Margaret Woodruff Principal The Bristol Group

National inpatient bed use declined in the late 1980s and through most of the 1990s, but it began to level off around 1998 or 1999 and now appears to be climbing. Over the last couple of years, many hospitals have found themselves struggling to find beds. Various tools and techniques have been used to predict future bed need. This article presents a refinement on these models that incorporates scenario planning and statistical techniques to address the variability in bed demand. The key variables that drive bed need--population, discharges within the population, lengths of stay, and market share--are discussed, along with other forces from the local market, use of critical care beds, and observation care. Scenario planning techniques can be used to develop future bed need scenarios with several plausible views of the future--steady state, future utilization changes, and future marketplace changes are provided as examples. Key to predicting future bed need is understanding the variability of the demand, which might be seasonal, month-to-month, and possibly even day-to-day. The author recommends searching hospital and state-specific data to find the peak period of demand and applying statistical probability analysis to that peak. Hospitals need to understand bed availability during peak demand periods and not simply rely on a bed supply to meet an average daily census. Planning for the peaks must be balanced with an acceptable overall annual occupancy that is financially viable.

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