A review of hospital bed capacity for the Health Service Executive has found there is no need to increase the number of acute hospital beds.
However, the study has concluded there is "a definite capacity gap" in non-acute beds. These would include beds for convalescing and long-term care.
The report compiled following the review, which has been seen by The Irish Times, states that many hospital beds are currently inappropriately used.
External consultants commissioned to do the study found 13 per cent of patients on admission to hospital could have been treated outside an acute hospital setting.
It also showed that 39 per cent of patients could have been treated in an alternative setting on the day of their care, if appropriate alternatives such as diagnostics in the community, non-acute beds or home-based patient care were available. The report says these percentages are "high and are not sustainable".
The percentage of patients who on admission could have been treated elsewhere varied between hospitals. It ranged from a high of 34 per cent at Bantry General Hospital, to 30 per cent at Portlaoise General and from 29 per cent at Merlin Park Hospital in Galway to 22 per cent at Monaghan, Louth and Drogheda hospitals. However, the report stresses that these figures should not be interpreted as a performance measure. "The level will depend on types of service provided by the hospital," it said.
The report's authors also emphasise that it may not be obvious to a clinician at the time of admission whether a patient should be admitted or not. "Each hospital requires a certain level of inappropriate admissions. This is to reduce the risk of non-admission of appropriate patients," it said.
The report also found that 75 per cent of the elective surgery patients surveyed were admitted to hospital earlier than necessary.
"The survey confirms there is significant opportunity to use the current complement of acute beds more efficiently through changes in hospital practice," it said.
"The review highlighted the need to improve the internal hospital organisational factors that influence length of stay, bed occupancy and bed utilisation. This includes the configuration of ward rounds, introduction of discharge planning and management, and multi-disciplinary working to reduce delay in assessment and discharge," it added.
The report noted that discharge planning was in evidence for just 40 per cent of all patients. It recommends better discharge planning. The shortage of non-acute beds was particularly acute in Dublin, it said, where the discharge of patients from hospitals is being delayed as a result.
It recommends improved access to specialist nursing to support the management of chronic disease outside of hospitals. It also says there is a need to increase the focus on illness prevention and management.
The review was conducted by PA Consulting Group and Balance of Care Group across 37 hospitals with A&E units between November last year and February this year. A total of 3,035 adult patients were randomly sampled.
The report's failure to recommend more acute hospital beds will be a disappointment to health professionals who have been calling for more acute beds.
But the report's conclusions mirror the views of the chief executive of the HSE, Prof Brendan Drumm, who has been saying the State is "massively equipped with hospital beds" and the focus needs to be on treating people in the community.