Hospital beds tend to get used simply because they're available – not necessarily because they're needed, according to a first-of-its-kind study that supports continued regulation of new hospitals.
Michigan State University researchers examined all 1.1 million admissions at Michigan's 169 acute-care hospitals in 2010 and found a strong correlation between bed availability and use, even when accounting for myriad factors that may lead to hospitalization. These factors include nature of the ailment, health insurance coverage, access to primary care and patient mobility.
In other words, the simple fact the beds were available led to higher use, said Paul Delamater, lead author and a researcher in MSU's Department of Geography. The study appears in the journal PLOS ONE.
"The findings support the regulation of hospital beds – of keeping the number of hospital beds aligned with the health care needs of the population," Delamater said.
Building new hospitals in Michigan requires approval from the state's Certificate of Need Program. Across the nation, 35 states have some form of CON program, with 28 states specifically regulating the supply of acute care hospital beds.
In Michigan, there are too many acute care hospital beds for the population, data show, and the CON Program in the past decade has rejected at least three requests for new hospitals in wealthy Oakland County.
Two of those hospitals were built only after their respective health systems won special legislative approval. In the latest case, McLaren Health System is currently appealing the CON Program's denial for a new hospital in Clarkston.
"Certificate of Need curbs unnecessary hospital construction and the higher health care costs that creates," Delamater said.
The study, which uses statistical models of the state of Michigan, is the first examination of hospital bed availability and use that addresses the geographic nature of the relationship. Unlike previous studies, the researchers modeled the entire acute care hospital system while accounting for the travel- and health-related behavior of patients.
The model can be replicated in other states.
"It has immediate statewide and potentially national implications," said Joe Messina, a study author and professor of geography. "To be able to demonstrate that the number of hospital beds predicts use – people have talked about this for years, but no one has been able to show it until now."