Hospital capacity problems will persist as patient acuity rises by 2033

Hospital capacity problems are expected to persist over the next decade even as care increasingly moves out of the traditional hospital into the home and outpatient settings, according to the latest forecasts from Sg2. 

In its 2023 Impact of Change Forecast, Sg2 notes that the case mix index — reflecting patient severity — is up 5 percent since 2019 while the average length of stay for patients admitted to a hospital has risen 10 percent. The report notes that the increasingly complex nature of the patient population exacerbates the closure of 30,000 patient beds between 2019 and 2022 and workforce challenges. 

Sg2 uses a disease-based model to analyze patient-level data and local market trends to project demand across inpatient and outpatient services. 

"As the population continues to age and chronic disease incidence rises, we expect increased demand across all sites of care," Tori Richie, intelligence senior director with Sg2, said in a news release for the report. "The reality is access is a challenge for these patient populations and care redesign will be critical to prevent the acute exacerbation of their medical conditions." 

Four other key takeaways from Sg2's forecasts:

  • Over the next 10 years, volumes are projected to increase by 2 percent in the inpatient hospital setting. Behavioral health, neuroscience and cardiovascular service lines are expected to see the greatest growth.
  • Volumes are projected to decrease by 13 percent to the urgent or retail clinic setting and by 1 percent to the emergency department by 2033. 
  • Outpatient surgical volumes are expected to grow 18 percent by 2033 to 109.5 million cases. Specific procedures will lead the transition to the outpatient setting, including total joint replacement, lumbar or thoracic spinal fusion, revision knee replacement and prostatectomy. 
  • Home care volume will increase 20 percent by 2033, while hospice stays will decrease by 5 percent, and skilled nursing facility volumes will decrease by 8 percent. The projected increase to home care volume is driven by a culmination of advances in remote monitoring and digital health capabilities and more favorable payment.



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