Actual Hospital Bed Utilization by Institutional Ownership during the COVID-19 Omicron Variant Epidemic in Japan

During the summer of 2021 in Japan, COVID-19 patients faced admission difficulties despite beds being available due to capacity mismatches. This study analyzes hospital admission patterns during the Omicron variant expansion (December 2021–March 2022), focusing on institutional ownership of acute care hospitals. Publicly owned and non-governmental hospitals may differ in their relationships with prefectural governments responsible for securing beds through vertical administrative structures. The analysis examines metropolitan versus non-metropolitan areas and hospitals with or without other acute care facilities within 10 km, comparing COVID-19 inpatients per 100 beds and reserved bed occupancy rates between ownership types. Results reveal that bed allocation ratios for COVID-19 patients vary between ownership types. Significant differences in inpatients per 100 beds appear in regions with nearby acute care hospitals and in non-metropolitan areas. Reserved bed occupancy rate differences between ownership types emerge in regions with proximate hospitals but not in single-hospital regions. Metropolitan areas frequently show no significant occupancy differences, indicating admissions matched reserved capacity. Findings demonstrate the necessity of strategic bed planning, particularly highlighting that non-governmental hospitals without nearby facilities face difficulties securing beds through administrative relationships. Enhanced monitoring during outbreaks is essential for such isolated hospitals.