Post the COVID-19 pandemic, the U.S. hospital occupancy rate climbed 11% compared to pre-pandemic levels largely because of a national reduction in staffed beds, a new UCLA study has found.

From 2009 to 2019, the U.S. had on average 802,000 staffed beds. That number has since dropped to 674,000.

This can have huge ramifications as the population ages, researchers said.

Without changes, the projected number of annual hospitalizations is expected to rise from 36.1 million this year to 40.1 million over the next decade.

This would equate to a roughly an 85% occupancy rate for adult beds by 2032 and for pediatric beds by 2035.

“This puts the U.S. on track for a severe shortage of hospital beds unless action is taken,” researchers said.

Among the study’s takeaways:

• From 2009 to 2019, the average hospital occupancy in the U.S. was 63.9%.

• In the year following the end of the pandemic emergency designation in 2023, the average occupancy was 75.3%.

• The number of staffed hospital beds declined roughly 16% from 802,000 pre-pandemic to 674,000 post-pandemic.

Hospital occupancy post-pandemic ranged widely from 43% in Wyoming to 88% in Rhode Island.

In Colorado, the rate was about 65% — about 10 percentage points less than the national average.

“It’s better positioned than other states to avoid a hospital bed shortage,” Richard Leuchter, the study’s lead author, said of Colorado.

Neither the state health department nor the Colorado Hospital Association track future capacity.

While the state health department tracks daily capacity, “long-term hospital bed planning is a different strategy,” said Kristina Iodice, a spokesperson for Colorado’s Disease Control and Public Health Response Division,

A bed utilization of 85% becomes a concern because it’s an indicator that a hospital is nearing full capacity that leaves little room for surges in patient demand, as was seen during spikes in COVID-19 infections. Overcrowding can result in longer wait times, an increased risk of hospital-acquired infections and strain resources that lead to staff burnout.

The reasons for the increased occupancy are diverse.

“There are a lot of reasons why we’re losing hospital beds that are separate from staffing issues,” Leuchter said.

These include hospital bankruptcies, administrative overhead and private equity acquisitions.

For example, between 2010 and 2019 private equity firms acquired 156 hospitals.

Nationally, 457 hospitals are owned or operated by private equity firms, according to an examination by the Private Equity Stakeholder Project. That represents about 8% of all privately operated hospitals. In Colorado, private equity firm ownership accounts for about 9% of the state’s privately operated hospitals.

The concern with private equity ownership is with aggressive cost-cutting measures to maximize returns, which has led to staff reductions and shorter hospital stays that — potentially — can compromise care and patient safety.

Building more beds, though, may not be the solution.

New delivery models such as telemedicine, hospital-at-home and urgent care centers can help reduce the need for hospital stays.

“If you’re going to an ER and are expected to be admitted, you may in the near future be referred to one of these,” Leuchter said.

Because the study relied on Department of Health and Human Services data, which was limited to mandated weekly reporting between August 2020 to April 2024, pre-pandemic state-level occupancy rates were not examined.