Hello fomoco-ga,
As I said in my earlier clarification request, I could not find much
in the way of specific projections for hospital construction based on
geography. In your remarks in response to the suggestions by
flajason-ga and Cynthia-ga you show that you’re all aware of the basic
findings of this study which showed that the greatest growth will be
in the South and West.
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GEOGRAPHIC PROJECTIONS FOR HOSPITAL CONSTRUCTION
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http://www.solucient.com/docs/Long_Term_Demo_Change.pdf
National and Local Impact of long-Term Demographic Change on Inpatient
Acute Care
Table 1 -- Highest Growth Markets for Acute Care Beds, Selected
Markets 2002 2027 Projections
***** This is a 10-page white paper that offers projections about the
growth rate for acute care hospital needs. The South and West are
projected for the highest growth rates regionally. You can also look
at the cities listed in Table 1 and do further research about the
situation for hospital and health care construction in those
locations.
The other statistic I was able to find to address the volume of
construction puts it in the neighborhood of 5000 major projects in a
year. The Advisory Board Company’s research is available to members
only so I was not able to see what other resources they might have
available.
http://www.stelizabeth.com/aboutus/article_Expansion.asp
December, 2002. St. Elizabeth Medical Center Announces Major Expansion
in Edgewood
… The Advisory Board Company of Washington, DC is tracking a boom in
hospital construction projects, with over 5,000 substantial hospital
projects developed in 2001 alone.
http://www.advisoryboardcompany.com/public/inbrief.asp
The Advisory Board Company (NASDAQ: ABCO)
Gathering data across and beyond the membership, the Advisory Board
publishes daily and weekly news services, 50 major studies and 3,000
customized research briefs each year on progressive management and
clinical practices in health care.
***** This is a consulting company that specializes in providing best
practices consulting to clients in the health care industry. It serves
some 2,000 hospitals, pharmaceutical companies, and insurance firms
and provides its members with research that might be very useful to
you.
==========================
HEALTHCARE INDUSTRY TRENDS
==========================
You indicated that you’re interested in the trends that will be
impacting the hospital construction industry. This portion of your
research project was quite interesting and turned up lots of resources
that should be helpful to your quest for broad-based information on
how the changes in the healthcare consumer population and how medicine
is practiced will change the places and methods of how healthcare is
delivered.
You already identified some of the factors that appear repeatedly in
the research results. The aging of the population and increased life
expectancy is one of the major drivers. Technology is another. How
people expect to be treated, the emerging focus on “patient-centered
care” is changing the design of healthcare facilities. I think the
collection of papers and articles will give you a good sampling of the
emerging trends.
http://www.healthdesign.org/coile1.html
Millennium Mega-Trends
Here are the "millennium mega-trends" that will influence healthcare
facility design and construction in the decade ahead:
• Aging – The Baby Boom are becoming 50-somethings, and their
accumulating sports injuries and early symptoms of chronic illness
will begin to make an impact on the nation’s health spending,
especially ambulatory care and "bedless hospitals."
• Alternative medicine
• Ambulatory care
• BBA = Capital shortages
• Building boom – A mini-boom in health facility construction is
happening in high-growth communities and on the campuses of
high-profit hospitals. Although overall capital spending for new
health facilities has slowed, some provider organizations have the
ability to compete with new facilities.
• Consumerism
• Cost-efficiency
• Centers of excellence – Back to 80’s! Many hospitals will competing
on their clinical centers of excellence, just as they did in the 1970s
and 1980s, before managed care arrived. Hospitals that don’t have the
capital for total replacement will focus their facilities spending on
the niches, either clinical services or key population groups. There
will be plenty of competition from entrepreneurs building specialized
facilities, such as heart-only hospitals. Most popular centers are
heart, cancer, women’s, surgical, and children’s.
• E-Health
• Emergency departments
• Healing environments
http://www.ahaonlinestore.com/ProductDisplay.asp?ProductID=650&cartID=826216&PCatID=31
Futurescan 2003: A Forecast of Healthcare Trends 2003-2007
Russell C. Coile, Jr. 2003, 36 pages, $55.00
A snapshot of the U.S. healthcare delivery system in 2003: managed
care has made a 180-degree turn, surging consumer demand is creating a
capacity crisis and workforce shortages are challenging hospitals to
meet rising demand. At the same time, medical inflation is back and
dwindling investment income is threatening hospitals’ financial
health. . . and that’s just the beginning. Futurescan 2003, the
Society’s annual environmental assessment, describes 70 key healthcare
trends and their corresponding strategic implications. Written by
renowned healthcare futurist Russell C. Coile, Jr., this concise
36-page report draws on a survey of 420 healthcare CEOs, executives,
strategists, marketers and communicators as well as extensive
secondary research. Sections include demand, consumerism, competition,
reform, technology, costs, digital hospitals, safety, workforce and
trust. Co-sponsored by the American College of Healthcare Executives
and Superior Consultant Company, Inc.
