Experts are warning that a disaster is set to hit US hospitals in less than a decade, with hundreds of thousands of people needlessly dying as a result.
An in-depth investigation of America’s healthcare system has revealed that US hospital occupancy is teetering on the brink of crisis levels.
Experts believe there could be a chronic hospital bed shortage as early as 2032.
In the decade leading up to the Covid pandemic, the average hospital occupancy nationwide was 64 percent.
But the post-pandemic national hospital occupancy average is now 75 percent – 11 percentage points higher than the previous average.
And looking ahead, researchers fear that the occupancy levels could easily creep up another 10 percentage points, if not more, in the coming years.
For general hospital beds that are not ICU-level, many consider a bed shortage to occur at an 85 percent national hospital occupancy.
This in turn leads to unacceptably long waiting times in emergency departments, medication errors and other in-hospital adverse events.
An in-depth investigation of America’s healthcare system has revealed that US hospital occupancy is significantly higher than it was before the Covid pandemic
According to the CDC, when national ICU occupancy reaches 75 percent, there are 12,000 excess deaths two weeks later.
Dr Richard Leuchter, an assistant professor of medicine at UCLA and the study’s lead investigator, says if the US was to sustain a national hospital occupancy of 85 percent or greater, ‘it is likely that we would see tens to hundreds of thousands of excess American deaths each year.’
For their study, published in the journal JAMA Network Open, researchers used data from the CDC to obtain hospital occupancy metrics from nearly every US hospital between August 2, 2020, and April 27, 2024.
They then combined these data with national hospitalization rates and the US Census Bureau’s official population projections to model future hospital occupancy scenarios through 2035.
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Hospital occupancy is calculated by dividing the number of patients by the number of beds available.
This essentially shows the percentage of beds that are occupied at a given time. The researchers examined both of these metrics over time.
They found that the increase in hospital occupancy has been primarily driven by a 16 percent reduction in the number of hospital beds rather than by an increase in hospitalizations.
The number of in-patients has remained relatively unchanged from the pre-to-post-pandemic years.
A national hospital occupancy of 75 percent is dangerously close to a bed shortage, the researchers say, because it ‘does not provide enough of a buffer against factors such as daily bed turnover, seasonal fluctuations in hospitalizations and unexpected surges’.
To model future hospital capacity, the authors calculated the number of expected hospitalizations for each year between 2025 and 2035.
They took into account an expected jump in the number of patients due to an aging US population.
They found that if the hospitalization rate and staffed hospital bed supply do not change, average national hospital occupancy could reach 85 percent by 2032 for adult hospital beds.
In a bid to avoid a hospital bed crisis, the experts say more effort needs to be made to prevent hospital bankruptcies and closures.
They say this can be done ‘partly by revamping hospital reimbursement schemes and regulating private equity involvement in health care, addressing factors driving staffing shortages such as provider burnout, and changing policy to expand the pipelines of health care professionals’.
Dr Leuchter says a recent government move that added to the staffing crisis was the decision to freeze all new visas for international nurses in June 2024.
While he says the aim of his study was not to investigate why staffed hospital beds have declined, other literature suggests it could be due to staffing shortages in the sector.
Another factor he highlights is a run of hospital closures ‘partially driven by the practice of private equity firms purchasing hospitals and effectively selling them for parts.’
A report from Chartis, a healthcare advisory firm, found 418 rural hospitals were at risk of closing in 2024 and half of the rural hospitals in the US were operating at a loss – creating even deeper financial burdens.
A separate analysis for the Center for Healthcare Quality and Payment Reform (CHQPR) found the state with the risk of most closures was Texas, with 75 of its rural hospitals – 47 percent – set to close and 28 hospitals – 18 percent – at risk of immediate closure.
There are approximately 2,200 rural hospitals across the US for which an estimated 60million Americans rely on for basic healthcare.
The report found the primary reason hospitals are at risk of closure is because private insurance plans pay them less than what it costs to treat patients, leading rural institutions to lose money on their patient services.
They also lose money on Medicaid patients and patients who do not have health insurance.
