Answer the following questions from the case study below.
Case Study 5.1. Determining Bed Demand for Cardiac Patients Aged 65–84
The Virginia Commonwealth University Medical Center is a 747-bed hospital located in Richmond, Virginia, which had a population of 228,783 in 2017. As vice president of planning, suppose that you are responsible for projecting bed size in a new hospital tower that is scheduled for construction in 2022. Determining bed demand is a complex process that involves consideration of: (1) the service area from which the hospital draws, (2) use rates for various kinds of medical and surgical conditions, (3) service lines, and (4) bed utilization. To simplify the analysis, you are concerned only with the group aged 65–84, and only with medical and surgical treatment for coronary heart disease (CHD). Obviously the analysis can be extended to all age groups, and to all medical and surgical conditions, and then aggregated to derive a total estimate of bed demand. Assume that we have a service area of 60,000 people aged 65–84 from which the hospital draws patients. The care can be broken up into primary (75 to 80 percent of admissions), secondary (10 to 15 percent of admissions), and tertiary (5 to 10 percent of admissions) service areas, each with distinct use rates that reflect underlying demographic characteristics. Assume that you use 2017 utilization rates to project bed demand to 2022 and that the population in the service area is expected to grow by 18 percent to 70,800 in 2022 and by 36 percent to 81,600 in 2027.
Questions
1.
Assume that 2017 utilization rates in patient days (per 1,000 population, aged 65–84) in the primary, secondary, and tertiary service areas are 90, 115, and 120, respectively, for CHD patients. What might explain these differences in use rates?
2.
Assume that the overall 2017 use rate (per 1,000) for all areas combined is 95. With a population of 60,000 eligible patients, aged 65–84, how many patient days does this represent? (A
patient day
is one patient occupying one bed for one hospital day; if one patient stayed in the hospital for an entire year, that patient would accrue 365 patient days.)
3.
Assuming that the use rate remains the same for CHD patients aged 65–84, how many patient days can be anticipated in 2022? In 2027?
4.
How many beds are required for CHD patients in 2022 and 2027, assuming 100 percent utilization (each bed is filled all the time)? What about 75 percent utilization? Why is the number of beds needed at 75 percent utilization higher?
5.
Why might the prevalence of smoking be lower among the oldest men and women?