http://seattle.bizjournals.com/seattle/stories/2001/11/05/focus10.html
Top trends to watch for health-care facility design
After a decade of slow growth, health-care design and construction is
poised to expand substantially in the first decade of the new
millennium. The baby boom generation, now ranging in age from 35 to 55
years, is influencing a wave of new and remodeled facilities. Also,
the benefits of healing design is transforming health-care design. In
striving to anticipate and pave the way for future health-care needs,
we have identified ten major trends that will shape this period of
expansion.
http://www.aia.org/pia/acadjour/articles/07/abstract07.asp
Healthcare Facilities: Currents Trends and Future Forecasts
The staid and predictable health-care industry of the past no longer
exists. Hospitals are going through a self-transformation of
institutional form and purpose. Over the last ten years the hospital
fraction of total insurance premium dollars has dropped by 33 percent.
Over the same period, almost 500 acute care hospitals have been shut
down. Average inpatient census has declined by 23 percent, leaving
most of our nation’s hospital beds empty half of the time. These grim
statistics would predict that the design and construction of
healthcare facilities is plummeting, but such is not the case.
While new hospital construction has declined over the last five years,
hospital renovations have increased 10 percent and the total square
footage of all healthcare facility construction has remained steady at
the 70 to 75 million square feet range.
***** The statistics in this article are somewhat dated but the
discussion of the issues and trends in the healthcare construction
industry are still valid and this paper gives a good overview of many
of the changes happening in the healthcare marketplace.
http://www.high-profile.com/2002/jan/article.html
New Trends in Healthcare Design: Public Spaces
Over the last 10-15 years, societal changes have transformed the way
the public views medicine, putting new demands on the economic,
social, and architectural role of healthcare facilities. Changes in
the structure and function of the healthcare industry itself have also
forced medical institutions to take another look at the architecture
and design of their buildings, especially public spaces.
Architecture, planning and design have become a language for
expressing the profound role hospitals and medical institutions play
in public life, a means of communication with the community, and a
marketing tool for attracting new patients. More frequently, these
new public spaces look less like hospital spaces than ever before,
recalling the character and ambiance of other project types such as
residential, hospitality, retail, and even transportation projects.
http://www.solucient.com/news_press/news20021219.shtml
December 19, 2002
Nation's seniors to represent more than half of all US hospital
admissions by 2027, according to new Solucient findings
Colorado, Washington among states that will show largest increases
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ARTICLES -- HOSPITAL / HEALTH CARE CONSTRUCTION ISSUES
======================================================
This selection of articles overlaps with the section on healthcare
trends but puts greater emphasis on the healthcare construction
industry.
http://www.hospitalconnect.com/aha/press_room-info/content/PwCcostsReport.pdf
PriceWaterhouseCoopers
Cost of Caring: Key Drivers of Growth in Spending on Hospital Care
***** This is a 20-page paper dated February, 2003 prepared for the
American Hospital Association and the Federation of American
Hospitals.
Page 16 – Hospitals must spend more on construction to meet the
changing needs of patients and the demands of an aging society.
***** See this section for a discussion of the mixed picture on
funding the investment in hospital construction and a review of the
chief drivers “fueling the need for investment in facilities.”
http://www.aecworkforce.com/enews/021703_trends.htm
Health care one of the few healthy markets in 2003
The value of construction put in place for health care and other
related institutional projects has increased by 22.6% from October
2001 to October 2002, according to the U.S. Census Department.
And the market is expected to remain robust in 2003 as statistics from
Modern Healthcare magazine estimated that the total construction costs
of projects designed in 2001 alone topped $34.1 billion, an indication
of the building boom experienced in 2002 and expected this year.
Operators of health care facilities are finding that it is less
expensive to replace inefficient and outdated facilities with new
construction than it would be to renovate existing buildings. In
Washington, D.C., for instance, George Washington University Hospital
moved into a brand new $96 million facility last summer rather than
renovate its exiting facilities.
