• Posted February 20, 2025

U.S. Facing Critical Hospital Bed Shortage

U.S. hospitals could face a bed shortage as early as 2032, with occupancy remaining elevated even as the country recovers from the COVID pandemic, a new study suggests.

Average hospital occupancy following the pandemic has been about 75%, researchers found, dividing the average daily number of patients by the number of staffed hospital beds.

That’s 11 percentage points higher than before the pandemic, when average hospital occupancy was around 64%, researchers reported in Feb. 19 in JAMA Network Open.

“We’ve all heard about increased hospital occupancy during the height of the Covid-19 pandemic, but these findings show that hospitals are as full, if not more so, than they were during the pandemic, even well into 2024 during what would be considered a post-pandemic steady state,” lead researcher Dr. Richard Leuchter, an assistant professor at UCLA's David Geffen School of Medicine, said in a news release.

A nationwide hospital occupancy of 75% is dangerously close to a bed shortage, because hospitals have lost much of the buffer they need to respond to unexpected surges related to infectious disease outbreaks or disasters, Leuchter said.

He noted that when occupancy in the nation's intensive care units (ICU) reaches 75%, there are 12,000 excess deaths among Americans two weeks later.

Hospital occupancy could reach 85% by 2032 for adult hospital beds, researchers estimated, based on the aging U.S. population and the increased likelihood that more seniors will require hospital care.

“For general hospital beds that are not ICU-level, many consider a bed shortage to occur at an 85% national hospital occupancy, marked by unacceptably long waiting times in emergency departments, medication errors, and other in-hospital adverse events,” Leuchter said.

“If the U.S. were to sustain a national hospital occupancy of 85% or greater, it is likely that we would see tens to hundreds of thousands of excess American deaths each year,” he added.

For the study, researchers used data from the U.S. Centers for Disease Control and Prevention (CDC) to track occupancy for every U.S. hospital between August 2020 and April 2024. They then combined that information with U.S. Census Bureau population projections to estimate future occupancy through 2035.

Higher post-pandemic occupancy appears to be driven by a 16% reduction in the number of staffed hospital beds rather than an increase in hospitalizations, which have returned to pre-pandemic levels, researchers said.

“Our study was not designed to investigate the cause of the decline in staffed hospital beds, but other literature suggests it may be due to healthcare staffing shortages, primarily among registered nurses, as well as hospital closures partially driven by the practice of private equity firms purchasing hospitals and effectively selling them for parts,” Leuchter said.

Researchers said a bed crisis could be averted if steps are taken to prevent hospital bankruptcies and closures, and to address staffing shortages by supporting current health care workers while bringing more into the fold.

For example, the U.S. State Department's decision in June to freeze all new visas for international nurses was a potentially catastrophic move that is likely to make hospital staffing shortages worse, Leuchter said.

Another tactic might involve specially designed acute care clinics that could take in patients who would otherwise be hospitalized, Leuchter added.

One example is the Next Day Clinic, a program launched at Olive View-UCLA Medical Center within the Los Angeles County Department of Health Services.

“The Next Day Clinic model pioneered at Olive View avoids hundreds of hospitalizations per year, and has been so successful that it has been adopted at UCLA Health’s flagship medical center,” Leuchter said.

“If these types of care delivery models become widespread enough, that could help offset the projected increase in hospitalizations arising from an aging U.S. population,” he concluded.

More information

Tufts University has more on the effect of hospital staff shortages on patient health.

SOURCE: UCLA, news release, Feb. 17, 2025