• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of hsresearchLink to Publisher's site
Health Serv Res. Jun 2001; 36(2): 421–442.
PMCID: PMC1089232

Strategies for cutting hospital beds: the impact on patient service.

Abstract

OBJECTIVE: To develop insights on the impact of size, average length of stay, variability, and organization of clinical services on the relationship between occupancy rates and delays for beds. DATA SOURCES: The primary data source was Beth Israel Deaconess Medical Center in Boston. Secondary data were obtained from the United Hospital Fund of New York reflecting data from about 150 hospitals. STUDY DESIGN: Data from Beth Israel Deaconess on discharges and length of stay were analyzed and fit into appropriate queueing models to generate tables and graphs illustrating the relationship between the variables mentioned above and the relationship between occupancy levels and delays. In addition, specific issues of current concern to hospital administrators were analyzed, including the impact of consolidation of clinical services and utilizing hospital beds uniformly across seven days a week rather than five. PRINCIPAL FINDINGS: Using target occupancy levels as the primary determinant of bed capacity is inadequate and may lead to excessive delays for beds. Also, attempts to reduce hospital beds by consolidation of different clinical services into single nursing units may be counterproductive. CONCLUSIONS: More sophisticated methodologies are needed to support decisions that involve bed capacity and organization in order to understand the impact on patient service.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Gaynor M, Anderson GF. Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds. J Health Econ. 1995 Aug;14(3):291–317. [PubMed]
  • Hershey JC, Weiss EN, Cohen MA. A stochastic service network model with application to hospital facilities. Oper Res. 1981 Jan-Feb;29(1):1–22. [PubMed]
  • Luft HS, Hunt SS, Maerki SC. The volume-outcome relationship: practice-makes-perfect or selective-referral patterns? Health Serv Res. 1987 Jun;22(2):157–182. [PMC free article] [PubMed]
  • Lynk WJ. The creation of economic efficiencies in hospital mergers. J Health Econ. 1995 Dec;14(5):507–530. [PubMed]
  • Myers LP, Fox KS, Vladeck BC. Health services research in a quick and dirty world: the New York City hospital occupancy crisis. Health Serv Res. 1990 Dec;25(5):739–755. [PMC free article] [PubMed]
  • Pasley BH, Lagoe RJ, Marshall NO. Excess acute care bed capacity and its causes: the experience of New York State. Health Serv Res. 1995 Apr;30(1):115–131. [PMC free article] [PubMed]
  • Pauly MV, Wilson P. Hospital output forecasts and the cost of empty hospital beds. Health Serv Res. 1986 Aug;21(3):403–428. [PMC free article] [PubMed]
  • Phillips KA, Luft HS, Ritchie JL. The association of hospital volumes of percutaneous transluminal coronary angioplasty with adverse outcomes, length of stay, and charges in California. Med Care. 1995 May;33(5):502–514. [PubMed]
  • Schneider D. A methodology for the analysis of comparability of services and financial impact of closure of obstetrics services. Med Care. 1981 Apr;19(4):393–409. [PubMed]
  • Schwartz WB, Joskow PL. Duplicated hospital facilities: How much can we save by consolidating them? N Engl J Med. 1980 Dec 18;303(25):1449–1457. [PubMed]
  • Worthington DJ. Queueing models for hospital waiting lists. J Oper Res Soc. 1987 May;38(5):413–422. [PubMed]
  • Yao SL, Lu-Yao G. Population-based study of relationships between hospital volume of prostatectomies, patient outcomes, and length of hospital stay. J Natl Cancer Inst. 1999 Nov 17;91(22):1950–1956. [PubMed]
  • Young JP. Stabilization of inpatient bed occupancy through control of admissions. Hospitals. 1965 Oct 1;39(19):41–48. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...