Hospitals represent a major component of health system infrastructure and account for a large share of capital investment in most countries. The availability of hospital beds provides an indication of the resources available to deliver inpatient care. However, higher bed supply is often associated with higher admission rates, a phenomenon known as Roemer’s Law, which states that “a built bed is a filled bed”. Ensuring that hospital resources are used efficiently and that access to inpatient care is well co‑ordinated is therefore essential. Increasing the number of hospital beds or hospital stays does not necessarily improve population health outcomes and may lead to inefficiencies if hospital care substitutes for more appropriate outpatient or community-based services.
The availability of hospital beds provides an indication of the resources available to deliver inpatient services. Across LAC countries, the number of hospital beds remains well below the OECD average Figure 5.5. On average, LAC countries have 22.6 hospital beds per 10 000 population, compared with 42.0 beds per 10 000 population across OECD countries. However, bed availability varies widely across the region. Barbados reports the highest density, with about 64 beds per 10 000 population, followed by Haiti and Cuba with around 40‑50 beds per 10 000 population. At the other end of the distribution, Guatemala has fewer than 5 beds per 10 000 population, while Honduras, Nicaragua and Mexico also report relatively low levels of hospital bed availability. These large disparities reflect differences in investment in hospital infrastructure, as well as variations in the organisation of care and the role hospitals play within national health systems. The availability of beds for psychiatric care is also substantially lower in LAC than in OECD countries. On average, OECD countries report about 6.2 psychiatric beds per 10 000 population (Figure 5.5). In contrast, the availability of psychiatric beds in the LAC countries with available data is much lower. Mexico reports around 0.3 beds per 10 000 population, while Ecuador, Costa Rica, Chile and Colombia report between 0.4 and 1.7 beds per 10 000 population. Argentina shows the highest availability among the countries with available data, with around 4.9 beds per 10 000 population. These figures highlight the relatively limited capacity for inpatient mental health care across much of the region.
Hospital discharge rates provide an indication of the use of inpatient services. Across nine LAC countries with available data, hospital discharge rates average about 5 543 discharges per 100 000 population, considerably lower than the OECD average of about 13 797 per 100 000 population (Figure 5.6). Within the region, discharge rates vary substantially. Uruguay and Chile report the highest levels, with around 9 300 and 8 300 discharges per 100 000 population, respectively, followed by Brazil with around 6 450 discharges per 100 000 population. At the lower end, Argentina and Mexico report fewer than 3 700 discharges per 100 000 population. In general, countries with greater hospital bed availability tend to have higher discharge rates and vice versa, although differences in admission practices, health system organisation and access to inpatient care also play an important role.
In eleven LAC countries with available data, the average length of stay (ALOS) in hospitals is about 5.7 days, shorter than the OECD average of 7.9 days (Figure 5.6). The longest stays are observed in Costa Rica, with about 7.1 days on average, followed by Panama (6.7 days) and Chile (6.1 days). The shortest stays are recorded in Ecuador (4.5 days) and Mexico (4.7 days). The ALOS reflects patterns of hospital use and efficiency, but it should be interpreted with caution. Shorter stays may indicate more efficient care and a shift towards outpatient or post-acute care settings, reducing the cost per discharge. However, excessively short stays may also indicate premature discharge, while longer stays may reflect delays in discharge due to limited availability of rehabilitation or long-term care services. Conversely, longer stays can sometimes reflect greater patient complexity or differences in clinical practice (Rojas-García et al., 2017[1]).
