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The effect of hospital bed reduction on the use of beds: A comparative study of 10 European countries


  • Kroneman, Madelon
  • Siegers, Jacques J.


In Europe, the reduction of acute care hospital beds has been one of the measures implemented to restrict hospital expenditure. The aim of this study is to gain insight into the effect bed reductions have on the use of the remaining beds within different healthcare systems. We concentrated on two healthcare system elements: hospital financing system (per diem and global budget systems) and physician remuneration system (fee-for-service and salary systems). We also controlled for technological development and demand for healthcare. We used data from the OECD health data files of 10 North-Western European countries on hospital bed supply and use. The hospital bed indicators used were occupancy rate, average length of stay and admission rate. The data were analysed with multilevel analysis. We found some indication that the different financial incentives of hospital financing systems do indeed influence hospital bed use in the case of reductions in acute care hospital bed supply in different ways. However, we found significant effects only for the hospital bed use indicators "occupancy rate" and "admission rate". For physician financing systems, no significant effects were found.

Suggested Citation

  • Kroneman, Madelon & Siegers, Jacques J., 2004. "The effect of hospital bed reduction on the use of beds: A comparative study of 10 European countries," Social Science & Medicine, Elsevier, vol. 59(8), pages 1731-1740, October.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:8:p:1731-1740

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    1. Piacenza, Massimiliano & Turati, Gilberto & Vannoni, Davide, 2010. "Restructuring hospital industry to control public health care expenditure: The role of input substitutability," Economic Modelling, Elsevier, vol. 27(4), pages 881-890, July.
    2. Manel Antelo & Francisco Reyes Santias & Adela Martinez Calvo, 2015. "Bed capacity and surgical waiting lists: a simulation analysis," European Journal of Government and Economics, Europa Grande, vol. 4(2), pages 118-133, December.
    3. Kristensen, Troels & Olsen, Kim Rose & Kilsmark, Jannie & Lauridsen, Jørgen T. & Pedersen, Kjeld Møller, 2012. "Economies of scale and scope in the Danish hospital sector prior to radical restructuring plans," Health Policy, Elsevier, vol. 106(2), pages 120-126.
    4. Massimiliano Piacenza & Gilberto Turati & Davide Vannoni, 2007. "Hospital Industry Restructuring and Input Substitutability: Evidence from a Sample of Italian Hospitals," CERIS Working Paper 200703, Institute for Economic Research on Firms and Growth - Moncalieri (TO) ITALY -NOW- Research Institute on Sustainable Economic Growth - Moncalieri (TO) ITALY.
    5. Garcia-Lacalle, Javier & Martin, Emilio, 2010. "Rural vs urban hospital performance in a 'competitive' public health service," Social Science & Medicine, Elsevier, vol. 71(6), pages 1131-1140, September.


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