Inpatient Bed Need Planning—Back to the Future?
Margaret Woodruff Principal Bristol Group Mitretek

How many new inpatient beds might I need to add to meet the future demand in my market?

If you are asking yourself this question today, you are not alone. You probably also find yourself reflecting on how many beds you actually decommissioned a decade ago and how you have permanently changed the function of these former nursing units, so that they can no longer be readily converted back to inpatient units. When it comes to future bed need planning, hospitals today are at a crossroads that few anticipated just a few years ago.

The Recent Rebound in Inpatient Bed Need

Predicting future bed need is particularly difficult. Throughout the 1990s, many healthcare planners believed that managed care would continue to push national inpatient use rates down to benchmark levels that had been established in the heavily managed markets in California. This had certainly been the trend in evidence during the late 1980s and most of the 1990s. However, in most markets across the country, these declining use rates began to level off around 1998 or 1999 before ever reaching the low levels of demand that had been predicted.

A review of recent national trends in use rates illustrates this apparent "bottoming out" of inpatient use rates, as illustrated in Figure 1.