Impact of Capacity Reductions in Acute Public-Sector Inpatient Psychiatric Services

Service changes at San Francisco General Hospital cut the number of beds for acute public-sector psychiatric patients by 50%, providing a natural experiment for documenting the effects. Researchers analyzed a range of indicators and found no evidence of anticipated negative consequences, such as increased demand for emergency services, more suicides, and more jail psychiatric evaluations. A key factor was collaboration of inpatient and outpatient providers, which reduced length of stay and enabled the hospital to continue serving the same number of patients.