Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law

Roemer’s Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. 

This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer’s Law. The authors pose the question, “Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?”

This study provides evidence for the effects of Roemer’s Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings suggest continued regulation of hospital bed supply to assist in controlling hospital utilization is justified.