Feb. 19, 2025 — U.S. hospitals could see a “dangerous” shortage of beds in the not-so-distant future as the population ages and hospitalizations are projected to rise.
This could lead to longer wait times, increase the risk for health complications, and hamper hospitals’ response when demand surges, such as during disease outbreaks.
“It is already the norm at many hospitals, including some of the ones I work at, for patients to wait 35 hours or more in the emergency department (sometimes over 120 hours) to get a bed upstairs,” said Richard K. Leuchter, MD, a hospital doctor and lead author of the new shortage projections. “This will become the norm throughout the nation.”
Largely driven by an aging population, annual hospitalizations are expected to increase from 36 million in 2025 to 40 million in 2035. Without changes to the number of hospital beds or staffing levels, that means hospital occupancy rates would reach 85% for adult beds in 2032 and for adult and pediatric beds combined by 2035.
An 85% occupancy rate is widely considered a conservative estimate as the starting point of a shortage.
The findings were published today in the journal JAMA Network Open and should be a call to action, said Leuchter, who is an assistant professor at UCLA’s David Geffen School of Medicine in Los Angeles.
“We aren’t too late to avoid a hospital bed shortage -- we certainly have the means to do so,” Leuchter said. “It will just take a concerted effort on the part of patients, physicians, policymakers, and health system leaders.”
Post-pandemic hospital occupancy rates have remained significantly elevated (by 11 percentage points compared to pre-2020 numbers), and it’s not due to more utilization but because staffing is down.
The new projections were possible because of federal requirements launched during COVID requiring more detailed reporting of hospital occupancy, the study authors wrote.
Leuchter called for greater investment in hospital care, noting that $1.5 trillion of annual U.S. health care spending is hospital expenditures, which is around 30% of national health care spending. (As of press time, many Trump administration health care spending cuts were still pending, unannounced, or part of legal challenges.)
“With that much spending, you would expect to have superb quality, yet nearly a quarter of hospitalizations contain at least one adverse event, 23% of which are preventable,” Leuchter said. “These errors might be something like a missed diagnosis by an overworked physician, a delayed antibiotic by a nurse stretched too thin, or a medication mix-up by an overburdened pharmacist. This is serious for patients, as prior studies using inpatient mortality data have estimated that medical error is the third leading cause of death in the U.S.”
What You Can Do
The projected shortage is an opportunity to consider new technologies — such as telehealth, remote patient monitoring, and AI-powered diagnostics — that can provide hospital care in less-expensive outpatient settings and that reduce the risk of infections commonly acquired during hospitalization. Reducing hospitalization needs by about 10% would be enough to prevent a shortage in the next decade, Leuchter said.
“As these types of models propagate nationally, one thing patients can do is be open to using them even though it’s not what they may be used to,” Leuchter said.
Another way to avoid long wait times is to consider reaching out to your primary care team before heading to the ER for non-life-threatening conditions that don’t need immediate attention, Leuchter said.
“If a patient makes it clear to their doctor that they want to stay out of the hospital, primary care clinics now often contain support staff who can help coordinate care, reach out to subspecialists, and provide an additional layer of support that may be enough to prevent a hospital admission,” Leuchter said.