Bed space at Tauranga Hospital is scarce during cooler months as patients with winter-related illnesses swarm to the hospital for help.
But figures show November was the busiest month last year when 259 patients stayed overnight.
These patients took up 91 per cent of the beds available in the main medical, surgical, paediatric, intensive care and cardiac care units.
The average overnight hospital occupancy was 238 beds of 286 available beds. This does not include the 30 beds in the hospital's maternity ward.
Bay of Plenty District Health Board chief executive Phil Cammish said respiratory conditions were the single biggest reason for admission to hospital during the typically busiest winter months.
"The top four major reasons for admission are digestive, circulatory, respiratory and musculoskeletal which combined make up 53 per cent of total annual acute admissions to Tauranga Hospital.
"Respiratory admissions have the largest seasonal impact on inpatient numbers - they went from 8 per cent of acute admissions in January 2012 to 19 per cent of acute admissions in August 2012." Last year 83 per cent of the beds at Tauranga Hospital were occupied.
Medical wards, admissions and the Emergency Department (ED) had high occupancy rates, particularly with Tauranga's older residents.
"The BOPDHB caters to predominantly an elderly population and this is represented in the presentations to ED. With age you not only build up wisdom and experience but you also are highly likely to have multiple medical problems which complicate emergency department presentations," Mr Cammish said.
Patients over the age of 65 made up 18 per cent of the population numbers in the Bay of Plenty but accounted for 65 per cent of overnight bed days last year.
When there were too many patients and not enough beds, the overflow was managed by housing patients in lounges, treatment rooms or by opening up spaces in medical day-stay unit.
These measures and the discharge lounge for patients who were ready to be picked up helped to alleviate congestion in the main wards, particularly during winter, Mr Cammish said.
Meanwhile, 620 patients from the Western Bay elected to have their surgery at Whakatane Hospital last year.
As of March 11, there were 71 Western Bay patients booked for procedures in the Eastern Bay during March and April.