Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.

<h4>Background</h4>Despite persistently high rates of mental illness and suicide, receipt of treatment for mental health conditions remains low. In this context, it is important to quantify the number of inpatient psychiatric beds (IPBs), and to understand differences in the number of IP...

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Main Authors: Zoe Lindenfeld, Jonathan H Cantor, Colleen M McCullough, Jemar R Bather, Ryan K McBain
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-07-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1004682
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author Zoe Lindenfeld
Jonathan H Cantor
Colleen M McCullough
Jemar R Bather
Ryan K McBain
author_facet Zoe Lindenfeld
Jonathan H Cantor
Colleen M McCullough
Jemar R Bather
Ryan K McBain
author_sort Zoe Lindenfeld
collection DOAJ
description <h4>Background</h4>Despite persistently high rates of mental illness and suicide, receipt of treatment for mental health conditions remains low. In this context, it is important to quantify the number of inpatient psychiatric beds (IPBs), and to understand differences in the number of IPBs throughout the U.S, as these provide critical evaluation, medication, and stabilization services.<h4>Methods and findings</h4>This study used nationally-representative data drawn from the 2011-2023 Centers for Medicare and Medicaid Services' Healthcare Cost Report Information System (HCRIS). From 2011-2023, while the total number of IPBs-in both psychiatric hospitals (PHs) and short-term acute care hospitals (STACHs)-did not change, the number IPBs within STACHs fell from 11.3 in 2011 to 9.06 in 2023. During this period, 846 counties (in which over 244 million individuals reside) experienced a decline in the rate of IPBs, while another 1,449 counties (in which 59 million individuals reside) never had IPBs. In regression models predicting the number of IPBs in STACHs and PHs, hospitals that received DSH payments (STACHs: IRR:1.93, 95% CI: 1.72, 2.15; PHs: IRR:1.40; 95% CI: 1.06, 1.84), had more full-time employees (STACHs: IRR:1.35, 95% CI: 1.31, 1.38; PHs: IRR:1.77; 95% CI: 1.75, 1.80) and were teaching STACHs (STACHs: IRR:1.78; 95% CI: 1.63, 1.95) had significantly more IPBs. In county-level regression models, counties with a lower percentage of Black residents (β: -21.15; 95% CI: -37.14, -5.16) had a significantly higher rate of IPBs. The absence of a causal design means we cannot assess the reasons behind changes in IPBs across time, and is a limitation of this study.<h4>Conclusions</h4>This study provides an overview of the availability of IPBs throughout the U.S, as well as the number of individuals without access to IPBs. Findings indicate a dearth of STACH-based IPBs, particularly in areas with a greater proportion of racial minority residents.
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spelling doaj-art-5b59516febc54e7a9ef4571c888ce1f32025-08-20T03:39:09ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762025-07-01227e100468210.1371/journal.pmed.1004682Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.Zoe LindenfeldJonathan H CantorColleen M McCulloughJemar R BatherRyan K McBain<h4>Background</h4>Despite persistently high rates of mental illness and suicide, receipt of treatment for mental health conditions remains low. In this context, it is important to quantify the number of inpatient psychiatric beds (IPBs), and to understand differences in the number of IPBs throughout the U.S, as these provide critical evaluation, medication, and stabilization services.<h4>Methods and findings</h4>This study used nationally-representative data drawn from the 2011-2023 Centers for Medicare and Medicaid Services' Healthcare Cost Report Information System (HCRIS). From 2011-2023, while the total number of IPBs-in both psychiatric hospitals (PHs) and short-term acute care hospitals (STACHs)-did not change, the number IPBs within STACHs fell from 11.3 in 2011 to 9.06 in 2023. During this period, 846 counties (in which over 244 million individuals reside) experienced a decline in the rate of IPBs, while another 1,449 counties (in which 59 million individuals reside) never had IPBs. In regression models predicting the number of IPBs in STACHs and PHs, hospitals that received DSH payments (STACHs: IRR:1.93, 95% CI: 1.72, 2.15; PHs: IRR:1.40; 95% CI: 1.06, 1.84), had more full-time employees (STACHs: IRR:1.35, 95% CI: 1.31, 1.38; PHs: IRR:1.77; 95% CI: 1.75, 1.80) and were teaching STACHs (STACHs: IRR:1.78; 95% CI: 1.63, 1.95) had significantly more IPBs. In county-level regression models, counties with a lower percentage of Black residents (β: -21.15; 95% CI: -37.14, -5.16) had a significantly higher rate of IPBs. The absence of a causal design means we cannot assess the reasons behind changes in IPBs across time, and is a limitation of this study.<h4>Conclusions</h4>This study provides an overview of the availability of IPBs throughout the U.S, as well as the number of individuals without access to IPBs. Findings indicate a dearth of STACH-based IPBs, particularly in areas with a greater proportion of racial minority residents.https://doi.org/10.1371/journal.pmed.1004682
spellingShingle Zoe Lindenfeld
Jonathan H Cantor
Colleen M McCullough
Jemar R Bather
Ryan K McBain
Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
PLoS Medicine
title Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
title_full Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
title_fullStr Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
title_full_unstemmed Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
title_short Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011-2023: A cross-sectional study.
title_sort inpatient psychiatric bed capacity within cms certified u s hospitals 2011 2023 a cross sectional study
url https://doi.org/10.1371/journal.pmed.1004682
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