Review of VA's Proposed Hospital Bed and Staff Reductions for Fiscal Year 1979

An investigation was conducted of the Veterans Administration's (VA) rationale for cutting over 3,000 operating hospital beds and associated staff from its hospital system. Over the past decade, VA hospitals have been treating a larger number of patients with fewer beds. During that period, about 20,000 hospital beds have been eliminated from the VA system because of improved staffing and an increase in the use of alternatives to hospitalization. To prevent the reduction of personnel and beds from impairing operations at an individual facility, VA decided to attempt to close entire units such as wards. It was also decided that hospitals which were treating a high percentage of veterans for nonservice-connected conditions should lose more beds than those hospitals with a low percentage of such veterans. The following criteria were used to determine the locations and numbers of beds to be cut: construction and renovation requirements, patient privacy considerations, and occupancy rates. Most of the bed cuts were based on low occupancy rates. However, VA did not identify the reasons for low or high occupancy rates; analysis of these factors could provide VA with a basis to assess a hospital's performance and identify opportunities for improvement. It does not appear that the bed and staffing cuts will seriously affect VA hospital operations, and the bed and staffing cut is not a cut in the strictest sense because the cut positions are to be redistributed to other facilities.