Spurring the need for new facilities has been the recent advancement
in medical technologies. "A lot of these older facilities just don’t
have the infrastructure to support new technologies," says Michael
Hicks, national director of business development at PCL Construction
Services, Inc. (Denver, CO), a $1.2 billion general contractor. "In
most cases, it's more cost-efficient to build a new facility than it
is to renovate an older one."
But other factors are also contributing to new health care
construction and renovations. The California state legislature passed
new seismic codes for hospitals in 1994 that require most hospitals in
the state to upgrade their safety standards by 2008. As a result,
hospitals have to spend millions of dollars to upgrade and renovate
existing facilities. "The deadline for a lot of these hospitals to
upgrade their facilities is fast approaching, and that's going to
create more work for contractors to renovate these buildings so they
comply with the new codes," Hicks says.
http://www.modernhealthcare.com/search.cms
Modern Healthcare's archives contain text articles from the magazine
dating back to 1994. Articles published within the last 30 days are
FREE, unless noted otherwise. All other articles can be obtained by
purchasing access to the archives.
http://www.modernhealthcare.com/chart.cms?id=1&type=surveys
Projects by Construction Phase in 2002
http://www.healthdesign.org/coile1.html
http://california.construction.com/CACN/CACN-Feb03/CA-feb03cover4.htm
Government Mandates Drive Hospital Design for the Next Decade
New Construction Drivers
Unlike the old days when doctors held the reins, today’s construction
drivers are cost cuts, patient outcomes and unfunded government
mandates.
In California, health care mandates cover everything from
nurse-to-patient ratios to seismic safety—all of which mean new
thinking in medical facility design and construction. At the same
time, these unfunded mandates could result in reduced funds for
outcomes-enhancing patient amenities.
Patient-centered Care
Rooms traditionally reserved only for patient holding or observation
areas can now be used for treating patients. Treatment rooms set up
primarily for treating lumps and bumps can be utilized for more
serious injuries and illnesses.
The cost to build bigger rooms with better lighting and more complex
equipment is higher, but gains in staff efficiency and better, faster
patient care far outweigh the costs.
Some other trends in patient-centered care:
http://southwest.construction.com/SWCN/SW-June03/SWJune03feature1.htm
Healthcare Construction Bounces Back
According to F.W. Dodge Dataline, more than $7 billion in healthcare
projects with individual contract values of more than $1 million are
in various stages of pre planning, planning and construction in
Arizona, Nevada and New Mexico. Low interest rates and demand are
teaming to create a sound Southwest healthcare market. ….
Nationally, according to lead McGraw-Hill Construction economist
Robert Murray, the first nine months of 2002 showed hospital
construction gaining 22 percent, while clinics and nursing homes rose
10 percent. Another 2 percent gain is expected in 2003.
http://sacramento.bizjournals.com/sacramento/stories/2001/11/05/focus4.html
November 2, 2001, Getting ready for hospital seismic jobs
Deadlines are looming for California hospitals, seven years after the
passage of Senate Bill 1953, which requires hospitals and their
buildings to be seismically retrofitted by 2008 or completely rebuilt
by 2030. Hospitals with inpatient beds must remain standing after a
major earthquake by 2008, or remain "operable" after a quake by 2030.
The law has led to a flurry of activity not only among seismic
engineers, but also among architects, hospital planners and hospital
groups. Funding arms of hospital chains and underwriters of hospital
debt have swung into gear to handle the expected rush of activity.
Current estimates of replacement and retrofit costs run at about $24
billion for the nearly 400 hospitals in California alone.
======================================================
FUNDING ISSUES FOR HEALTH CARE / HOSPITAL CONSTRUCTION
======================================================
Since you said in your clarification that you were interested in
funding issues as they related to some of the emerging trends, I’ve
included a sampling of articles. You can find much more along these
lines by starting your search at each state’s Hospital Association web
site or at the McGraw-Hill Construction site.
http://aspe.os.dhhs.gov/cfda/p64005.htm#top
CATALOG OF FEDERAL DOMESTIC ASSISTANCE
64.005: Grants to States for Construction of State Home Facilities
Popular Name: State Home Construction
Applicant Eligibility: Any State may apply after assuring that the
assisted facility will be owned by the State; and will be used
primarily for veterans.
Examples of Funded Projects: 1) Constructed new 120 bed State home
nursing home building; 2) Constructed new 100 bed State home
domiciliary building to nursing home care standards for easy
conversion; 3) Remodeled existing State home nursing home building; 4)
Remodeled existing State home domiciliary building; and 5) Remodeled
existing State home hospital building.
