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Myths of ideal hospital occupancy

David Mountain, Daniel Fatovich and Sally McCarthy
Med J Aust 2010; 193 (1): . || doi: 10.5694/j.1326-5377.2010.tb03751.x
Published online: 5 July 2010

To the Editor: Many of the arguments put forward by Bain and colleagues about modelling hospital occupancy1 are true in an academic sense. We agree that many acute care models use simplified inputs and outputs, without accounting for rapid daily fluctuations in occupancy. Occupancy definitions are often misleading and subject to gaming. We agree with the work by Bain, Taylor and others that highlights as a problem “the inability to move patients from the [emergency department] to a ward” and that hospitals should “engage procedures to free inpatient beds well in advance” of access block occurring.2 The capacity of a hospital must have flexibility to deal with demand fluctuations.1


  • 1 Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth, WA.
  • 2 Australasian College for Emergency Medicine, Melbourne, VIC.
  • 3 Centre for Clinical Research in Emergency Medicine, University of Western Australia, and Emergency Department, Royal Perth Hospital, Perth, WA.
  • 4 Emergency Medicine, Prince of Wales Hospital, Sydney, NSW.



  • 1. Bain CA, Taylor PG, McDonnell G, Georgiou A. Myths of ideal hospital occupancy. Med J Aust 2010; 192: 42-43. <MJA full text>
  • 2. Au L, Byrnes GB, Bain CA, et al. Predicting overflow in an emergency department. J Management Math 2009; 20: 39-49.
  • 3. Cooke MW, Black S, Fletcher A, Jennings M. Flows through beds not occupancy. [e-letter in reply to “Total time in English accident and emergency departments is related to bed occupancy”]. Emerg Med J [internet] 2005. Epub 2005 Jan 17. http://emj.bmj.com/content/21/5/575.extract/reply#emermed_el_446 (accessed Mar 2010).
  • 4. Richardson DB, Mountain D. Myths versus facts in emergency department overcrowding and hospital access block. Med J Aust 2009; 190: 369-374. <MJA full text>
  • 5. Garling P. Final report of the Special Commission of Inquiry. Acute care services in NSW public hospitals. Overview. Sydney: New South Wales Government, 2008. http://www.lawlink.nsw.gov.au/lawlink/Special_Projects/ll_splprojects.nsf/vwFiles/E_Overview.pdf/$file/E_Overview.pdf (accessed May 2010, link no longer available).

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