Shortage of Hospital Beds in Israel at Worst Level in Three Decades

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Patients in the internal medicine department of Assaf Harofeh Medical Center in Be'er Yaakov, south of Tel Aviv.
Patients in the internal medicine department of Assaf Harofeh Medical Center in Be'er Yaakov, south of Tel Aviv.Credit: Tomer Appelbaum

The ratio of hospital beds to population across the country has reached its lowest level in three decades, according to a Ministry of Health report. The number of hospital beds per thousand people in 2017 was 1.796, compared to 1.913 in 2010, 2.224 in 2000 and 2.68 in 1988.

The report notes that between 2010 and 2017, the country’s population grew by 1.1 million people, while the number of beds in the inner core wards grew by only 358.

The inner core of a hospital is comprised of the main hospitalization wards. It includes internal medicine, rheumatology, cardiology, endocrinology, nephrology, hematology, hemato-oncology, gastroenterology, lung units, geriatric internal medicine, neurology, brain stroke, oncology, oncology intensive-care, skin and venereal diseases, bone marrow transplantation, bone marrow intensive care and pediatric bone marrow transplantation. It does not include intensive care, surgical units, pediatrics and maternity wards which are also located in general hospitals.

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The number of beds did not keep up with the natural growth in population, let alone additional factors like a rise in life expectancy and an aging population. Thus, the data shows that 37 percent of people in internal medicine wards are 75 or older, compared to 33 percent in 2000.

The numbers indicate that Israel is gradually receding from OECD averages, which stand at 3.6 beds per 1,000 people, twice as high as in Israel.

The report shows that only 242 hospital beds were added in 2017, 83 of these going to inner core wards. Most of the new beds were accounted for by the new Assuta Hospital in Ashdod. In 2016, 69 beds were added to general hospitals, with 26 new ones in 2015.

The report also highlights a wide gap between the situation in large cities and central Israel on one hand, and the country’s periphery on the other.

Thus, the number of beds available for general admissions in Tel Aviv is 2.398 per thousand residents, in Haifa it’s 2.394, in Jerusalem it’s 2.068. In contrast, in the south the ratio is 1.523 beds per thousand residents, and in the north, 1.43.

The report shows an average 93 percent occupancy of beds in 2017, compared to 96 percent in 2012. In some departments, such as geriatrics, neurology, skin and venereal diseases, occupancy was above 95 percent.

That does not include the extremely high occupancy rate in internal medicine wards and emergency rooms, which bear the brunt of the load in winter.

Shorter average hospital stays is another sign of the stress on the system.

The average stay in internal medicine wards, pediatrics, intensive care and surgery is now two days, compared to three days in the previous two decades.

Department heads testified that they have to forgo some examinations and completion of treatment due to the shortage of beds and the need to release patients quickly to make room for others. They say that hospitals currently treat only the most severe cases, with other patients not receiving full care.

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