Inappropriate Number of Acute Care Beds Planned by VA for New Hospitals

HRD-78-102: Published: May 17, 1978. Publicly Released: May 17, 1978.

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The Veterans Administration (VA) is planning four replacement hospitals as part of its construction program. VA relied on historical patient work load data trends projected to 1985 from each of the existing facilities in making its estimates of future bed requirements. However, historical data on patient use of existing facilities are not considered a good indicator of future needs if lower-cost alternatives to acute care are not readily available to VA in sufficient quantities. Without access to such alternatives as intermediate care and nursing home care, VA hospital patients would tend to remain longer than necessary in acute care beds, and historical data on patient use would be artificially inflated.

To suggest a way to overcome these problems, a new model was developed which analyzed past practices and determined what different degrees of care should have been provided. The model is designed to analyze computerized medical records of each patient discharged from the existing VA hospital and to determine how long, on an average, such a patient would have remained in an acute care bed section of a nonfederal community hospital. The model does not suggest that VA hospital beds are used for patients without medical problems but that their problems often do not require the resources associated with acute care beds for the full period of their medical treatment. The VA method of projecting admissions and average length of stay should be changed because it does not adequately discern between acute and other types of care or show expected changes in the age mix of eligible veterans.

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