bed occupancy


Summary: A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.

Top Publications

  1. Olshaker J, Rathlev N. Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department. J Emerg Med. 2006;30:351-6 pubmed
    ..This article will review how overcrowding occurred with a focus on the significance and potential remedies of extended boarding of admitted patients in the Emergency Department. ..
  2. Chrusch C, Olafson K, McMillan P, Roberts D, Gray P. High occupancy increases the risk of early death or readmission after transfer from intensive care. Crit Care Med. 2009;37:2753-8 pubmed publisher
    ..Overloading the capacity of an intensive care unit to care for critically ill patients may affect physician decision-making, resulting in premature discharge from the intensive care unit. ..
  3. Richardson D. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust. 2006;184:213-6 pubmed
    ..The magnitude of the effect is about 13 deaths per year. Further studies are warranted. ..
  4. DeLia D. Annual bed statistics give a misleading picture of hospital surge capacity. Ann Emerg Med. 2006;48:384-8, 388.e1-2 pubmed
    ..Annual bed statistics give a misleading picture of hospital surge capacity. Analysis of surge capacity should account for daily variation in patient volume and within-year variation in bed supply. ..
  5. Halpern N, Pastores S, Greenstein R. Critical care medicine in the United States 1985-2000: an analysis of bed numbers, use, and costs. Crit Care Med. 2004;32:1254-9 pubmed
    ..S. hospital system. CCM occupancy is lower than expected. Despite its increasing use and cost, CCM is using proportionally less of national health expenses and the gross domestic product than previously estimated. ..
  6. Kydd A. The patient experience of being a delayed discharge. J Nurs Manag. 2008;16:121-6 pubmed publisher
    ..Qualified and unqualified staff need to understand that patients in transition have many anxieties about their futures. The stress of moving on should be sensitively addressed in everyday care. ..
  7. Majeed M, Williams D, Pollock R, Amir F, Liam M, Foong K, et al. Delay in discharge and its impact on unnecessary hospital bed occupancy. BMC Health Serv Res. 2012;12:410 pubmed publisher
  8. Howell E, Bessman E, Marshall R, Wright S. Hospitalist bed management effecting throughput from the emergency department to the intensive care unit. J Crit Care. 2010;25:184-9 pubmed publisher
    ..This efficiency is likely to positively have impacted on patient satisfaction and safety. ..
  9. Sprivulis P, Da Silva J, Jacobs I, Frazer A, Jelinek G. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust. 2006;184:208-12 pubmed
    ..The Overcrowding Hazard Scale may be used to assess the hazard associated with hospital and ED overcrowding. Reducing overcrowding may improve outcomes for patients requiring emergency hospital admission. ..

More Information


  1. Orendi J. Health-care organisation, hospital-bed occupancy, and MRSA. Lancet. 2008;371:1401-2 pubmed publisher
  2. Schull M, Stukel T, Vermeulen M, Guttmann A, Zwarenstein M. Surge capacity associated with restrictions on nonurgent hospital utilization and expected admissions during an influenza pandemic: lessons from the Toronto severe acute respiratory syndrome outbreak. Acad Emerg Med. 2006;13:1228-31 pubmed
    ..Sufficient surge capacity in a pandemic will likely require the implementation of other measures, including possibly stricter implementation of hospital utilization restrictions. ..
  3. Borg M, Suda D, Scicluna E. Time-series analysis of the impact of bed occupancy rates on the incidence of methicillin-resistant Staphylococcus aureus infection in overcrowded general wards. Infect Control Hosp Epidemiol. 2008;29:496-502 pubmed publisher
    We investigated the impact of bed occupancy, particularly overcrowding, on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in general ward settings...
  4. Travers C, McDonnell G, Broe G, Anderson P, Karmel R, Duckett S, et al. The acute-aged care interface: exploring the dynamics of 'bed blocking'. Australas J Ageing. 2008;27:116-20 pubmed publisher
    ..Access-block cannot be understood by viewing the hospital system in isolation from other sectors that support the health and well-being of older Australians. ..
