same revenue differently: ARPP is approximately ARPOB multiplied by ALOS, so a hospital that shortens stays sees ARPOB rise even when revenue per admission does not.
What is the difference between bed turnover rate and turnover interval?
Bed turnover rate is the number of patients each bed served in a period (discharges ÷ beds). Turnover interval is the average number of days a bed stays empty between patients ((available − occupied bed-days) ÷ discharges).
Which KPIs does NABH require?
NABH's 6th edition requires hospitals to identify and monitor key indicators of structure, process and outcome, including managerial indicators such as bed occupancy and ALOS, and to monitor discharge time against a benchmark the hospital sets.
Run your hospital on numbers you trust
KPIs are only as good as the admission, bed and billing data underneath them. Book a demo of Healthixio to see the dashboard and reports on real screens, or browse the product tour.
Sources
- WHO Europe, bed occupancy rate and average length of stay definitions: gateway.euro.who.int
- ICRA, hospital sector update, 30 July 2026: icra.in
- NABH, implementation plan for the 6th edition hospital standards: portal.nabh.co
- Bagust et al., dynamics of bed use in accommodating emergency admissions, BMJ 1999: PMC
- Company figures from quarterly disclosures and broker notes for Q1–Q2 FY27, including Fortis, Rainbow and KIMS
Last reviewed 5 November 2026. Company figures change every quarter; check the latest investor presentation.