High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark

Abstract

High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact of these shortages on patients' outcomes. We analyzed all 2.65 million admissions to Danish hospitals' departments of medicine in the period 1995-2012. We found that high bed occupancy rates were associated with a significant 9 percent increase in rates of in-hospital mortality and thirty-day mortality, compared to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should be allocated to researching the causes and effects of bed shortages, with the aim of creating greater interest in exploring new methods to avoid or reduce bed shortages.

The Association Between Hospital Capacity Strain and Inpatient Outcomes in Highly Developed Countries: A Systematic Review

“…53,54 Thirty studies analyzed the association between capacity strain and mortality. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][32][33][34][35][36][37][38][39][40][41][42][43]48,49,53 All observational studies were cohort studies; all but four were retrospective. 32,42,43,46 Eight studies described interventions to improve care during times of capacity strain, [55][56][57][58][59][60][61][62] none using randomization to assign treatment category.…”

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

“…Furthermore, a Danish study recently demonstrated how high bed occupancy rates were associated with increased inpatient and 30-day mortality. 28 Improved risk assessment may help identify patients suitable for outpatient treatment and thus decrease bed occupancy. Our study shows that a low suPAR can identify patients with an even lower mortality than the average, who may be suitable for treatment outside the hospitals.…”

Is "boarding" appropriate to help reduce crowding in emergency departments?

“…10 11 "Boarding"-moving patients from emergency departments to corridors of wards that are full to help spread the burden-has been offered as a solution in the United Kingdom in the past couple of winters, but this approach fails to tackle the problem and is likely to compromise our ability to deliver dignified, high quality care within the hospital system. 12 There is a paucity of formal evidence in this controversial area, though.…”

“…12 13 We accept that crowding in emergency departments is hazardous, but we also need to recognise that crowding within the whole hospital is hazardous and that it hinders flow.…”