  5. Cunningham J, Kernohan W, Rush T. Bed occupancy, turnover intervals and MRSA rates in English hospitals. Br J Nurs. 2006;15:656-60 pubmed
    ..a follow on from an article concentrating on Northern Ireland) examines the relationship between percentage bed occupancy (PO), turnover interval (TI) and methicillin-resistant Staphylococcus aureus (MRSA) rates in the acute beds of ..
  6. Kanter R, Moran J. Hospital emergency surge capacity: an empiric New York statewide study. Ann Emerg Med. 2007;50:314-9 pubmed
    ..Typically, there are not enough vacant hospital beds available to serve 500 children per million population. Modified standards of hospital care to expand capacity may be necessary to serve children in a mass-casualty event. ..
  7. Cunningham J, Kernohan W, Sowney R. Bed occupancy and turnover interval as determinant factors in MRSA infections in acute settings in Northern Ireland: 1 April 2001 to 31 March 2003. J Hosp Infect. 2005;61:189-93 pubmed
    ..Centre (CDSC) Northern Ireland for 2001-2002 and 2002-2003: bed turnover interval (TI), percentage bed occupancy (PO) and methicillin-resistant Staphylococcus aureus rates per 1000 bed-days of patient episodes [MRSA (PE)]...
  8. Fieldston E, Hall M, Sills M, Slonim A, Myers A, Cannon C, et al. Children's hospitals do not acutely respond to high occupancy. Pediatrics. 2010;125:974-81 pubmed publisher
    ..Additional modeling techniques also revealed little response. We found a low rate of acute response to high occupancy. When there was a response, the magnitude was small. ..
  9. Webb S, Pettila V, Seppelt I, Bellomo R, Bailey M, Cooper D, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009;361:1925-34 pubmed publisher
    ..8%) remained in the hospital. The 2009 H1N1 virus had a substantial effect on ICUs during the winter in Australia and New Zealand. Our data can assist planning for the treatment of patients during the winter in the Northern Hemisphere. ..
  10. Elsayed S, Cosker T, Grant A. Pressure for beds--does it put our orthopaedic patients at risk?. Injury. 2005;36:86-7 pubmed
    ..Compartment syndrome is a limb-threatening condition which requires prompt recognition. Patients at risk should be nursed in an appropriate environment. ..
  11. Cooke M, Wilson S, Halsall J, Roalfe A. Total time in English accident and emergency departments is related to bed occupancy. Emerg Med J. 2004;21:575-6 pubmed
  12. Benson R, Drew J, Galland R. A waiting list to go home: an analysis of delayed discharges from surgical beds. Ann R Coll Surg Engl. 2006;88:650-2 pubmed
    ..Due to problems in defining delayed discharge Government figures probably underestimate the true numbers. Lack of intermediate care and social service provision are a major cause of bed blocking. ..
  13. Sampson M, Crowle T, Dhatariya K, Dozio N, Greenwood R, Heyburn P, et al. Trends in bed occupancy for inpatients with diabetes before and after the introduction of a diabetes inpatient specialist nurse service. Diabet Med. 2006;23:1008-15 pubmed
    To compare diabetes bed occupancy and inpatient length of stay, before and after the introduction of a dedicated diabetes inpatient specialist nurse (DISN) service in a large UK Hospital...
  14. Earnest A, Chen M, Ng D, Sin L. Using autoregressive integrated moving average (ARIMA) models to predict and monitor the number of beds occupied during a SARS outbreak in a tertiary hospital in Singapore. BMC Health Serv Res. 2005;5:36 pubmed
    ..and probable cases admitted on the previous day were also found to be independent prognostic factors of bed occupancy. ARIMA models provide useful tools for administrators and clinicians in planning for real-time bed capacity ..
