Unoccupied Beds Research Articles

Mapping choice in the NHS: cross sectional study of routinely collected data

Objective To identify where in England there are likely to be most constraints on choice of hospital for patients waiting longer than six months for elective care.Design Cross sectional study...

Association of Market, Mission, Operational, and Financial Factors on Hospital Acquisition Prices

Since the Balanced Budget Act of 1997, there has been a decline in the number of hospital acquisitions. Using data from 1999 through 2001, we examined the relationship between market, mission, operational, and financial factors on hospital acquisition prices. Using an ordinary least squares regression model, we found that acquiring multihospital systems paid a higher price for larger hospitals with fewer unoccupied beds and greater profitability. Although only marginally significant, we also found that acquiring hospital systems paid a higher purchase price for hospitals in near urban markets and for hospitals located in the Central region of the United States. From a policy standpoint, we found no significant difference in the purchase price paid between for-profit and nonprofit hospitals.

A simple method to optimize hospital beds capacity

The number of acute hospital beds is determined by health authorities using methods based on ratios and/or target bed occupancy rates. These methods fail to consider the variability in hospitalization demands over time. On the other hand, the implementation of sophisticated models requires the decision concerning the number of beds to be made by an expert. Our aim is to develop a new method that is as simple to use as the ratio method while minimizing the roundabout approaches of these methods. A score was constructed with three parameters: number of transfers due to lack of space, number of days with no possibility for S unscheduled admissions and number of days with at least a threshold of U unoccupied beds. The optimal number of beds is the number for which both the mean and the standard deviation of the score reach their minimum. We applied this method to two internal medicine departments and one urological surgery department and we compared the solutions proposed by this method with those put forward by the ratio method. The solutions proposed by this method were intermediate to those calculated by the local and national length of Stays ratio methods. Simulating an unusual increase in admission requests had no consequence on the bed number selected, indicating that the method was robust. Our tool represents a real alternative to the ratio methods. A software has been developed and is now available for use.

Early Ambulation in a Postpartum Unit

from the experimental stage to that of being a generally accepted practice. It is accepted generally, but is it understood generally? Many patients who have been "early ambulators" can ask this question from their own experiences. They have seen that facilities, care, and thinking are still geared to those patients who are confined to their beds. The feeling seems to prevail among nurses that the person who is allowed out of bed requires little of the nurse's or auxiliary worker's time. They seem to think the patient has been cared for if someone has made her unoccupied bed, has given her medications, treatments, and diet. Variations in the practice of early ambulation depend largely upon the physician and the patient. Before the days of early ambulation, postpartum patients remained in bed for about seven days and were sent home on about the tenth day. At present, patients may go to the bathroom and shower as early as the day of delivery, and can be out of bed at will on the first or second day following delivery. They go home in five or seven days. Formerly, in one 25-bed unit, 17 mothers would be in bed, and 8 would be out of bed and using the toilet and hand basin. No shower facilities were required. By contrast, in a situation where early ambulation is practiced, 4 mothers will be bed patients with bathroom privileges and 21 will be out of bed most of the time so that toilet and shower facilities are needed for all 25.

Early Ambulation in a Postpartum Unit

from the experimental stage to that of being a generally accepted practice. It is accepted generally, but is it understood generally? Many patients who have been ambulators can ask this question from their own experiences. They have seen that facilities, care, and thinking are still geared to those patients who are confined to their beds. The feeling seems to prevail among nurses that the person who is allowed out of bed requires little of the nurse's or auxiliary worker's time. They seem to think the patient has been cared for if someone has made her unoccupied bed, has given her medications, treatments, and diet. Variations in the practice of early ambulation depend largely upon the physician and the patient. Before the days of early ambulation, postpartum patients remained in bed for about seven days and were sent home on about the tenth day. At present, patients may go to the bathroom and shower as early as the day of delivery, and can be out of bed at will on the first or second day following delivery. They go home in five or seven days. Formerly, in one 25-bed unit, 17 mothers would be in bed, and 8 would be out of bed and using the toilet and hand basin. No shower facilities were required. By contrast, in a situation where early ambulation is practiced, 4 mothers will be bed patients with bathroom privileges and 21 will be out of bed most of the time so that toilet and shower facilities are needed for all 25.