How many medical beds does a country need? An international perspective

Abstract

Background/aims: While many methods exist for calculating bed numbers, the current method for making international comparisons is inadequate, as it makes no adjustment for population age or the nearness to death effect. This study investigated the number of acute medical beds in various countries using a new method to compare bed numbers within and between countries. Methods: The number of available medical beds in various (mainly European) countries were obtained from the World Health Organization. These were divided by the number of deaths in each country to give the ratio of beds per 1000 deaths and this was plotted against the ratio of deaths per 1000 population (the crude mortality rate) in each country. This was compared to similar data, but for occupied rather than available beds, for England over the period 2000/01 to 2018/19. Results: In England, the medical group of specialties accounts for over 60% of all occupied acute beds. Since 2011 this proportion has risen to over 64%. For two decades England has had around 165±5 occupied medical beds per 1000 deaths (at an assumed 95% average occupancy), and England therefore has a similar number of medical beds to 11 of the 37 other countries. The relatively low slope of the relationship between beds per 1000 deaths and deaths per 1000 population indicates that the nearness to death effect is the major driving force for medical bed requirements. conclusions: Both data sets indicate that the nearness to death effect is the most important variable in forecasting occupied and available medical bed numbers. Based on the forecasted increase in deaths, demanf of medical beds in England is likely to increase by 39% over the next 40years.