Bed Capacity and Utilization at Hospitals With Trauma Centers

Area of Science:

• Emergency Medicine
• Health Systems Research
• Public Health Preparedness

Background:

• Rising demand on US trauma care systems necessitates an evaluation of current bed utilization and surge capacity for mass casualty events.
• Understanding trauma bed occupancy and reserve capacity is crucial for effective national preparedness and response.

Purpose of the Study:

• To assess the occupancy and distribution of adult trauma-designated beds across US hospitals.
• To evaluate the US trauma system's capacity to absorb sudden and sustained surges in trauma volume.

Main Methods:

• A cross-sectional study analyzed 121 weeks of facility-level bed data for 2027 US trauma centers (January 2022-April 2024).
• Simulation modeling assessed bed capacity under various casualty influx scenarios, focusing on Level I/II trauma centers.

Main Results:

• Level I/II trauma centers consistently operated above 80% inpatient and 75% ICU bed occupancy, with significant regional disparities.
• Simulation showed national trauma bed deficits exceeding 20,000 beds within 45 days at influx rates of 1500-2000 patients/day.
• Even modest influxes of 241 patients/day saturated designated trauma beds within 90 days.

Conclusions:

• The US trauma system, particularly tertiary centers, operates at high occupancy with limited reserve capacity for surges.
• Urgent need for national trauma capacity planning, regional load-balancing, and scalable infrastructure to enhance system resilience.