Hospital beds keep withering despite demographic change

The Treasury has not allowed the addition of any new hospital beds in a decade, but has agreed to 1,000 more around the country over the next 6 years.

By JUDY SIEGEL-ITZKOVICH
Hospital 311 (photo credit: Ariel Jerozolimski)
Hospital 311
(photo credit: Ariel Jerozolimski)
Although Israel’s population continues to grow and to age, the number of budgeted hospital beds continues to decline as some departments close or are reduced due to the lack of funding and medical staffers.
The Health Ministry’s annual hospitalization report covering 2009, issued for publication on Thursday, does not include the possible closing of Jerusalem’s 200-bed Bikur Cholim Hospital within a month.
According to the report, bed rates in all types of hospitals – general, psychiatric, geriatric and rehabilitation – are lower here than in the rest of the OECD countries, with higher occupancy rates and shorter hospital stays. The number of beds, 42,119 at the end of 2009, has declined especially in general hospitals and psychiatric institutions.
There were 371 institutions with hospital beds in 2009, just 45 of them general hospitals and 31 of these with more than 100 beds. There were 13 psychiatric institutions (11 with more than 100 beds), 311 for chronic illnesses and the aging (79 with more than 10 beds) and two rehabilitation hospitals.
There has been a 13-percent decline in the number of budgeted beds since 2000. Beds are added to hospital departments when there is a rise in patients, but these are not funded, and nurses and doctors are not added. The bed rates are lowest in the North and South, compared to those in the Center of the country.
Ninety-six percent of hospital beds are occupied at any one time, and that rate has remained stable in recent years. In 2009, there were 5.1 million hospitalization days, 37% in internal medicine and 34% in surgical departments. In 2009, 22,333 patients died in hospitals, more than half of them in general hospitals.
The average patient is hospitalized for only four days; a quarter of general hospital patients remain there for only a day, and only 12% are there for more than a week.
A quarter of patients were under the age of 24, a fifth aged 25 to 44, another fifth aged 45 to 64, and a third aged 65 and up. The rate of people over 75 in the hospitals is growing, reaching 22% compared to only 19% in 1999.
The trend of a decline in day-hospital treatments has been observed in all types of hospitals – general, psychiatric, geriatric and rehabilitation. There were 1,164 beds for kidney dialysis at 64 dialysis units in 2009, with half of them in private institutions, a quarter in state hospitals and 15% owned by Clalit Health Service.
There were 435 beds for giving birth, with a low rate of 1.5 beds per 1,000 live births. The lowest rate was in the South.
The Treasury has not allowed the addition of any new hospital beds in a decade, but it has agreed to 1,000 more around the country over the next six years.