A 54-year-old pronouncement known as Roemer’s Law says that the more beds a hospital has, the more beds it will use. The statement has been widely cited by healthcare policy influencers as a reason for facilities to be required to justify their number of beds as a way to contain healthcare costs—to avoid, presumably, any subconscious tendencies to hospitalize patients whether they really need it or not.

A new study funded by the Michigan Department of Health’s Certificate of Need Program sought to put Roemer’s Law to the test. “Despite its influence, a surprisingly small body of empirical evidence supports its content,” the study’s authors write. Pointing to specific factors that “have not been sufficiently explored in past examinations of Roemer’s Law,” they continue, “we pose the question, ‘Accounting for space in healthcare access and use, is there an observable association between the availability of hospital beds and hospital utilization?’”

Apparently, yes. The research team used various methods to explore Roemer’s Law, including testing across numerous geographic scales of analysis. While Roemer’s initial work was based on a regional study in which a single hospital added more beds, the new study encompassed an entire state system of hospitals and evaluated more than a million inpatient admissions. The researchers found that a “positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates.”

Adding more support to the idea of controlling costs by controlling the number of patient rooms, this study provides yet another signpost for the healthcare design industry regarding the future direction of facility size and/or space usage. The full research report, titled “Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law,” can be found at www.plosone.org.