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NYC OB units losing millions due to misallocation of beds

Almost no obstetric units in New York City correctly match their bed capacity and patient demand, according to a recently published study in Medical Care Research and Review.

“Our study reveals significant variation across NYC obstetrics units in their capacity utilization…If obstetrics beds were allocated appropriately citywide, the financial savings due to this reallocation alone could amount to between 10.4 and 26.5 million dollars per year,” Linda V. Green, BS, Columbia Business School, and Nan Liu, PhD, MS, Mailman School of Public Health, Columbia University, wrote.

Nan Liu

Green and Liu analyzed data from 40 hospitals, which included all births in NYC from 2008 and 2009, to evaluate bed capacity within obstetric units. Admission date and time, discharge date and time, delivery method and institution were all included in the analysis. In total, the hospitals collectively had roughly 240,000 maternal admissions between 2008 and 2009.

Results demonstrated that the average bed capacity between 2008 to 2009 within obstetric units was 34.5 beds, and a total capacity of 1,381 beds. Significant discrepancies were seen between the hospitals, with some units having a yearly occupancy rate of 34%, while others were almost always above capacity, resulting in one-fifth of postpartum women being delayed bed placement.

Of the 40 obstetrics units, 8 units in 2008 and 9 units in 2009 were significantly under-utilized. Over-utilization was seen in 11 units in 2008, and 12 units in 2009. This over-utilization led to a bed delay of more than 10%. Overall, excess capacity exceeded 183 beds, while overall shortages were more than 54 beds per year.

The researchers noted that moving forward, hospitals should be identifying bed demands using data-based models. This will ensure that patients receive timely access to care in addition to controlling costs.

“Insufficient bed capacity could lead to congestion in the delivery units, placement of postpartum mothers into inappropriate areas and earlier discharge of patients than desired, all of which might be associated with adverse patient outcomes and result in additional health care costs. In an environment which it has become critical to reduce unnecessary costs, it is imperative to identify excess impatient bed capacity,” Liu and Green wrote. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.