For many people, the hospital has come to symbolize the modern health care system. Yet in many countries, the role of the acute hospital is changing, with an emphasis on outpatient diagnosis and treatment as well as alternatives to long-term hospital care, leading to reductions in numbers of hospital beds. International comparisons that show large variations in hospital bed numbers, combined with the knowledge that hospitals are relatively expensive, often create political pressure to reduce hospital capacities. As a result, there is considerable interest in how countries that have reduced hospital capacity have done so, and what impact such changes have had on different stakeholders. This policy brief looks at how hospital bed capacity has changed in Europe during the past decade and at possible explanations for these changes.