  15. Sampson M, Dozio N, Ferguson B, Dhatariya K. Total and excess bed occupancy by age, specialty and insulin use for nearly one million diabetes patients discharged from all English Acute Hospitals. Diabetes Res Clin Pract. 2007;77:92-8 pubmed
    To investigate total diabetes bed occupancy and prolonged inpatient length of stay (LOS) in all English Acute Hospitals, we analysed hospital episode statistics (HES) discharge data for all English Acute Hospitals over 4 years for ICD10 ..
  16. Kaier K, Mutters N, Frank U. Bed occupancy rates and hospital-acquired infections--should beds be kept empty?. Clin Microbiol Infect. 2012;18:941-5 pubmed publisher
    There is growing evidence that bed occupancy (BO) rates, overcrowding and understaffing influence the spread of hospital-acquired infections (HAIs)...
  17. McCoy D, Godden S, Pollock A, Bianchessi C. Carrot and sticks? The Community Care Act (2003) and the effect of financial incentives on delays in discharge from hospitals in England. J Public Health (Oxf). 2007;29:281-7 pubmed
    ..There is no evidence to support government policy of charging SSDs for delay. Other factors, including NHS provision, are important, and a comprehensive overview of health and social care is vital. ..
  18. Ercole A, Taylor B, Rhodes A, Menon D. Modelling the impact of an influenza A/H1N1 pandemic on critical care demand from early pathogenicity data: the case for sentinel reporting. Anaesthesia. 2009;64:937-41 pubmed publisher
    ..admitted to hospital, 95% confidence limit on admission rates led to a range in predicted peak critical care bed occupancy of between 0% and 37% of total critical care bed capacity, half of these cases requiring ventilatory support...
  19. Godden S, McCoy D, Pollock A. Policy on the rebound: trends and causes of delayed discharges in the NHS. J R Soc Med. 2009;102:22-8 pubmed publisher
    ..There are few good data available to monitor the impact of earlier discharge, such as on the quality and availability of post-discharge care. ..
  20. Hillier D, Parry G, Shannon M, Stack A. The effect of hospital bed occupancy on throughput in the pediatric emergency department. Ann Emerg Med. 2009;53:767-76.e3 pubmed publisher
    ..12 to 1.31) or being treated in a hallway bed (odds ratio 1.18; 95% CI 1.15 to 1.22). High hospital occupancy has a significant and quantifiable negative influence on ED throughput, affecting patients both discharged and hospitalized. ..
  21. Burns C, Bennett C, Myers C, Ward M. The use of cusum analysis in the early detection and management of hospital bed occupancy crises. Med J Aust. 2005;183:291-4 pubmed
    ..To assess the value of cusum analysis in hospital bed management. Comparative analysis of medical patient flows, bed occupancy, and emergency department admission rates and access block over 2 years...
  22. Kaier K, Meyer E, Dettenkofer M, Frank U. Epidemiology meets econometrics: using time-series analysis to observe the impact of bed occupancy rates on the spread of multidrug-resistant bacteria. J Hosp Infect. 2010;76:108-13 pubmed publisher
    Two multivariate time-series analyses were carried out to identify the impact of bed occupancy rates, turnover intervals and the average length of hospital stay on the spread of multidrug-resistant bacteria in a teaching hospital...
  23. Matt W, Healey K. Managing capacity and workload in children's services. Paediatr Nurs. 2005;17:31-4 pubmed
  24. Priebe S, Badesconyi A, Fioritti A, Hansson L, Kilian R, Torres Gonzales F, et al. Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. BMJ. 2005;330:123-6 pubmed
    ..General attitudes to risk containment in a society, as indicated by the size of the prison population, may be more important than changing morbidity and new methods of mental healthcare delivery. ..
