What are the primary causes of hospital overcrowding?
The primary cause is a mismatch between the supply of beds, poor flow of patients through beds, and demand. As demand increases and the bed supply shrinks, flow through hospitals becomes impaired. The most important driver has been the increasing age of patients coming into hospitals. As patients get older, they tend to consume more resources for the same kind of medical conditions.
Another most important reason is inconsistent standards across different hospitals. Obviously, people will prefer to spend a bit more but get a better services during the tough time. A basic common service must be guaranteed by every hospital.
Some of the other reasons for overcrowding IPD/Ward are :
- The admission of those patients who needs its treatment in OPD.
- Some of the patients escaping from work, by getting himself/herself unnecessarily admitted
- Delay in the treatment of the patient due to insufficient resources of the hospitals.
- Delay in discharging of patients.
- The unnecessary or unscheduled absence of doctors or other medical services.
Similarly, the common reason for overcrowding in OPD are:
- lack of clarity in terms of information
- Irregularities in the attendance of doctors/nurses and other medical staff.
- Absence and poor functioning of inquiry services.
- Rhythmic visiting of patients, who have already been visited by the same ward doctors.
Suggestion for overcoming the overcrowding problem
There are three broad strategies for managing access block resulting from hospital overcrowding —
1) Reducing hospital demand
through the diversion/substitution of the patient to community services and provide more services in the community that traditionally occur in hospital. Some of the program that may be very useful are hospital outreach programs, a hospital in the home, and improved after-hours general practice services
2) Optimizing hospital bed capacity: this includes:
- Balancing elective and emergency workload
- Better and quicker discharge by moving patients quickly from acute hospitals to more appropriate facilities
- Access to the rehabilitation center and residential aged care can also improve the effectiveness of bed usage
- If the infrastructure expansion is feasible then the hospital should also increase bed numbers
3) better scheduling (specially for OPD) and booking
can ensure that the patient doesn’t need to wait for a longer period and hence you need less resources to manage the OPD area as well as there will be less crowding.
As a health care provider, we must understand that the demand for health care is elastic and potentially unlimited. We must be judgmental about what is essential versus what is desirable, and how much the community should pay (where health care is being provided free of cost). Also, special focus must always be on prevention. There is potential to reduce demand by disease prevention strategies, and improved management of patients with chronic ill health.
The prevention must be initiated at the individual level. We must take personal responsibility and adopt a better life style to live a healthy life. It is not at all a bad idea to include total health checkup in your yearly goal even if you are a healthy person.
