US health care staffing shortages could lead to national hospital bed shortage by 2032
Key takeaways:
- The number of staffed hospital beds decreased after the COVID-19 public health emergency.
- The average national hospital occupancy could reach 85% by 2032 for adult hospital beds.
Researchers project a hospital bed shortage in less than a decade due to health care staffing shortages across the U.S., according to study results.
“When occupancy rates are high, hospital mortality [increases], so if our projections turn out to be correct, we could be facing tens to hundreds of thousands of excess deaths per year,” Catherine A. Sarkisian, MD, MSHS, professor at UCLA David Geffen School of Medicine, staff physician at Greater Los Angeles VA Healthcare System and director of the UCLA Value-Based Care Research Consortium, told Healio.
‘A moment of optimism’
During the early days of the COVID-19 pandemic, Sarkisian said she was surprised that only a few patients were on inpatient service at her institution when there were normally between 15 to 20 patients prepandemic.
“It made me realize that many times, patients are coming into the hospital that probably don’t need to come in. I had a moment of optimism thinking we would be able to keep the low census counts after the lockdowns ended; but, unfortunately, the inpatient numbers are as high as ever,” she said. “That led my colleague, Richard K. Leuchter, MD, to get the idea to project forward what could happen if we don’t change the status quo.”
Researchers multiplied U.S. Census Bureau population projections for 2025 to 2035 by an age-adjusted hospitalization rate from the 2019 to 2020 National Inpatient Sample to calculate the aging-adjusted annual number of future hospitalizations that were then used to calculate future hospital census.
They additionally calculated hospital occupancy for each year between 2025 and 2035 by dividing mean daily census by staffed hospital bed supply.
Staffed hospital beds
Results showed a mean U.S. hospital occupancy rate of 63.9% between 2009 and 2019 compared with 75.3% in the year after the end of the COVID-19 public health emergency.
Researchers also found that the number of staffed hospital beds decreased from 802,000 between 2009 and 2019 to 674,000 after the public health emergency.
The mean daily census steady state remained at nearly 510,000 staffed hospital beds, according to the researchers.
“We also calculated the number of expected hospitalizations for each year between 2025 and 2035 by adjusting for an expected jump in hospitalizations due to an aging U.S. population,” Sarkisian said. “We found that if the hospitalization rate and staffed hospital bed supply do not change, average national hospital occupancy could reach 85% by 2032 for adult hospital beds.”
‘Inspire policies’
“Our hope is that this paper can inspire policies to ensure that we do not face a catastrophic hospital bed shortage in the future,” Sarkisian said. “First and foremost, we need to dramatically improve Americans’ health so that there is much less need for hospitalizations. We also need policies that ensure there are enough hospital beds with adequate staffing, and we should implement creative health care models that allow people with acute illnesses to be safely treated as outpatients.”
Sarkisian said the UCLA Healthcare Value Analytics and Solutions team is working on projects to help keep people safely out of the hospital.
“In one exciting project, Dr. Leuchter and colleagues at Olive View-UCLA Medical Center recently launched a new health care model, Next Day Clinic, within the Los Angeles County Department of Health Services to avoid hospitalizations,” Sarkisian said. “In this innovative program, patients who might normally be admitted to the hospital immediately are given the option to be sent home and seen as outpatients the next day. At Olive View this safely prevents hundreds of hospitalizations per year; now Dr. Leuchter is leading a team measuring the impact of this model at UCLA Health.”
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For more information:
Catherine Sarkisian, MD, MSHS, can be reached at csarkisian@mednet.ucla.edu.
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