Influence of bed occupancy and patient characteristics on bedspacing practices: a multicentre retrospective cohort study
- 1Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden
- 2Health Services Research, Uppsala University, Uppsala, Sweden
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.
Related
- The effectiveness of a complex intervention, aimed at reducing hospital occupancy, to improve Emergency Department patient flow: a retrospective controlled interrupted time series
- Pretreatment AMH–AFC stratification of poor-ovarian-response risk in young women with diminished ovarian reserve: a multicentre retrospective cohort study
- Burr-Hole Intersection of Middle Meningeal Artery Branches and Recurrence in Chronic Subdural Haematoma: a Multicentre Retrospective Cohort Study
- Routes to Diagnosis and Stage at Diagnosis of Colorectal Cancer in Patients Aged ≥ 50 Years: A Multicentre Retrospective Cohort Study From North Wales, UK
- Clinical and Genetic Spectrum of VPS13A Disease Across India: A Retrospective Multicentre Genetically Confirmed Cohort
BibTeX
@article{linder2026influence,
title = {{Influence of bed occupancy and patient characteristics on bedspacing practices: a multicentre retrospective cohort study}},
author = {Wilhelm Linder and Ulrika Winblad and David Isaksson},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-120864},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-120864},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Influence of bed occupancy and patient characteristics on bedspacing practices: a multicentre retrospective cohort study
AU - Wilhelm Linder
AU - Ulrika Winblad
AU - David Isaksson
PY - 2026
DA - 2026/10/26
JO - BMJ Open
DO - 10.1136/bmjopen-2026-120864
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-120864
AB - 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.
SN - 2044-6055
SN - 2044-6055
ER -