For this analysis publicly available data from the OECD is used. The time series run from 1975 to 2013 (where available).
Let’s focus on Belgium, Germany, France, The Netherlands, United Kingdom, United States, Norway and Switzerland and have a look at their number of hospital beds per 1000 population. The blue line is a trend line (linear regression).
This already shows an interesting trend; all countries show a decrease in the number of hospital beds per 1 000 population. This most likely is the result from advances in medicine. This has made it possible to decrease the length of stay and transform some hospital stays to ambulatory care / ambulatory surgery.
On the other hand, the nurse-to-bed ratio seems to remain stable or is growing in most countries. It is important to note that the number of nurses refers to all active nurses in these countries and not only those active in bed-side care.
Number of discharges / consultations
Another important factor here is whether the need for care is growing. We can get a notion of this by looking at the number of discharges and consultations.
The number of inpatient discharges seems to be growing overall. This is somewhat contra-intuitive with a decrease in the number of hospital beds. However, the overall decrease in length-of-stay probably offsets the decrease in hospital beds. Let’s have a look at the evolution of the average length-of-stay.
If there is indeed a shift from hospital based care towards outpatient / ambulatory care, the consultation data should and does show this:
- Number of hospital beds per 1000 is decreasing overall
- Nurse-to-bed ratio: growing overall (fast in US and Norway)
- Number of discharges: slowing increasing overall
- Length-of-stay: strong decrease overall
- Outpatient care: steady to slow growth
The R analysis can be found here.
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