Even in “peacetime”, however, capitated reimbursement levels and the need to decrease hospital-acquired conditions made LOS reduction key for health systems. While efforts to reduce LOS often focus on specific disease classes, there are general operational factors that are more straightforward to address.
The Economic Driver: As patient access is inversely proportional to LOS, the impact of even an incremental change in LOS can be quite significant. If a 300-bed hospital with an average LOS of four days could reduce the average LOS by 5%, or five hours, they could treat over 1,350 more patients per year. That’s also millions of additional dollars of income generated from the same fixed capacity.
The Basic Demand-Supply Problem: In most hospitals, daily demand for beds usually swells before the supply of right beds opens up. In other words, the arrival patterns of patients who need a bed are “out of phase” with the departure patterns of patients who are leaving the hospital. At most hospitals, morning surgeries and overnight ED arrivals create a need for beds in the morning, while typical hospital discharge processes make beds available later in the day.
Bed capacity must also be divided into “units,” as determined by the level of care and skilled staffing required. This adds up to a limited availability of inpatient beds on a recurring basis.
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