Local Hospital Capacity: How Full Are They?

As COVID-19 cases surge, hospitals are under increasing strain. It is important to know how full hospitals in your area are, as this can indicate the pressure on healthcare services and the risk of visiting. Several tools and maps are available to check hospital capacity and bed use at the facility level, including Propublica's tool, NPR's interactive map, and a dashboard by Definitive Healthcare. These tools can help individuals make informed decisions about seeking medical attention and highlight the importance of flattening the curve to ensure the healthcare system can cope.

COVID-19 hospitalizations

The increase in hospitalizations among the elderly and senior citizens is particularly concerning. This age group is more susceptible to severe illness from COVID-19, and the presence of underlying health conditions further exacerbates the risk. Additionally, experts have observed that the most vulnerable individuals in this age bracket are often not receiving potentially life-saving treatments, such as Paxlovid, due to varying prescription rates across different states.

Middle-aged adults, specifically those aged 50 to 64, represent the second-highest rate of weekly hospitalizations by age group at 2.7% per 100,000. This trend underscores the emerging presence of chronic underlying health conditions within this demographic, which elevate the risk of severe COVID-19 outcomes.

Young children, surprisingly, constitute the third most common age group requiring hospitalization due to COVID-19. Despite being less likely to experience severe COVID infections compared to older adults, the relatively low vaccination rates among children have contributed to their increased vulnerability. As of November 25, 2023, only 6.9% of children aged 6 months to 17 years had received an updated COVID-19 vaccine, whereas 38.2% had gotten a flu shot, indicating a notable disparity in vaccine preferences among parents.

The rise in COVID-19 hospitalizations is attributed to a combination of factors, including seasonal trends and gatherings during the holidays. Epidemiologists note that respiratory viruses tend to spread more easily during the colder months when people spend more time indoors with closed windows and increased heating. Additionally, holiday gatherings create favourable conditions for viral transmission, especially when coupled with factors like inadequate ventilation and the absence of mask-wearing in crowded places.

Hospital capacity at a local level

Hospital capacity in local areas is a critical aspect of healthcare, especially during public health emergencies such as the COVID-19 pandemic. Knowing how full hospitals are in your area can help individuals make informed decisions about their healthcare and local authorities to impose necessary measures.

The Department of Health and Human Services (HHS) in the United States has been collecting and releasing data on hospital capacity and bed utilization at the facility level. This data provides a detailed insight into how individual hospitals are coping during health crises. For instance, during the COVID-19 surge, HHS data showed that hospitals across the country were running out of space, with many hospitals at full capacity. In Maricopa County, four hospitals reached full capacity, including the Abrazo Arrowhead Campus in Glendale. Similarly, Cook County in Illinois, experienced a high number of COVID-19 patients, with a 7-day average of 2,271 patients.

In Denver's metro area, hospitals also faced high occupancy rates. National Public Radio created a "look-up" tool that showed the following average rates: Denver at 66%, Jefferson County at 67%, Arapahoe County at 75%Adams County at 65%. These rates included the percentage of COVID-19 patients, which contributed to the overall strain on hospitals.

The COVID-19 Hospitalization Tracking Project analyzed data from 2,200 counties and found that in 126 counties, the average hospital was at least 90% occupied. States like Texas, Kentucky, Georgia, Minnesota, and Oklahoma had multiple hospitals above this threshold. For example, the Memorial Hermann Hospital System in Texas, with 250 beds, operated above 90% capacity. These numbers highlight the extreme stress hospitals are under, affecting both large and small medical facilities.

It's worth noting that hospitals can become overloaded not only due to COVID-19 but also other factors such as the flu and respiratory syncytial virus (RSV). Official data has shown that during certain periods, up to 80% of beds nationwide were occupied, driven by seasonal infections and viruses other than COVID-19. This "tripledemic" has further strained hospitals, with the Centers for Disease Control and Prevention (CDC) recommending masking to prevent the spread of non-COVID illnesses.

