Bed Occupancy Rate (BOR)
Last updated: Sep 12, 2025
What is Bed Occupancy Rate?
The Bed Occupancy Rate is a fundamental metric in healthcare management that measures the percentage of staffed hospital beds that are in use over a specific period of time. It is an essential indicator of a hospital's efficiency and capacity. A higher rate indicates a greater utilization of available beds. While there is no single benchmark for an "ideal" rate, it must be balanced to ensure a hospital is efficiently using its resources without becoming so full that it cannot accommodate new patients or handle unexpected surges in demand.
Bed Occupancy Rate Formula
How to calculate Bed Occupancy Rate
The Bed Occupancy Rate is a percentage calculated by dividing the number of occupied beds by the number of staffed and available beds over a specific period and then multiplying the result by 100. For a more comprehensive view over time, the calculation often uses "patient days" and "bed days available". Consider "Maple Creek General Hospital" for a one-year period. - Total number of staffed and available beds: 150 beds - Total number of inpatient days for the year: 48,000 First, calculate the "Bed Days Available" for the year. Bed Days Available = 150beds × 365days = 54,750 Next, use the calculation to find the BOR. Bed Occupancy Rate = 48,000 patient days / 54,750 bed days X 100 = 87.7% This result indicates that, on average, 87.7% of Maple Creek General Hospital's staffed beds were occupied during the year.
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What is a good Bed Occupancy Rate benchmark?
While there is no single universally accepted benchmark for the ideal Bed Occupancy Rate, a range of 85-90% is often considered optimal. A rate within this range suggests a hospital is operating efficiently. When occupancy rates are higher than 90%, it may indicate a danger of overcrowding and the potential need to turn away patients. On the other hand, rates below 85% might suggest inefficient resource utilization. In Canada, the average hospital occupancy rate was over 85% in 2021, putting it among a small group of high-occupancy countries, including Israel and Ireland. The average bed occupancy rate for OECD countries in 2021 was 69.8%. In the U.S., the average hospital occupancy rate was approximately 64% in the decade leading up to the COVID-19 pandemic, but new research suggests a post-pandemic average of 75%, driven by a reduction in the number of staffed beds.
More about Bed Occupancy Rate
The Bed Occupancy Rate (BOR) is a critical tool for healthcare leaders and professionals who need to make data-driven decisions about resource management, patient flow, and financial performance. A hospital's BOR provides insight into how effectively it is managing its bed capacity and can be a component of a hospital's overall profile.
High levels of bed occupancy can indicate that a health system is under pressure. While it may seem that 100% occupancy would be the most efficient, hospitals cannot operate at this level. A certain amount of spare bed capacity is necessary to accommodate daily fluctuations in demand and to ensure that patients can be moved through the system in a timely manner. Overly high occupancy rates can be a cause for concern as they can lead to negative consequences, such as regular bed shortages, increased wait times in the emergency department, delays in patient admissions, and a greater risk of healthcare-acquired infections. Studies suggest that when a hospital's occupancy exceeds 80%, emergency department waiting times can increase significantly. Some research suggests that hospitals with average occupancy levels above 85% can expect regular bed shortages and periodic crises.
Conversely, a very low bed occupancy rate may indicate inefficient resource management. This could suggest that a hospital has too many staffed beds for its patient volume, leading to higher operational costs without a corresponding increase in patient care. The goal is to find a range that minimizes unused capacity while maintaining the flexibility to respond to patient needs.
Many factors can influence a hospital's BOR. These include:
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Medical Specialties: Certain specialties, such as general surgery, may have higher bed utilization rates than others, like ophthalmology, due to a higher ratio of emergency admissions.
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Demographics: Patient demographics can also play a role, as younger patients tend to have shorter lengths of stay compared to older patients.
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Patient Flow: Issues such as "alternate level of care" (ALC) patients, who no longer require acute care but remain in a hospital bed while waiting for placement in a long-term care facility or for home care services, can significantly impact the BOR and push the system past safe occupancy thresholds.
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Infection Control: Measures taken for infection control, such as creating space for social distancing, can also affect bed availability and occupancy rates.
Monitoring the BOR alongside other key performance indicators, such as average length of stay and hospital readmission rates, provides a more comprehensive picture of a hospital's performance. By analysing these metrics together, administrators can make more informed decisions to optimize operations, reduce costs, and improve patient care. For instance, improvements in clinical practices that reduce the average length of stay can lead to a lower BOR.
Bed Occupancy Rate Frequently Asked Questions
Why is a 100% bed occupancy rate not considered a good thing for a hospital?
A 100% occupancy rate would mean there are no empty beds available to accommodate new patients. This situation can lead to significant problems, such as longer waiting times for emergency care, a lack of capacity for unexpected surges in demand, and an increased risk of infections due to a lack of buffer space.
Can bed occupancy rates be over 100%?
In some contexts, a hospital's occupancy rate can exceed 100% if the number of patients being treated exceeds the number of staffed beds. This can occur when patients are placed in temporary beds in emergency rooms, hallways, or other non-traditional areas due to a lack of available beds on regular wards.
What is the main difference between "licensed beds" and "staffed beds"?
Licensed beds are the total number of beds a hospital is permitted to operate by a provincial or state government. Staffed beds, which are used to calculate the BOR, are the subset of licensed beds that are actually available for patient use because they have the necessary staff and resources to support them.