Hospital Readiness for COVID-19: Analysis of Bed Capacity and How It Varies Across the Country

A nurse with a cancer patient who is receiving chemo therapy.

Severe strain on health system will overwhelm hospitals’ capacity to treat COVID-19 patients.

The Issue

As COVID-19 spreads across the United States, concerns mount that the need for hospital beds will overwhelm national capacity, putting severe strains on the health care system and limiting access to necessary care. As federal, state, and local policymakers prepare for a potentially very large increase in demand for inpatient hospital care, they must understand how existing bed capacity varies across states and communities.

Key Findings

Using data from the 2018 American Hospital Association Annual Survey, which collects extensive data on topics including hospital organization structure, facilities and services, and utilization from 6,500 U.S. hospitals, researchers find that availability of unoccupied beds per 1,000 people varies significantly across urban and rural areas, states, and counties across the country.

  • In 2018, the United States had 728,000 medical and surgical hospital beds available to the public, or 2.2 hospital beds per 1,000 population.

  • Only 36 percent of these beds were unoccupied on a typical day, leaving just 0.8 unoccupied beds per 1,000 people.


Findings from this brief, along with the interactive county-level map, can assist policymakers and local officials in identifying regions and hospitals with the greatest capacity constraints when treating COVID-19 patients. This will help federal, state, and local policymakers considering ways to generate surge capacity in identifying areas with the greatest need for additional inpatient beds.

Report authors cite expert recommendations to improve capacity such as creating internal rapid-response groups; transferring equipment to essential units like ICUs; categorizing and prioritizing non-COVID-19-related patient caseloads; cancelling elective surgeries; speeding the discharge of patients well enough to leave; using naval and military aid to meet civilian needs; and utilizing alternative spaces such as halls, conference rooms, and amphitheaters to increase physical capacity.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.