July 2020
Volume
Volume by Region *
Hospitals in all regions saw volumes reduced year-over-year and compared to budget for a fourth consecutive month across Discharges, Adjusted Discharges, Adjusted Patient Days, and ED Visits. However, the variance in performance across regions continues to grow as recovery rates differ geographically. Hospitals in the Midwest saw the greatest decreases in Discharges, falling 16% both compared to June 2019 and to budget. Those in the South saw the smallest decreases at 2% year-over-year and 10% below budget.
For Adjusted Discharges, the Northeast/Mid-Atlantic had the greatest year-over-year decrease of 18%, while the Midwest had the greatest decrease to budget at 15%. Hospitals in the South again saw the smallest decreases at just 1% year-over-year and 6% below budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Four of five regions saw year-over-year decreases of 8% or greater for Adjusted Patient Days. The Great Plains saw the greatest year-over-year decrease at 13%, and was 5% below budget. ED Visits fell 13% or more across all regions year-over-year. Hospitals in the Midwest and Northeast/Mid-Atlantic had the greatest decreases for this metric, falling 23% compared to June 2019 and 22% to budget.
Operating Room Minutes varied. The Great Plains saw the largest year-over-year increase at 15% but fell 2% below budget. The Northeast/Mid-Atlantic was down 6% year-over-year and 15% below budget. Hospitals in the Midwest, South, and West all were up about 3-7% year-over-year, but the Midwest fell below budget while the South and West were slightly above budget.
Average LOS results also varied greatly. Hospitals in the Northeast/Mid-Atlantic and West were up year-over-year and compared to budget. The Northeast/Mid-Atlantic saw the greatest increases at 3% year-over-year and 5% above budget. The Midwest was up year-over-year but was the only region to fall slightly below budget, while the South and Great Plains were above budget but down compared to the same period last year.
National Volume Observations
Hospital volumes continued to demonstrate recovery from prior month in June, but maintained their four-month trend of falling below 2019 performance and below budget across most metrics. Operating Room Minutes saw the greatest month-over-month increase in June, having seen the greatest decreases during the peak of shutdowns. It also was the only volume metric to see a year-over-year increase as hospitals across the country continued to regain surgery volumes from procedures that were postponed in the early months of the pandemic. Operating Room Minutes increased 41% month-over-month and 6% year-over-year, but still fell 3% below budget.
Discharges increased 8% month-over-month, but remained 8% below June 2019 and fell 13% below budget. Adjusted Discharges were up 18% month-over-month, but down 7% year-over-year and 9% below budget, while Adjusted Patient Days increased 13% compared to May 2020, but were down 8% to June 2019 and 7% below budget.
Emergency Department (ED) Visits rose 14% month-over-month, but fell 19% both year-over-year and to budget. Average Length of Stay (LOS) was the only volume metric to decrease month-over-month, falling 3%. Average LOS also declined slightly year-over-year at 1%, but was about 2% above budget.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(12.6%)
8.2%
(7.7%)
discharges.svg
Adjusted Discharges
(9.4%)
17.8%
(7.2%)
adjusted_discharges.svg
Adjusted Patient Days
(6.7%)
12.8%
(7.5%)
adjusted_patient_days.svg
Average Length of Stay
2.1%
(3.3%)
(0.7%)
average_length_of_stay.svg
ED Visits
(19.0%)
14.1%
(19.1%)
ed_visits.svg
Operating Room Minutes
(2.9%)
40.6%
5.5%
operating_room_minutes.svg
Volume by Bed Size
Similarly, hospitals of all sizes saw decreases both year-over-year and compared to budget for Discharges, Adjusted Discharges, Adjusted Patient Days, and ED Visits.
The nation’s smallest hospitals of 0-25 beds saw the greatest decreases in Discharges, falling 17% year-over-year and 19% below budget. For Adjusted Discharges, hospitals with 200-299 beds saw the greatest year-over-year decrease of 11%, while hospitals with 0-25 beds saw the greatest decrease to budget, at 12%. Hospitals with 100-199 beds had the greatest year-over-year decrease in Adjusted Patient Days at 10%, while hospitals with 200-299 beds saw the greatest decrease to budget, also at 10%.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Hospitals of all sizes saw year-over-year decreases in ED Visits of 17% or more. Hospitals with 100-199 beds saw the biggest decreases at 22% both year-over-year and to budget. Operating Room Minutes rose year-over-year in four of six bed-size cohorts, with the smallest hospitals of 0-25 beds seeing the greatest increase at 29%. Meanwhile, the largest hospitals of 500 beds or more fell the greatest both year-over-year (less than 1%) and below budget (9%).
Average LOS was down year-over-year in five of six bed-size cohorts, with decreases ranging from less than 1% for hospitals with 200-299 beds to 5% for those with 26-99 beds. Hospitals with 300-499 beds were the only cohort to see increases, rising 2% both year-over-year and above budget for this metric.
©2020 Kaufman, Hall & Associates, LLC
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