Excess acute care bed capacity and its causes: the experience of New York State

The study was developed to identify numbers of excess hospital medical-surgical and pediatric bed capacity and the variables that produce them in the counties of New York State. Data were collected from New York's Statewide Planning and Research Cooperative System (SPARCS) for 1991. This system includes data for all hospital discharges in New York State by county. The counties of New York State include a full range of urban, suburban, and rural settings. A methodology was developed for projecting excess numbers of acute medical-surgical and pediatric beds. The impact of utilization variables (such as hospital discharge rates and lengths of stay) on bed levels were analyzed, as well as the effects of demographic, social, and health care resource availability. Data were collected through discharge abstracts provided by hospitals in New York State. The data demonstrated that hospital discharges and lengths of stay contributed to excess utilization at different levels in New York State counties. The data also identified relationships between lower incomes and educational levels, as well as larger supplies of physicians and high-variation discharges, and excess beds. The causes of excess hospital beds varied considerably among communities in New York State; each community must develop its own approach to this problem.