Los Angeles County has 44 hospitals' worth of excess beds, according to a new study just completed for the Los Angeles Department of Water and Power.

The DWP? Yes, the DWP, which faces deregulation next year and is trying to better understand its customer base to prepare for competition. A large customer group for the DWP is hospitals.

The DWP commissioned the study from L.A.-based Analysis Group Economics and UC Irvine professor Paul Feldstein, who holds the school's chair in health care management.

The research team looked at demographic changes, health insurance trends and employer purchasing strategies to project the likely operational health of the county's 145 public and private hospitals in coming years.

Leading the study's findings, not surprisingly, is that demand for inpatient services is falling precipitously, while outpatient care is on the rise. That means, while the number of hospitals in L.A. County has dropped by 14 percent in the 1990s, far more downsizing is likely on the way.

"There remains a large surplus of beds in Los Angeles compared to other parts of the state," the report states. "Other Southern California counties had 80 fewer hospital beds per 100,000 population than did Los Angeles County."

Assuming a cost-minimizing occupancy rate of 70 percent for the hospitals, the county needs a total of about 25,400 acute care hospital beds to serve its 6.5 million inpatient days per year, the report concludes.

"Comparing 25,400 required beds with the county's current actual bed count of 36,320 indicates some 10,900 excess hospital beds in the county. This is the equivalent of 44 average-size hospitals," the report states.

L.A. is seeing faster reductions in the number of acute-care inpatient days, and slower growth in outpatient days than the rest of the state, according to the report. Inpatient days in L.A. County dropped 15 percent from 1990 to 1995, compared to a 10-percent drop statewide, while outpatient visits increased 13 percent, compared to a statewide increase of 29 percent.

That doesn't necessarily mean Angelenos are getting healthier, said Dr. Alyssa Lutz, one of the study's co-authors. Rather, the L.A. area has a higher concentration of stand-alone outpatient treatment centers, whose statistics were not included in the sampling. Much of L.A.'s growth in outpatient treatment has occured in those facilities, said Lutz.

Other findings of the study:

- 70 percent of all L.A. hospital beds, including those at county-owned facilities, are now operated by multi-hospital systems such as Kaiser Permanente, Tenet Healthcare Corp. and Catholic Healthcare West.


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