OECD: Israel has highest hospital turnover rate
With annual number of patients per hospital bed nearing 100, quality of care is first to suffer; newborns, preemies are worst off
Each Israeli hospital bed is occupied by an average of 90 patients a year, according to an OECD report ranking the Jewish state as the worst among developed nations when it comes to hospital overcrowding.
According to the organization, Norway ranks second on the patient-per-bed scale, with 70 patients occupying each bed bed per year. Mexico and Turkey are next on the list, with 63.2 and 58.8 patients per bed, respectively.
The hospital bed turnover rate is the unofficial benchmark for hospital occupancy and the workload faced by hospital crew, both of which carry significant implications for the quality of care.
"This bit of data allows us to evaluate the manner in which we utilize the healthcare system's resources, as well as to measure the quality of care provided to hospitalized patients," said Dr. Ehud Kantor, a surgeon who deals with healthcare policy at the Israeli Medical Association. "The frequent turnover of patients that we see here in Israel points not only to the severity of the patients' illness, but also to incorrect or inefficient treatment caused by overload."
Patients released too soon
The hospital bed turnover rate incorporates two main factors – the number of beds, and the number of patients released each year. The latter factor could point to a positive trend for Israel; a relatively high rate of individuals discharged from hospitals could indicate that the medical technology here allows patients to be sent home quickly.
But Kantor notes that hospital officials face pressure to release patients too soon in order to clear bed for new patients, which is why the rate of repeat hospitalization in the country is also relatively high – 30%.
The number of hospital beds per 1,000 people in Israel is 1.88, below the OECD average of 3.8. Occupancy correlates directly, often surpassing the 100% come winter.
The ones who must bear the pressure are the hospital crews, who must go through the lengthy reception and discharge procedures far too frequently.
"You're not supposed to work at 100% capacity... The current situation forces you to work at the maximum intensity, all the time," Kantor said. "It's inhuman, not just for ethical reasons, but also for physiological ones… No wonder that mistakes are made."
The data is even more disconcerting when it comes to the number of beds designated for newborns and babies who are born prematurely. According to Health Ministry data, the average hospital bed turnover rate for babies and preemies is 125.9. In Jerusalem, the number is as high as 139 young patients per bed each year, but no district tops the Tel Aviv district, where 187 newborns occupied each hospital bed in 2010.
Newborn turnover is always higher than the general average due to the fact that their hospital stays are often shorter – 2.6 days on average, compared to 5.9 days in the general public.
Preemie units face bed shortage
But the preemie turnover is beyond any statistical adjustment, and underlines an overcrowding crisis of which medical professionals are well aware. A series of incentives given to neonatal doctors has increased the number of such medical residents from three to 16 a year, but the number of beds is yet to be increased. According to a study conducted by the Knesset Research and Information Center, Israel is currently short as many as 200 preemie beds.
Professor Shaul Dolberg, the chairman of the Israel Neonatal Society who also heads the Neonatology Department at Tel Aviv's Sourasky Medical Center, said that he does not see the shortage being remedied in the near future. He noted that hospitals often resort to placing preemies in the neonatal units, where issues that are unique to babies who are born ahead of time sometimes go unnoticed.
The Health Ministry received a budget for an additional 960 hospital beds last year, but officials in the ministry stress that the shortage is closer to 4,000.
"We're making efforts to improve response, reduce repeat hospitalizations and decrease the hospital bed turnover rate," said Professor Arnon Afek, deputy director-general of the Health Ministry. "The data shows the increasing efficiency of the healthcare system, both in the hospitals and the community. It's about time we added beds to the system."
