The first question that health authorities often ask about hospitals is, “How many beds do you have?” Traditionally, this indicator has been one of the most iconic units of measurement of health planning and one of the most emblematic resources in the psychology of patients.
However, the hospital bed will no longer be such a significant point of reference. This is because of the convergence of factors that intensify and have generated changes in the organization of health systems and the role of hospitals within them.
Hospitals face new challenges
The primary factor in the midst of these new trends is the demographic and epidemiological transition – older populations and a higher burden of chronic diseases and multiple pathologist. This generates a growing demand for services in a general context of secured financing. Also, the pressure on health spending intensifies due to the high inflation rates in the sector, the new high-cost technologies, and the inefficiencies of the systems historically oriented to pay attention to acute conditions in the face of the wave of synchronicity.
The patients themselves have also transformed the way hospital consultancy services in India work. They are increasingly better informed about health, are more proactive in the management of their conditions and have higher expectations about the quality of services. Likewise, information and communication technologies allow new ways of interaction between health personnel and patients, as well as the spatial configuration of services.
To survive, adaptation is mandatory
There are several ways in which hospitals are responding to this new reality, among which the following stand out:
– Articulation of hospitals in integrated networks of diversified services. Advances in medical technology associated with outpatient surgery and hospital consultancy services (in oncology, for example), the predominance of the chronic patient, and the development of information and communication technologies (ICT) make it possible to transfer services outside the hospital, through tel monitoring recovery and home hospitalization, remote consultations, and medicine.
Also, complementary health services are being configured, such as long-term intermediate care for subacute patients, which seek to reduce the risk of acquired infections in hospitals and use beds efficiently. To adequately care for chronic patients with multiple pathologist, greater continuity of care, multidisciplinary, integration with social health services and strengthened primary care are required.
– Specialization of the offer. The traditional model of the general hospital with a portfolio of similar services has proved unviable in many countries. Therefore, it is increasingly common to find hospitals with a particular focus to increase patient volumes to optimize quality and reduce unit costs. This phenomenon, together with the departure of non-acute patients to secondary health services, is resulting in hospitals that concentrate a higher proportion of complex cases and require more sophisticated medical-surgical interventions.
Consequently, in some countries, there is a reduction in the number of beds for acute patients and also a shorter average stay, associated with the perfection of medical technologies.
– New collaboration and contracting relationships. Hospitals traditionally operated entirely autonomously; however, it is more efficient to structure some independent services that can serve multiple providers. Diagnostic imaging and laboratory, for example, were the first to use this model, maximizing the productivity of technology and human resources of high cost and limited, which could hardly be absorbed by a single entity. Likewise, different providers are integrating clinical services through the creation of unique teams, the exchange or rotation of professionals and residents, the adoption of standard protocols, the joint accounting of production, and the use of ICT.