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Influence of bed occupancy and patient characteristics on bedspacing practices: a multicentre retrospective cohort study

Year: 2026

Type: article

Abstract: Objectives Hospitals cohort similar patients in departments. When departments are operating under high bed occupancy, patients may be relocated from the admitting department to a ward belonging to an off-service ward of a different clinical specialty. This process, often referred to as bedspacing, is not well understood and may have a negative impact on patient safety. As such, the objective of this study is to investigate the impact of patient characteristics and bed occupancy on bedspacing. Design Retrospective cohort study. Setting Nine hospitals in a Swedish healthcare region between 2015 and 2019. Participants 2 34 325 patients above the age of 18 who experienced unplanned hospital admission. Outcome measurements Bedspacing operationalised as patients that were admitted to a cohorting department but physically located in an off-service ward. Results The most important determinants of bedspacing were diseases of the genitourinary system (HR 1.23 (95% CI 1.16 to 1.31)) and musculoskeletal system (HR 1.37 (95% CI 1.27 to 1.47)). Patients with diseases of the circulatory system (HR 0.58 (95% CI 0.54 to 0.61)) and nervous system (HR 0.52 (95% CI 0.47 to 0.57)) were less likely to be bedspaced. Other patients characteristics such as age (HR 0.954 (95% CI 0.940 to 0.970 per SD increase), registered sex (HR 0.841 (95% CI 0.82 to 0.86) for men) and marital status (HR 1.194 (95% CI 1.16 to 1.23) for widows/widowers) were also found to influence bedspacing. Regarding bed occupancy, the HR of being bedspaced was 1.46 (95% CI 1.39 to 1.54) when comparing above 115% to less than 85% bed occupancy. Conclusions Both clinical and non-clinical patient factors influenced bedspacing. Bedspacing was positively associated with bed occupancy with substantial variation across departments and operationalisations of bedspacing. Future research should differentiate between different types of bedspacing and bed occupancy to identify conditions under which bedspacing may be safe and equitable.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-120864

Authors: Wilhelm Linder, Ulrika Winblad, David Isaksson

Institution: Uppsala University

Language: English

Topic: Healthcare Operations and Scheduling Optimization

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839