Why The U.S. Has A Problem With Hospital Capacity : NPR

MICHEL MARTIN, HOST:

You may be surprised to learn that the U.S. has fewer hospitals and hospital beds per capita than almost all other industrial nations, including Italy, France and the U.K. That’s according to analysis by the Peterson Center on Healthcare and the Kaiser Family Foundation. We wanted to learn more about why this is the case and how it could be affecting efforts to combat the coronavirus pandemic, so we’ve called Nancy Foster. She is vice president for quality and patient safety policy at the American Hospital Association, and she’s with us now.

Nancy Foster, welcome. Thank you for joining us.

NANCY FOSTER: My pleasure to be with you today. Thank you, Michel.

MARTIN: So before we jump in, as we mentioned, there are surges across the country. And I’m imagining as part of your work, you’re hearing from hospitals across the country about what they’re experiencing. Like, what are some of the top lines that they’re telling you?

FOSTER: You are exactly right. We are hearing from hospitals across the country. They are concerned because there are growing numbers of positive patients in their communities. Many of our members are already reaching capacity or have really struggled to keep enough staff on duty in order to care for all who are coming to them.

MARTIN: So it’s a staffing problem as well as an infrastructure problem.

FOSTER: It is.

MARTIN: So I want to talk about that infrastructure issue. I mean, according to data analysis by the Peterson Center on Health Care and the Kaiser Family Foundation that we cited earlier, the U.S. actually has fewer hospitals and hospital beds per capita than other industrialized nations, including Italy, China and South Korea. This is before the pandemic. Why is that?

FOSTER: In the U.S., we tend to use our hospitals to care for only those who are critically ill or, for instance, giving birth to a baby. Our length of stay in hospitals is generally less than that in other countries, so we tend to keep people in the hospital less time. We send them home to recuperate and provide support to them while they’re at home. Or if they need additional support, we send them to skilled nursing facilities or rehab facilities in order to recuperate from whatever brought them to the hospital in the first place.

MARTIN: So this reflects – what? – a different philosophy about how care should be delivered?

FOSTER: It does – a different utilization of the facilities.

MARTIN: What happens, though, if a hospital gets overwhelmed? What does that affect their ability to do?

FOSTER: Each of these jurisdictions has a plan for what to do when there is an emergency that overwhelms an individual hospital. And that plan will draw on other resources in the community. And that plan will also draw on available resources from the federal government or from hospitals across the country in sort of a volunteer effort to step forward and help each other out. We’ve seen nurses and doctors from other parts of the country voluntarily move to hard-hit communities in order to support the caregivers there.

The challenge we’re facing right now is that the outbreak is so widespread that it’s harder to find critical health care workers who are available to move into some of those hardest-hit areas. And so it is an ongoing challenge for us to try to meet the needs of patients in all areas of the country right now.

MARTIN: So before we let you go, as we know, we’re nearing the end of this election season. No matter who wins the election, we know that this health crisis will be with us for a while. And a number of commentators have observed that this crisis has laid bare issues that needed to be addressed anyway – you know, about issues around access to health care and things of the like as well as a number of issues, safety issues – the access to protective equipment, all these other supply chain issues.

Is there something that you would point attention to that this crisis has revealed that you think the public should be aware of anyway when it comes to the question of hospital capacity or the ability – of hospitals having what they need to serve the country in the days that – in the days and months ahead? Has something been revealed that you think people should know about anyway?

FOSTER: This virus has tested our ability to work collaboratively as a team across the health care continuum, keeping us integrated from public health to hospital to physician office to post-acute care setting or nursing homes so that we are effectively working as a collaborative team is something that has been absolutely necessary in this pandemic and something we need to work on for the future so that we are better caring for individuals in our communities.

MARTIN: That is Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association.

Nancy Foster, thank you so much for your time.

FOSTER: Thank you, Michel.

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