December 18, 2012

Empty beds may signal too many hospitals

A low occupancy rate in some of Maine's acute care centers raises questions about their roles.

By Jessica Hall
Staff Writer

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Erik Steele, chief medical officer at Eastern Maine Healthcare Systems, said some small or regional hospitals have scaled back certain services because they may not have the staff to handle complex health problems, and have focused instead on a core group of procedures.

"The low-volume issue has an impact, but it's hard to quantify," Steele said. "It's certainly true as the numbers of patients you have with certain complex problems gets small, you have trouble preventing against skill-set degradation. Not every organization is comfortable with every problem."

The most complex cases are sent to bigger urban hospitals in Bangor, Portland or even Boston, where there is a diversity of staff and expertise, and more experience handling unusual or complex problems.

While too few occupied beds is a risk, hospitals also face financial problems when they are too full or overcrowded. More mistakes are made, infection rates rise, more patients die and readmission rates increase, experts said.

Hospital officials said occupancy rates are only one metric for rating hospitals.

As more care shifts to outpatient clinics, rehabilitation services and home health services, hospitals are becoming a smaller and smaller piece of the overall medical system.

"Beds is less of a marker of what hospitals are doing these days," Steele said.

While Litvak said occupancy rates could rise under the Affordable Care Act, as more people get access to health insurance, others suggest that the swing towards outpatient care will be more likely to increase.

The battle over Parkview is just one of several changes afoot in Maine's health care system.

The parent of Mercy Hospital signed a letter of intent to be acquired by Eastern Maine Healthcare, the parent of Eastern Maine Medical Center.

Goodall Hospital in Sanford recently got approval to join MaineHealth, which includes Maine Medical Center in Portland and 10 other hospitals. 

Staff Writer Jessica Hall can be contacted at 791-6316 or at:

CORRECTION: This story was updated Dec. 18, 2012 to reflect that Erik Steele's title is chief medical officer of Eastern Maine Healthcare Systems, not Eastern Maine Medical Center.

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