Researchers: Netanel Avraham Horowitz ¹, Shlomo Pashkos ¹, Michael Halbertal

Background: The relationship between low bed occupancy in the hospital and mortality rates is unclear. We used the decrease in occupancy rates during the first wave of the COVID-19 pandemic and the onset of Operation Shield Sword to explore this issue based on administrative data from a large hospital.

Objectives: 1. To assess the causal relationship between a reduction in bed occupancy in the hospital’s internal departments mortality and readmission rates.
2. To conduct a comparative analysis of overall mortality rates and mortality rates by patient complexity.
3. To perform an economic evaluation of the impact of reduced occupancy on resource allocation for patient care.

Method: Difference-in-differences methodology

Findings: 1. During the study periods, bed occupancy decreased from 99% and 96% to 75% and 81%, respectively.
2. During periods of reduced occupancy, there was an increase in resource allocation for patient care.
3. Our estimation results regarding patient’s indicators correlation with mortality rates were found to be consistent with existing literature.
4. A reduction in bed occupancy was not found to significantly decrease mortality rates for all patients in the internal departments.
5. Lower occupancy reduced mortality rates among patients requiring intensive care unit (ICU) during hospitalization.
6. Lower occupancy was not found to decrease the rate of recurrent hopitalizations.

Conclusions: It is not recommended to universally reduce bed occupancy in internal medicine departments with the aim of improving mortality rates. However, patient’s experience can be factor in resource allocation.

Recommendations: Consider concentrating patients with complicated conditions in a single internal medicine department, while maintaining low occupancy in that department, thus allowing for appropriate resource allocation for optimal care of this group.

Research end date: 11/2024