  25. Vincent J, Suter P, Bihari D, Bruining H. Organization of intensive care units in Europe: lessons from the EPIC study. Intensive Care Med. 1997;23:1181-4 pubmed
  26. Fatovich D, Hirsch R. Entry overload, emergency department overcrowding, and ambulance bypass. Emerg Med J. 2003;20:406-9 pubmed
    ..Unless something is done in the near future, the general public may no longer be able to rely on EDs for quality and timely emergency care. A "whole of system" approach is necessary to tackle the problem. ..
  27. Trzeciak S, Rivers E. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J. 2003;20:402-5 pubmed
    ..4) Potential solutions for ED overcrowding will require multidisciplinary system-wide support. ..
  28. Green L, Nguyen V. Strategies for cutting hospital beds: the impact on patient service. Health Serv Res. 2001;36:421-42 pubmed
    ..More sophisticated methodologies are needed to support decisions that involve bed capacity and organization in order to understand the impact on patient service. ..
  29. McDonagh M, Smith D, Goddard M. Measuring appropriate use of acute beds. A systematic review of methods and results. Health Policy. 2000;53:157-84 pubmed
    ..Before definitive conclusions on the inappropriate use of acute beds can be made, future research needs to take into account the methodological problems discussed here. ..
  30. Borg M. Bed occupancy and overcrowding as determinant factors in the incidence of MRSA infections within general ward settings. J Hosp Infect. 2003;54:316-8 pubmed
    Methicillin-resistant Staphylococcus aureus (MRSA) incidence and bed occupancy rates at St Luke's Hospital, Malta, were assessed over a 24-month period. A significant positive correlation was established (r=0.463; P<0...
  31. Chin J, Sahadevan S, Tan C, Ho S, Choo P. Critical role of functional decline in delayed discharge from an acute geriatric unit. Ann Acad Med Singapore. 2001;30:593-9 pubmed
  32. Florenzano O, Matarazzo G, Iovino E. [Aorn A.Cardarelli Hospital: the re-entry plan in the Region Campania]. Ig Sanita Pubbl. 2010;66:177-92 pubmed
    ..In the article are shown in the interventions application for re-entry plan in the Region Campania. ..
  33. Beniuk K, Boyle A, Clarkson P. Emergency department crowding: prioritising quantified crowding measures using a Delphi study. Emerg Med J. 2012;29:868-71 pubmed publisher
    ..These quantified measures have the potential to make a considerable contribution to decision making by ED management and to provide a basis for learning across different departments. ..
  34. Metnitz B, Metnitz P, Bauer P, Valentin A. Patient volume affects outcome in critically ill patients. Wien Klin Wochenschr. 2009;121:34-40 pubmed publisher
    ..Besides the total number of patients, diagnostic variability plays an important role. The relationship between volume and outcome seems, however, to be complex and to be influenced by other variables, such as workload of nursing staff. ..
  35. Rimar J, Diers D. Inpatient nursing unit volume, length of stay, cost, and mortality. Nurs Econ. 2006;24:298-307, 279 pubmed
    ..This finding suggests that, in some cases, aggregating inpatients with similar clinical conditions may result in lower cost of care, shorter length of stay, and fewer hospital deaths. ..
  36. Harding Price D. Read all about it--operation cancelled. Nurs Stand. 2007;21:28-9 pubmed
  37. Norwood M, Bown M, Bell P, Spiers P, Leslie A, Sayers R. Evaluation of level 1 care facilities for vascular patients. ANZ J Surg. 2004;74:346-9 pubmed
    ..It has had no discernible impact on admission time or mortality, but might reduce the number of cancelled operations caused by a lack of level 2 beds. ..
  38. Motohashi T, Hamada H, Lee J, Sekimoto M, Imanaka Y. Factors associated with prolonged length of hospital stay of elderly patients in acute care hospitals in Japan: a multilevel analysis of patients with femoral neck fracture. Health Policy. 2013;111:60-7 pubmed publisher
  39. Castle N. Consistent assignment of nurse aides: association with turnover and absenteeism. J Aging Soc Policy. 2013;25:48-64 pubmed publisher
    ..01). Consistent assignment is a practice recommended by many policy makers, government agencies, and industry advocates. The findings presented here provide some evidence that the use of this staffing practice can be beneficial. ..
