May 2020
Volume
Volume by Region *
Hospitals across all regions of the country saw volumes fall year-over-year and compared to budget for five of six metrics—Discharges, Adjusted Discharges, Adjusted Patient Days, ED Visits, and Operating Room Minutes.
Results were clustered for Discharges. Hospitals in the Midwest had the largest declines at 34% year-over-year and 33% below budget. Hospitals in the West and South saw the lowest year-over-year decreases at 28%, and hospitals in the South saw the lowest decrease to budget, also at 28%.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
The Midwest region had the greatest decreases both year-over-year and compared to budget for Adjusted Discharges and Adjusted Patient Days. Hospitals in the region were down 48% both year-over-year and to budget for Adjusted Discharges, and 44% year-over-year and 48% to budget for Adjusted Patient Days. Hospitals in the Great Plains saw the lowest decreases for Adjusted Discharges, down 31% year-over-year and 34% to budget, while hospitals in the West saw the least decreases for Adjusted Patient Days, down 36% year-over-year and 37% to budget. For ED Visits, hospitals in the Northeast/Mid-Atlantic had the steepest declines, down 46% year-over-year, in contrast to a 34% year-over-year decline for hospitals in the Great Plains.
Hospitals across all regions saw significant declines in Operating Room Minutes. Hospitals in the Northeast/Mid-Atlantic were the most affected, as the region continues to see high rates of COVID-19 and slow returns of non-urgent procedures. Operating Room Minutes in the Northeast/Mid-Atlantic were down 83% both year-over-year and to budget. Hospitals in the West also were significantly impacted, but had the lowest percentage decreases compared to other regions, at 49% year-over-year and 48% below budget.
Average LOS results varied widely across regions. Hospitals in the Great Plains and South were down year-over-year and to budget for this metric, while hospitals in the Northeast/Mid-Atlantic and West both increased year-over-year and to budget. Hospitals in the Midwest were up slightly year-over-year, but saw the greatest variance to budget at 5% below budget.
National Volume Observations
Volumes were down significantly both year-over-year and month-over-month across most metrics in April. Surgery volumes saw the most significant declines, as patients and providers continued to defer non-urgent procedures. Operating Room Minutes fell 61% compared to April 2019—more than triple the 19% year-over-year decline seen the month before. Operating Room Minutes fell 51% compared to March 2020, and 63% below budget expectations.
Overall Discharges fell 30% year-over-year and 23% month-over-month, and were 31% below budget. Adjusted Discharges declined 41% year-over-year and 34% month-over-month, and were 43% below budget, while Adjusted Patient Days fell 39% year-over-year, 30% month-over-month, and were 40% below budget.

Emergency Department (ED) Visits declined 43% compared to the same period last year, and were down 36% compared to March, and 43% compared to budget. Average Length of Stay (LOS) was relatively unchanged, down less than 1% year-over-year, up 5% compared to prior month, and falling close to budget expectations.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(30.9%)
(23.4%)
(30.1%)
discharges.svg
Adjusted Discharges
(43.0%)
(33.9%)
(41.4%)
adjusted_discharges.svg
Adjusted Patient Days
(40.1%)
(29.9%)
(39.0%)
adjusted_patient_days.svg
Average Length of Stay
(0.3%)
5.4%
(0.7%)
average_length_of_stay.svg
ED Visits
(43.3%)
(35.9%)
(43.0%)
ed_visits.svg
Operating Room Minutes
(62.9%)
(51.3%)
(61.4%)
operating_room_minutes.svg
Volume by Bed Size
Hospitals across all bed-size cohorts also experienced declines both year-over-year and to budget for Discharges, Adjusted Discharges, Adjusted Patient Days, ED Visits, and Operating Room Minutes. For Discharges, the nation’s smallest hospitals with 0-25 beds saw the greatest decreases, down 38% year-over-year and 35% to budget. At the other end of the spectrum, the nation’s largest hospitals of 500 beds or more saw the lowest declines, at 28% both year-over-year and to budget.
The smallest hospitals (0-25 beds) also saw the most significant year-over-year declines for both Adjusted Discharges and Adjusted Patient Days, down 47% and 46%, respectively. Hospitals with 0-25 beds had the greatest budget impact for Adjusted Patient Days, down 47%, while hospitals with 26-99 beds had the greatest budget impact for Adjusted Discharges, down 46%. The largest hospitals of 500 beds or more again had the least declines for Adjusted Discharges, down 33% year-over-year and 35% below budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
For ED Visits, hospitals with 0-25 beds had the least declines at 38% year-over-year and 40% to budget, while hospitals with 26-99 beds had the greatest declines, down 46% both year-over-year and to budget. Year-over-year declines in Operating Room Minutes ranged from 52% for hospitals with 500 beds or more, to 70% for hospitals with 26-99 beds. Declines to budget ranged from 53% for the largest hospitals (500 beds or more) to 74% for the smallest hospitals (0-25 beds).
Average LOS results again were the most varied. Hospitals with 0-25, 100-199, and 200-299 beds all were down year-over-year and compared to budget, while hospitals with 26-99 beds were down year-over-year but above budget, and hospitals with 300-499 and 500 beds or more were up year-over-year and above budget.
©2020 Kaufman, Hall & Associates, LLC
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