Myths of ideal hospital size

Current methods used to calculate the required size of hospitals are underestimating the true capacity needed for operational efficiency. Trends in occupied bed-days (rather than admissions and length of stay) give better estimates of future bed requirements. Hospital occupancy rates depend on volatility in demand, not efficiency. Larger bed pools and hospitals can operate at higher average occupancy. Cost efficiency should be focusing on staffing based on the patients in the beds and not on the available beds. Hospitals require supporting climatalogical forecasts to allow for seasonal and other climate-related changes in admissions, if flexible staff deployment is to become a reality. MJA 2010; 193: 298-300