UPMC has become one of the latest hospital operators to reduce its bed count, in this case by hundreds, reflecting the recent trend of more patients seeking care outside hospital inpatient settings.
The Pittsburgh-based hospital giant in the six months that ended last December reduced its number of beds by 8.5%. The drop, first reported by the Pittsburgh Business Times, reduced UPMC medical, surgical, psychiatric and skilled-nursing capacity by 410 beds. The system now has 4,429 beds in operation.
Demand for hospital care, as measured by the aggregate number of days patients were hospitalized, dropped 2.2% during the same period, UPMC's financial statements show.
Similar declines have been reported in hospitals across the U.S. since a sharp drop in demand during the Great Recession. The weak economy, changes to health insurance coverage and the continued shift of care to clinics and other outpatient locations are widely credited for the changing demand picture.
UPMC has invested to expand its outpatient network, said system spokeswoman Susan Manko. “We are always adjusting our inpatient capacity to meet the demands and to remain efficient,” she said. “At the same time, we have been shifting our costs to outpatient settings in many cases, increasing our outpatient services everywhere.”
Recent hospital acquisitions also expanded UPMC's hospital capacity and broadened its geographic reach. The system moved some services to newly acquired hospitals. Patients followed, creating capacity at UPMC's tertiary hospitals. “We are always shifting services to where they are needed in the setting in which they are needed,” she said. The system did not lay off any workers to offset the reduced hospital capacity, she said.
UPMC is far from the only hospital to eliminate beds. Baxter Regional Medical Center, Mountain Home, Ark., closed hospital units, saving money on staff and other expenses, for example, Moody's Investors Service said in a report last month.
“Hospitals don't want to have to staff more beds than they have to,” said Daniel Steingart, a Moody's vice president and the rating agency's senior analyst who tracks Baxter Regional.
Moody's saw the median for hospital admissions drop 1.3% in 2013, the most recent year available, after four years of stagnation. The drop in hospital admissions also can be seen in the recent slowdown in U.S. healthcare spending and federal snapshots of hospital demand.
New federal policy that labels some hospital patients with very short visits as outpatients has contributed significantly to the drop in admissions, Steingart said. New payment models that give hospitals an incentive to treat patients in less costly settings have made little difference so far, he contended. Such efforts are too small to significantly change hospital use, he said.
Growth in U.S. health spending dipped to a record low 3.6% in 2013, the most recent year available, thanks in part to the deceleration of hospital spending as patients spent less time in the hospital, a federal analysis showed. That year, the number of hospital discharges dropped 1.4%, the CMS Office of the Actuary reported in January.
Some of the largest and most prominent U.S. health systems have reported their hospitals now care for fewer patients. Trinity Health, Livonia, Mich., reported a 3.7% drop in admissions in 2014 and 3.4% fewer patient days.
Not all systems reported sharp declines last year, however. Rush University Medical Center, Chicago, reported largely flat admissions but an increase in patient days, suggesting that patients were sicker and required longer hospital visits.
Some actually saw more patients. New York Presbyterian Hospital reported increases in admissions and patient days of 3.7% and 4.8%, respectively, for example.
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