Hospital Emergency Surge Capacity: An Empiric New York Statewide Study
Received 9 February 2006; received in revised form 19 May 2006 and 11 September 2006; accepted 20 October 2006. published online 19 December 2006.
Study objective
National policy for emergency preparedness calls for hospitals to accommodate surges of 500 new patients per million population in a disaster, but published studies have not evaluated the ability of existing resources to meet these goals. We describe typical statewide and regional hospital occupancy and patterns of variation in occupancy and estimate the ability of hospitals to accommodate new inpatients.
Methods
Daily hospital occupancy for each hospital was calculated according to admission date and length of stay for each patient during the study period. Occupancy was expressed as the count of occupied beds. Peak hospital capacity was defined as the 95th percentile highest occupancy at each facility. Data obtained from the New York Statewide Planning and Research Cooperative System were analyzed for 1996 to 2002. Patients were classified as children (0 to 14 years, excluding newborns) or adults. Vacant hospital beds per million age-specific population were determined as the difference between peak capacity and average occupancy.
Results
In New York State, 242 hospitals cared for a peak capacity of 2,707 children and 46,613 adults. Occupancy averaged 60% of the peak for children and 82% for adults, allowing an average statewide capacity for a surge of 268 new pediatric and 555 adult patients for each million age-specific population. After the September 11, 2001, attacks, in the New York City region, a discretionary modification of admissions and discharges resulted in an 11% reduction from the expected occupancy for children and adults.
Conclusion
Typically, there are not enough vacant hospital beds available to serve 500 children per million population. Modified standards of hospital care to expand capacity may be necessary to serve children in a mass-casualty event.
aDepartment of Pediatrics, State University of New York--Upstate Medical University, Syracuse, NY
bDepartment of Health Policy and Administration, Pennsylvania State University, University Park, PA.
Address for correspondence: Robert K. Kanter, MD, Department of Pediatrics, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY 13210; 315-464-5800, fax 315-464-7564.
Supervising editor: Kathy J. Rinnert, MD, MPH
Author contributions: RKK and JRM conceived and designed the study. RKK obtained the data from the New York State Department of Health. RKK and JRM managed the data. JRM performed the statistical analysis. RKK drafted the article, and both authors contributed to the revisions. RKK takes responsibility for the paper as a whole.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.
ABSTRACT