Range and Average of Financial Assistance: From $140,870 to
$27,182,408. Average: $2,400,000.
http://sacramento.bizjournals.com/sacramento/stories/2003/05/05/story1.html
May 5, 2003, Hospital construction begs for bill -- Agency logjam ties
up billions
A little-known state agency that regulates hospital building standards
could stall billions of dollars of new construction -- with each day's
delay potentially adding hundreds of thousands of dollars to the costs
-- because it doesn't have enough staff to quickly review hospital
plans. The Office of Statewide Health Planning and Development has
about 45 reviewers on board and can't hire any more because of a state
hiring freeze to fight the projected $26 billion-plus state budget
deficit.
A deluge of construction plans from many of the 450 acute-care
hospitals in the state is beginning to hit the agency. Healthcare
systems are ramping up construction to meet strict new state
earthquake-safety standards and to keep up with increased demand for
services.
http://www.wha.org/governmentRelations/hospital_reregulation.aspx
Wisconsin Hospital Association
Hospital Re-Regulation
http://www.jsonline.com/bym/news/apr02/32949.asp
Budget amendment would limit hospital construction
http://www.ziegler.com/HealthCare113320AM/files/Articles/HFMA_Magaziine_Cover_Story.pdf
Cover Story - November 2002 Positioning Hospitals for Improved Access
to CapitalThe crash of the equities markets in the summer of 2002
undoubtedly will provoke a sustained, long-term move to all sectors of
the bond markets.
Issues and Actions Hospitals need to actively position themselves in
the next 18 to 24 months to ensure continued access to financing.
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ASSOCIATIONS, ORGANIZATIONS, PUBLICATIONS, PORTALS
==================================================
As I was doing the research I kept coming across these resource sites.
I’ve included them so you can continue your explorations.
http://www.hospitalconnect.com/DesktopServlet
HospitalConnectTM links together the Internet sites for dozens of
organizations serving health care providers. This health leadership
portal, found at hospitalconnect.com, makes it faster and more
convenient for you to access information from member sites, no matter
where you are going within the HospitalConnectTM family.
http://www.hospitalconnect.com/hospitalconnect/org/org_chart.html
Portal communities and resources
http://www.hospitalconnect.com/aha/about/index.html
The American Hospital Association (AHA) is the national organization
that represents and serves all types of hospitals, health care
networks, and their patients and communities. Close to 5,000
hospitals, health care systems, networks, other providers of care and
37,000 individual members come together to form the AHA.
http://www.pohly.com/assoc.html
Hospital and Healthcare Associations by State
http://www.pohly.com/assoc4.html
Hospital & Healthcare Associations by Metro Area
http://www.americashospitals.com/
Federation of American Hospitals
http://www.hfma.org/publications/
Healthcare Financial Management Association
HFMA Publications bring you the latest industry news, legislative and
regulatory updates, in-depth issue analyses and hands-on
problem-solving techniques. Written expressively for professionals
responsible for the financial leadership of America's healthcare
system, HFMA's publications are the foremost resource for healthcare
financial managers across the continuum of care.
http://dodge.construction.com/Magazines/Default.asp
McGraw-Hill Construction – Regional Publications
http://dodge.construction.com/Reports/
Dodge Reports give you the information you need to prepare a bid or
enter negotiations. The detailed project information will also enable
you to sell products or services. You can tailor the service to see
only those projects that are meaningful to you by choosing the
specific geography, project types, and stages of construction that
meet your needs.
http://dodge.construction.com/AboutDodge.asp
Dodge is part of the McGraw-Hill Construction Information Group, along
with its powerful, leading sister brands: Sweet's, Engineering
News-Record, Architectural Record, CAP, Design-Build magazine and
construction.com. Together, these brands provide the design and
construction community with the most comprehensive, timely and
accurate sales, marketing, information and knowledge solutions
available through a staff of over 1,700 employees throughout North
America.
http://www.ahaonlinestore.com/default.asp?PCatID=7
American Hospital Association
Design & Construction Resources
http://www.njha.com/librarysection/pdf/windowhospitaldesign.pdf
New Jersey Hospital Association – Library Section
Hospital Design & Construction
***** This is a 13-page bibliography of articles and other resources.
The healthcare industry is definitely going through major changes and
the trends that I’ve been able to identify will clearly impact what
kinds of facilities will be built in the future. I hope that you find
this research helpful. Please ask for clarification if any of this is
confusing.
Best wishes for your strategic planning.
czh
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hospital construction trends
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