Percentage of beds occupied

The percentage of beds occupied in hospitals, also known as the Bed Fill Rate or bed occupancy rate, is a critical metric used to evaluate the efficiency and effectiveness of hospital bed management. This rate represents the percentage of available beds that are currently occupied by patients.

During the COVID-19 pandemic, the availability of real-time data on bed occupancy became crucial in understanding the stress on healthcare systems and improving patient safety during emergencies. For example, in a large university hospital in northern Italy, COVID-19 patients gradually occupied all available beds, with 52% of hospitalized patients suffering from COVID-19 during the peak of the pandemic.

To address this issue, initiatives such as the Hospital Bed Capacity Project by the CDC's NHSN Connectivity Initiative aim to establish real-time, automated collection and transmission of hospital bed capacity data. As of 2024, Oregon and Hawaii have implemented daily automated reporting of hospital bed capacity data to the NHSN. This allows for better planning and optimization of bed capacity to meet demand, efficient resource allocation, and improved patient flow and quality of care.

By analyzing trends in bed occupancy rates and predicting future demand, hospitals can identify periods of high and low occupancy and adjust their staffing levels and resources accordingly. This helps ensure that beds are available when needed and reduces wait times for patients. Overall, the percentage of beds occupied is a vital performance indicator that guides hospital management, resource allocation, and patient flow optimization.

Hospitals under extreme stress

Hospitals across the United States are under extreme stress as COVID-19 cases surge once again. Data released by the Department of Health and Human Services (HHS) reveals the dire situation in hospitals, with many operating under "extreme stress". According to the Institute for Health Metrics and Evaluation at the University of Washington, a hospital is considered to be under extreme stress when more than 20% of its beds are occupied by COVID-19 patients.

In Maricopa County, four hospitals have reached full capacity, with no spare adult beds available at the Abrazo Arrowhead Campus in Glendale. The situation in Cook County, Illinois, is equally concerning, with a 7-day average of 2,271 COVID-19 patients. Hospitals in Denver's metro area are also struggling, with National Public Radio reporting the following occupancy rates: Denver (66%), Jefferson County (67%), Arapahoe County (75%), and Adams County (65%). The high occupancy rates are not solely due to COVID-19, as other illnesses, such as the flu and respiratory syncytial virus (RSV), are also contributing to the surge.

The release of hospital-level data by HHS has provided valuable transparency and helped local officials and individuals make informed decisions to alleviate the strain on hospitals. However, the situation remains critical, and hospitals continue to face the challenge of managing the influx of patients while maintaining the delivery of essential services.

The current crisis underscores the ongoing impact of the COVID-19 pandemic and the importance of proactive measures to prevent the spread of infectious diseases and alleviate the burden on healthcare systems.

Patient transfers

Hospitals across the U.S. are running out of space as COVID-19 cases spike. An interactive map and lookup tool developed by NPR show the average rates of hospital capacity in your area. For instance, in Maricopa County, four hospitals are at full capacity, including the Abrazo Arrowhead Campus in Glendale. In Illinois' Cook County, the 7-day average of COVID-19 patients is 2,271.

When hospitals reach full capacity, they are required to notify the state agency, which can then order the hospital to stop taking new patients and transfer them to other hospitals. To support safe and seamless patient transfers, hospitals and health systems can adopt several strategies. Effective communication is the foundation of a successful patient transfer process. All team members involved in patient transfers should have easy access to the same, up-to-date patient information. Hospitals must identify opportunities to expedite a physician's acceptance of incoming patients through streamlined communication among physicians, clinicians, administrative staff, and other clinical staff.

To support streamlined processes and timely transfers, hospitals should develop and disseminate adequate transfer protocols and ensure robust technology and a high degree of teamwork. They should also address competing hospital priorities and manage hospital capacity. Patient transfers often involve multiple clinicians performing coordinated tasks, leaving patients vulnerable to adverse outcomes such as delays in care, interruptions in treatment, medication errors, increased infections, and inappropriate unit placement. Therefore, it is crucial to have well-defined transfer protocols and collaborative staff development to ensure safe and efficient patient transfers.

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