Should hospital beds be kept full or empty?

Should physicians strive to keep hospital beds full or empty?

Obviously, in an economically optimal situation, just like in the hotel business, the hospital beds that are “needed” and available should be kept pretty close to full, in order to cover fixed costs and balance the hospital budget.

A recent discussion board on another physician website has called attention to an alleged practice of both emergency physicians and hospital administrators being paid bonuses for upping the number of admissions.

I suppose that could be one permutation of the “pay for performance” concept. But what if that patient could be cared for just as well at home?

A variation on this theme would be bonuses for keeping ICU beds full by fudging who actually needs them.

We all know that hospitals can be dangerous places to be.

I think such alleged practices fail the “smell test,” and may well be at least unethical, if not downright illegal.

My goal would be to keep the population well, treat illness on an ambulatory basis, until old people are ready for hospice care.

That way we could empty most hospitals.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit for more health policy news.

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