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


METHODS
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.


METHODS
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.


RESULTS
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.
Green
L V
LV
Graduate School of Business, Columbia University, New York, NY 10027-6902, USA.
Nguyen
V
V
D001508:Bed Conversion / Q000191:economics / Q000706:statistics & numerical data*; D001509:Bed Occupancy / Q000191:economics / Q000706:statistics & numerical data*; D001900:Boston; D003363:Cost Control; D004465:Economic Competition; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000191:economics / Q000706:statistics & numerical data*; D006754:Hospital Restructuring / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D017059:Models, Econometric; D020380:Needs Assessment / Q000458:organization & administration; D009518:New York; D010351:Patient Discharge / Q000191:economics / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D013597:Systems Analysis; D013997:Time Factors