The Incredible Shrinking Hospital

It’s not just your imagination—hospitals are shrinking. Across the nation, the newest acute care facilities are designed and developed with fewer beds, according to Hilda Martin, a principal with research firm Revista.

Today’s hospitals boast 100 beds or fewer. In contrast, hospitals developed from 1950 to 1980 had an average of nearly 200 beds. Martin notes that these averages were consistent, despite the increase in small rural hospital construction during this period, largely due to the Hill-Burton Act, which provided subsidies for the construction of government and nonprofit local hospitals.

Source: Revista

The evolution in bed count can be traced to technology and reimbursement changes that have shifted the focus to patient experience and wellness and preventative medicine. Patients are choosing to receive care in outpatient settings, and when they find themselves in the hospital, they prefer private rooms.

Healthcare systems have embraced smaller hospitals, also known as micro-hospitals. Twenty-two of these projects broke ground in 2017, and another 22 have either started or will break ground later this year, according to Revista. Many more are in planning.

These facilities, often known as community or neighborhood hospitals, can vary in format, but typically include an emergency department, imaging and lab services, and up to 20 inpatient beds. They’re open 24 hours a day, 7 days a week, and 90% of cases can typically be accommodated without the need to transfer to a larger hospital facility.

Many micro-hospitals focus on one aspect of healthcare service or patient population—surgery or women’s services, for example. Healthcare systems use micro-hospitals to provide access to communities and patient populations that cannot support a full-blown hospital campus.

A handful of systems are developing several at a time, including St Luke’s in Kansas City (rendering above), Integris in Oklahoma City, and Allegheny Health Network in Pittsburgh.

For questions, comments or concerns, please contact Jennifer Duell Popovec