By 2032, the average U.S. hospital occupancy will rise from 75% to 85%, according to University of California Los Angeles researchers.
In the decade before the COVID-19 pandemic, the national occupancy average was about 64%. Post-pandemic, the average is 75%, which the report characterized as "dangerously close to a bed shortage." At that level, hospitals are increasingly buffeted by "daily bed turnover, seasonal fluctuations in hospitalizations and unexpected surges," according to a news release.
Using the CDC's COVID-19 data-tracking dashboards, UCLA researchers acquired hospital capacity metrics between Aug. 2, 2020, and April 27, 2024. They then calculated occupancy by dividing hospital census by the number of staffed beds.
The analysis found that a 16% decrease in staffed hospital beds, rather than more hospitalizations, resulted in the higher hospital occupancy rates.
"Our study was not designed to investigate the cause of the decline in staffed hospital beds, but other literature suggests it may be due to healthcare staffing shortages, primarily among registered nurses, as well as hospital closures partially driven by the practice of private equity firms purchasing hospitals and effectively selling them for parts," lead author Richard Leuchter, MD, said in the release.
To model hospital occupancy scenarios, the researchers used the U.S. Census Bureau's population projections to calculate the number of expected hospitalizations through 2035.
If hospitalization and staffed bed supply rates do not change, the average occupancy could reach 85% by 2032 for adult hospital beds.
"For general hospital beds that are not ICU-level, many consider a bed shortage to occur at an 85% national hospital occupancy, marked by unacceptably long waiting times in emergency departments, medication errors and other in-hospital adverse events," Dr. Leuchter said. "If the U.S. were to sustain a national hospital occupancy of 85% or greater, it is likely that we would see tens to hundreds of thousands of excess American deaths each year."
Recommendations include increasing hospital reimbursement, regulating private equity in healthcare, addressing drivers of workforce shortages and changing policy to increase the healthcare professional pipeline.