Hospitals are more packed post-pandemic

Hospital occupancy rates were higher in 2024 than 2019. If occupancy rates trend up, the nation could face a bed shortage by 2032, according to researchers.

Article By: Susanna Vogel

Blog Source From : https://www.healthcaredive.com/

Dive Brief:

• U.S. hospitals are busier than they were before the COVID-19 pandemic, according to a study published Wednesday in JAMA Open Network. If occupancy trends continue to rise as expected, the nation could be on the brink of a bed shortage.
• Average hospital occupancy rates were up 11% in 2024 compared to 2019, due mostly to a declining supply of staffed beds rather than an increase in hospitalizations. The average supply of staffed beds fell from 802,000 beds between 2009 and 2019 to 674,000 beds between May 2023 and April 2024.
• Without changes to the projected hospitalization rate or existing bed supply, the U.S. is poised to experience an adult bed shortage by 2032, with some states experiencing a shortage before that time, according to the study.

Dive Insight:

Hospital occupancies have been elevated for several years, rising from an average of 63.9% between 2009 and 2019 to 75.3% between May 2023 and April 2024. If the average hospital occupancy rates hit 85%, researchers say the country will have a bed shortage.

Bed shortages can arise from reductions in supply, higher care demands from sicker patients or a combination of both factors. 

While hospitalizations are expected to tick up toward the end of the decade as Americans age, researchers said thus far capacity constraints have been due to reductions in available beds.

Some of the major for-profit health systems have signaled an interest in realigning their portfolios away from inpatient services toward lower cost outpatient care. Tenet Healthcare, for example, has said its main priority is growing its ambulatory surgery business line.

Other health systems are reducing services, such as maternity care, due to financial challenges or low patient volumes.

Remaining inpatient providers and consultancies have sounded the alarm about how hospital closures and service line reductions impact their operations, noting substantial spillover effects.

For example, South Shore Health told the Massachusetts Health and Hospital Association in July it was treating patients in hallways and converted conference rooms in an effort to meet heightened demand after a neighboring facility shut down, another caught fire and a third flooded.

“We physically have no more space,” South Shore Health’s Chief Medical Officer Jason Tracy told the industry group. “We’re running 550 inpatients in a 374-bed hospital.”

In California, the state hospital association likewise blamed facility closures for overcrowded emergency rooms and lengthy wait times for patients seeking care.

Backlogs can be worse for highly desirable facilities — high-quality, urban and teaching hospitals — which studies show are more likely to receive swells of new patients after a facility closure. Mass General Brigham, one of Massachusetts’ top performing academic hospitals, said in December it was experiencing an unrelenting capacity crisis and had to turn away nearly 2,000 patient transfers due to a lack of space.

Rural areas may be the most vulnerable to further reductions in services. A recent study from healthcare advisory firm Chartis found approximately 10% of rural hospitals have closed or stopped providing inpatient care since 2010, and 432 rural hospitals are presently at risk of closure. 

One study found that some hospitals can accommodate increased patient demand from closures without significant changes to their own bed count. However, researchers warned that many do so by speeding up patient care — which could be detrimental to quality.

Ahead of the projected bed shortage, health systems and hospital associations can take steps to better manage capacity.

Some systems are beginning to leverage AI, for example, to improve patient scheduling and efficiency, including coordinating with post-acute services. In Massachusetts, the MHA put together resources to help patients determine the right source of care and encourage them to use primary care services or urgent care for less serious medical matters to avoid further straining emergency departments.