Study: Hospitals Running Out of Room

Israeli hospitals are overwhelmed with patients, and on dozens of occasions the Health Ministry has had to suspend the admission of new patients, according to reports issued by the ministry.

The emergency room at Rambam Medical Center in Haifa.
Tomer Neuberg

The peak season for hospitalization in Israel is usually winter, but this year hospital wards were at overcapacity even last week. According to data compiled by the medical administration at the Health Ministry, inpatient departments at Schneider Children's Medical Center of Israel was at 149 percent of capacity. Shaare Zedek Medical Center, Jerusalem, was at 127 percent; Laniado Hospital, Sanz Medical Center, Netanya was at 124 percent. Tel Aviv's Ichilov was at 122 percent, Hadassah University Hospital Ein Karem at 121 percent, Sheba Medical Center, Tel Hashomer was at 117 percent and Hadassah University Hospital Mount Scopus was at 105 percent of capacity.

The aggregate capacity use at all Israeli hospitals combined was 98 percent, similar to winter months and above the average annual capacity of 96.2 percent.

According to one recent report, in the past 18 months the Health Ministry approved the temporary closure of various hospital departments to new admissions 251 times. The report, issued by the ministry's head of general medicine, Dr. Michael Dor, found that Schneider had the most closures. The hospital's trauma unit was closed for new admission 90 times during the period, while its pediatric intensive care unit was closed to new patients 50 times.

Significant overload was also noted in Haifa, where on one occasion the Rambam, Carmel and Bnei Zion hospitals all requested permissions for temporary closure, prompting the ministry to ask all Haifa hospitals to coordinate their emergency-room hours so that each one admitted new patients for a few hours at a time in rotation. The ministry also allowed 30 temporary closures due to outdated medical equipment, including 20 cases involving nonworking CT scanners.

The hospitalization overloads come as life expectancy continues to rise, exacerbating a severe shortage of hospital beds. In August 2007 the Health Ministry suspended the addition of new hospital beds. That agreement is due to expire later this year. Speaking at a conference at the National Health Policy Institute in May, Health Ministry Director General Dr. Ronni Gamzu hinted that he will begin lobbying for additional beds.

According to a recent ministry survey, Israeli patients spent a total of 70,000 days on beds in hospital corridors due to the shortage of space in patient rooms.

During a recent tour of hospitals in the north of the country Deputy Health Minister Yaakov Litzman said that 1,600 additional hospital beds are needed.

As of late 2008 Israel had a total of 14,582 hospital beds, or fewer than two beds per 1,000 residents, the lowest rate among OECD members with the exception of Mexico. By comparison, Britain has 2.6 beds per 1,000 residents, while the numbers for the United States, France, Germany and Japan are 2.7 beds, 3.6 beds, 5.7 beds and 8.2 beds, respectively.

The field of "internal medicine is collapsing," said Dr. Dror Dicker, chairman of the Israel Society for Internal Medicine and director of the internal medicine department of Hasharon Hospital. "The population growth increases the number of hospitalized patients and the improvement of medical care leads to the hospitalization of patients with more critical and complicated conditions."

"Last year, internal medicine departments admitted more than 300 patients beyond the permitted capacity, and many patients had to be placed in hallways. This is a problem we cannot ignore any longer. What's needed is a strategic decision to increase the number of beds and add human resources, together with improving salary conditions for internists," Dicker said.

The Finance Ministry issued the following response "The new health ministry director general, as a former hospital director, is pushing an agenda in which improving hospitals is a higher priority than expanding the health care services basket or dental care for children. All these and other issues are being discussed with the Health Ministry as part of the state budget deliberations, in which the priorities of the health care system for the next two years will be determined."