Bryan T, Pathak D; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 652.
The Ohio State University, Health SErvices Management and Policy, 1583 Perry Street, Columbus, OH 43210 Tel. (614) 688-3956 Fax (614 ) 292-3572
RESEARCH OBJECTIVE: The goal of this project was to identify and evaluate the national use of statewide proactive bed need methodology for acute care beds. STUDY DESIGN: State health planning agencies participated in phone interviews explaining their bed need methodology. These agencies also provided copies of methodology formulas for further analysis. POPULATION STUDIED: The health planning agencies and their methodologies were the populations studied. Methods for determining targeted capacity date back to the origin of Certificate of Need. Certificate of Need, as a method of health planning, limits, evaluates, and forecasts the bed need. In the 1980's the market was over saturated with beds and into the 1990's, inpatient bed use rates declined because of the inception of managed care. After declining to a low point in bed capacity, many health planners now have to readdress the unanticipated additional need of beds because of the following trends: Increase in the acuity of care, increase in the aging population who require inpatient acute care, a cease in the speed of inpatient procedures being preformed on an outpatient basis, a stabilization of the inpatient length of stay, and the aging of older patient rooms in need of reconstruction. The need for planning of additional beds is upon us and only fourteen states currently utilize the CON bed methodology to plan. Although CON relies on these same basic goals, every state uses a slightly different methodology. While many states are aggressively addressing overcapacity, individual hospitals and geographic areas are in need of additional beds. Many bed need formulas are out of date and are not longer considered. This paper hopes to show formula inaccuracies in determining future bed need. PRINCIPAL FINDINGS: Only eleven states utilize statewide proactive bed plans and some states are under revision of there programs or find the methods outdated and no longer under consideration. Ten states have hospital specific formula and specific criteria for existing institutions. In most cases the formula is based on population, midnight or noon census, target occupancy rates, and in some cases simply a longer-time period average. Other considerations include geographic factors, indigent care, and travel time to other institutions. Some of the more debated issues in bed need formulas are census time and utilization by bed type. Census determination at midnight is used in four states. Other states determine census based on discharge information, patient days, and solely on inpatients. By defining all medical/surgical, pediatric, obstetric, and psychiatric beds as general acute care beds, the methodology does not account for census variations in the specialized units. CONCLUSIONS: Bed need formulas allow states to proactively determine need whether it is specific geographic area need or a statewide need. Eight states are currently revising their bed need methodology and four states have not experienced need. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The success of methodologies is unknown and while each state's healthcare system is unique, an explanation of success and failure of formulas would improve the planning process.
Publication Types:
Keywords:
- Beds
- Child
- Data Collection
- Evaluation Studies
- Health Planning
- Health Services Needs and Demand
- Hospitalization
- Hospitals
- Humans
- Patient Discharge
- methods
- therapy
- utilization
- hsrmtgs
Other ID:
UI: 102275622
From Meeting Abstracts