Impact of shortened length of stay for delivery on the required bed capacity in maternity services: results from forecast analysis on administrative data

Abstract

Background We examine the implications of reducing the average length of stay (ALOS) for a delivery on the required capacity in terms of service volume and maternity beds in Belgium, using administrative data covering all inpatient stays in Belgian general hospitals over the period 2003–2014. Methods A projection model generates forecasts of all inpatient and day-care services with a time horizon of 2025. It adjusts the observed hospital use in 2014 to the combined effect of three evolutions: the change in population size and composition, the time trend evolution of ALOS, and the time trend evolution of the admission rates. In addition, we develop an alternative scenario to evaluate the impact of an accelerated reduction of ALOS. Results Between 2014 and 2025, we expect the number of deliveries to increase by 4.41%, and the number of stays in maternity services by 3.38%. At the same time, a reduction in ALOS is projected for all types of deliveries. The required capacity for maternity beds will decrease by 17%. In case of an accelerated reduction of the ALOS to reach international standards, this required capacity for maternity beds will decrease by more than 30%. Conclusions Despite an expected increase in the number of deliveries, future hospital capacity in terms of maternity beds can be considerably reduced in Belgium, due to the continuing reduction of ALOS. Electronic supplementary material The online version of this article (10.1186/s12913-019-4500-8) contains supplementary material, which is available to authorized users.

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“…Majority of measures were focused on facility-based care, revealing a gap in measures covering the postnatal period after discharge at home. Over the last years many countries have shortened the length of stay after birth [107][108][109], with home visits by trained health workers becoming a more important part of PNC [110,111]. More quality of care measures focusing on the care at home (including professional care by health care workers, self-care and family care practices in the home) will be needed to also monitor and guarantee PNC quality outside the facility.…”