Cold bed: A challenge for an academic medical center in San Luis Potosi, Mexico

Cir Cir. 2020;88(2):189-193. doi: 10.24875/CIRU.19001198.

Abstract

Objective: The objective of this study was to identify the time period during which a hospital bed could be virtually available according to the informatics and administrative hospital system while still being physically occupied by a patient in a hospital in Mexico.

Materials and methods: A cross-sectional study was conducted in a 250-bed Academic Medical Center located in Central Northern Mexico during February 2015. Both administrative and real patient discharges were registered in a hospital format. Central tendency measures were used to present collected data and bed/day costs were obtained from official national published costs.

Results: Nine hundred and forty-three patients were followed up during their hospital discharge process. Overall, 2.4% of hospital beds were occupied by discharged patients. The annual cost only for cold beds was $959,220.00 US$ ($14,348,304.00 MNX), without bringing about any benefits for patients. Cold beds represented 1.31% of the 2015 annual hospital budget.

Conclusions: Quality improvement initiatives must be implemented to allocate beds to patients more efficiently. The discharge process must be standardized to reduce bed/day direct hospital costs and strengthen the supervision of medical residents during this process.

Objetivo: Identificar el periodo de tiempo durante el cual una cama hospitalaria está virtualmente disponible en el sistema informático, mientras está ocupada por un paciente, en un hospital de México.

Método: Se realizó un estudio transversal en un centro médico académico de 250 camas, localizado en el centro-norte de México, en febrero de 2015. El alta administrativa y real del paciente fueron registradas en un formato institucional. Se utilizaron medidas de tendencia central para presentar los datos. El costo del día/cama se obtuvo de lo oficial publicado para la nación.

Resultados: 943 pacientes fueron seguidos durante el proceso de egreso. El 2.4% del total de las camas estuvo ocupada por pacientes egresados. El costo anual por las camas frías/muertas fue de $959,220.00 US$ ($14,348,304.00 MNX), sin beneficio para los pacientes. Las camas frías/muertas representaron el 1.31% del presupuesto hospitalario anual en el año 2015.

Conclusiones: Es necesario implementar iniciativas de mejora para asignar eficientemente las camas a los pacientes. El proceso de egreso debe estandarizarse para reducir el costo directo hospitalario por día/cama. Hay que fortalecer la supervisión de médicos residentes que participan en este proceso.

Keywords: Academic medical center; Alta del paciente; Bed occupancy; Capacidad hospitalaria de 100 a 299 camas; Centro médico académico; Hospital bed capacity 100-299; Ocupación de la cama; Patient discharge.

MeSH terms

  • Academic Medical Centers
  • Bed Occupancy / economics
  • Bed Occupancy / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Hospital Costs
  • Humans
  • Male
  • Mexico
  • Patient Discharge*