Association between hospital bed supply and health outcomes: an ecological analysis and narrative review with insights from Japan

Objective

Despite a comparatively lower physician-to-population ratio, Japan has one of the highest hospital bed densities, thus reflecting a hospital-centered care model associated with prolonged stays and high inpatient expenditures. This study aimed to examine the association between hospital bed supply and health outcomes using insights from Japan. Materials and Methods: This was a narrative review with an ecological analysis. Quantitative analyses performed were explicitly hypothesis-generating and exploratory, not causal. Publicly available national datasets from 2021 to 2022 were used to examine international differences in hospital bed and physician densities and to assess the associations between hospital bed supply, per capita medical expenditure, life expectancy, and healthy life expectancy across Japan's 47 prefectures. Descriptive statistics and Pearson's correlation analyses were performed, with sex-stratified outcomes.