  40. Hoot N, Zhou C, Jones I, Aronsky D. Measuring and forecasting emergency department crowding in real time. Ann Emerg Med. 2007;49:747-55 pubmed
    ..None of the measures provided substantial advance warning before crowding at low rates of false alarms. ..
  41. Leslie G. "Stay, just a little bit longer...". Aust Crit Care. 2006;19:119 pubmed
  42. Dara S, Afessa B. Intensivist-to-bed ratio: association with outcomes in the medical ICU. Chest. 2005;128:567-72 pubmed
    ..Differences in intensivist-to-ICU bed ratios, ranging from 1:7.5 to 1:15, were not associated with differences in ICU or hospital mortality. However, a ratio of 1:15 was associated with increased ICU LOS. ..
  43. Jessup M, Wallis M, Boyle J, Crilly J, Lind J, Green D, et al. Implementing an emergency department patient admission predictive tool: insights from practice. J Health Organ Manag. 2010;24:306-18 pubmed
    ..The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations. ..
  44. Hewett N, Halligan A, Boyce T. A general practitioner and nurse led approach to improving hospital care for homeless people. BMJ. 2012;345:e5999 pubmed publisher
  45. Fieldston E, Li J, Terwiesch C, Helfaer M, Verger J, Pati S, et al. Direct observation of bed utilization in the pediatric intensive care unit. J Hosp Med. 2012;7:318-24 pubmed publisher
    ..The method should be reproducible in other settings to learn more about the structure and processes of care and patient flow and to make improvements. ..
  46. Rinkel G, Visser Meily J, Speelman H. [More rapid transfer to an additional-care facility]. Ned Tijdschr Geneeskd. 2004;148:2426-8 pubmed
    ..There are various possible ways to make the discharge procedure more efficient. Should the available capacity within the facilities be the only delaying factor, then this would constitute a task for the regional care office. ..
  47. Gershengorn H, Iwashyna T, Cooke C, Scales D, Kahn J, Wunsch H. Variation in use of intensive care for adults with diabetic ketoacidosis*. Crit Care Med. 2012;40:2009-15 pubmed publisher
    ..Institutional practice patterns appear to impact admission decisions and represent a potential target for reduction of resource utilization in higher use institutions. ..
  48. Keegan A. Hospital bed occupancy: more than queuing for a bed. Med J Aust. 2010;193:291-3 pubmed
    ..There is an urgent need to develop meaningful outcome measures of patient care that could replace the process measures currently in use. ..
  49. Sheaff R. Governance in gridlock in the Russian health system; the case of Sverdlovsk oblast. Soc Sci Med. 2005;60:2359-69 pubmed
    ..Gridlock resulted from the interaction of the two, a problem to which all health system reform is potentially vulnerable. ..
  50. Li X, Sun H, Puri A, Marsh D, Anis A. Medical withdrawal management in Vancouver: service description and evaluation. Addict Behav. 2007;32:1043-53 pubmed
    ..In addition, the patterns of utilization of VD were changed over the welfare check issuance period. Our analysis indicates that operational accessibility and efficiency at VD could be improved by specifically addressing these factors. ..
  51. Dexter F. Bed management displays to optimize patient flow from the OR to the PACU. J Perianesth Nurs. 2007;22:218-9 pubmed
  52. Trossman S. A case for safe staffing. ANA brings together RNs, other stakeholders for summit. Am Nurse. 2008;40:1, 8, 12 pubmed
  53. Weich S. Availability of inpatient beds for psychiatric admissions in the NHS. BMJ. 2008;337:a1561 pubmed publisher