Hospital bed shortage looms as occupancy rates soar

The United States faces a potential critical shortage of hospital beds by 2032 if current trends continue, according to new research from University of California, Los Angeles.

A study published in JAMA Network Open found that U.S. hospital occupancy has risen significantly since the COVID-19 pandemic, setting the stage for a looming capacity crisis. Researchers project average national hospital occupancy could reach 85% for adult beds within a decade, a level associated with adverse patient outcomes.

The team analyzed data from Centers for Disease Control and Prevention dashboards covering nearly every U.S. hospital between August 2020 and April 2023. They found post-pandemic hospital occupancy averaged 75%, up from about 64% before COVID-19.

"Hospitals are as full, if not more so, than they were during the pandemic, even well into 2023 during what would be considered a post-pandemic steady state," said Dr. Richard Leuchter, assistant professor of medicine at UCLA and lead study author.

The increased occupancy stems primarily from a 16% reduction in staffed hospital beds rather than rising admission rates. Researchers cited healthcare staffing shortages, especially among nurses, and hospital closures as likely factors.

"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," Leuchter said.

The study combined occupancy data with population projections to model scenarios through 2035. Without changes to bed supply or hospitalization rates, researchers predict adult bed occupancy could hit 85% nationally by 2032.

Experts consider 85% occupancy a critical threshold for general hospital beds, associated with longer emergency room waits and increased adverse events.

Averting a crisis will require preventing more hospital closures, addressing staffing shortages, and expanding healthcare professional pipelines, Leuchter said. He also called for innovative care models to reduce unnecessary admissions.

The research team noted limitations, including inability to determine exact causes of bed reductions. They emphasized the projections assume continuation of current trends.