Julio Carrillo is a Senior Planner & Manager with PSC’s Landscape Architecture & Planning Sector. With over 15 years of experience, he has managed and directed projects ranging from architecture and green building consulting to urban design and community planning. Through his diverse knowledge of residential, multifamily, corporate office, educational, institutional, municipal, and neighborhood design, Julio builds communities, not only projects.


PSC is proud to support Texas Health and Human Services (TX HHS) in their search for opportunities to improve the healthcare system serving the Texas population. This analysis showcases the history behind population growth for specific areas of the state, and how Texas Healthcare Systems have has been responding in the last five years (2015-20) in terms of hospital improvements (availability of the number of beds).

Figure 1 highlights that bed distribution is in direct correlation with the proportion of highly populated areas within the state. The “Texas Triangle” area formed between San Antonio, Dallas-Fort Worth, and Houston, is the primary section of the state where the concentration of beds is high to serve these cities.

This concentration is also a clear indicator of the number of hospitals available to serve these areas.

Understanding this correlation of population and number of hospitals/beds, PSC planners took the data to the county level to get an initial idea of the geographical expansion of this distribution.

The spatial distribution of these assets (beds) is more clearly represented in a county by county level. Figure 2 shows the total number of beds per county.

The Travis County Challenge

At a county level, the offer of beds per 1000 people tells a very interesting and contrasting story: some of the highly populated counties have a lower proportion of beds/1000 population. A great example is Travis County (City of Austin) which shows a higher number of beds, but a lower proportion in beds / 1000 people see Figure 3.

Between the years 2015 and 2020, Travis County experienced an increase in population, but at the same time a reduction in the number of beds. These are the specific metrics for Travis County between 2015 and 2020 as shown in Figure 4.

  • In 2015, the Travis County population was 1,024,266.
  • In 2020 Travis County experience growth in population to a total of 1,291,502 inhabitants.
  • In 2015, there were 3,037 beds in Travis County.
  • In 2020, the number of beds for Travis County was reduced to 2,831.
  • 2.97 was the total number of beds / 1000 people in 2015 for Travis County.
  • 2.19 is the total number of beds /1000 people in 2020 (a loss of ~0.8 beds per 1000 people).

In some counties, the proportion of beds per 1000 people was increased between 2015 and 2020 (see countries in yellow as illustrated in Figure 4), while some counties considerably reduced this proportion as high as – 11.7% in comparison to the year 2015. Some of this is speculated to be directly related to population growth and its consequent delayed response for infrastructure provision: a fast population increase does not necessarily mean a quick response in the provision of infrastructure.

The Midland / Odessa Challenge in Population Growth

While many counties in Texas continued their population growth trends, some showcased a minor reduction. It is expected that these trends will continue between 2020 and 2025, with growth estimated as high as 20.5% for a few counties. Figure 5 shows these projections of population growth up to 2025. A “hot spot” area is clearly showing signs of independence away from the expected Texas Triangle section: The Midland / Odessa region.

Next Steps for Texas Healthcare Infrastructure

While the State’s infrastructure commonly reacts to current needs, a more proactive approach could be planning “ahead of the curve” in terms of provision of infrastructure. PSC’s Analytics team has identified areas of high opportunity for the provision of Healthcare Infrastructure. These areas identified are picked based on the age of current infrastructure and population growth trends. PSC could support both Texas Health and Human Services, and Healthcare Systems in their decision-making process while supporting our mission of Building Community.