September 2020
Volume
Volume by Region *
Hospitals in all regions across the country saw Discharges fall year-over-year and below budget in August. Hospitals in the Great Plains had the most significant declines, falling 15% year-over-year and 13% below budget. Hospitals in the Midwest and West fell 12% and 9% year-over-year respectively, and both regions were 12% below budget for the month.
Hospitals in four of five regions saw Adjusted Discharges fall both year-over-year and compared to budget. Hospitals in the Great Plains saw the greatest year-over-year decrease at 13%, while hospitals in the West saw the greatest decrease to budget at 12%. The Northeast/Mid-Atlantic was the only region to perform above budget for Adjusted Discharges at 2% but was down 11% from August 2019.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days were down year-over-year and to budget in the Midwest, South, and West. Hospitals in the Northeast/Mid-Atlantic were down 5% year-over-year but performed 6% above budget, while hospitals in the Great Plains saw a 1% year-over-year increase and performed 11% above budget.
ED Visits fell year-over-year and below budget for hospitals across all regions. Hospitals in the South and Northeast/Mid-Atlantic both saw the greatest year-over-year decrease at 18%, while hospitals in the South and West saw the greatest decrease to budget at 17%.
Operating Room Minutes fell year-over-year and compared to budget in the Great Plains, South, and Midwest. Hospitals in the Great Plains saw the largest year-over-year decrease of 12% and fell 6% below budget. The Northeast/Mid-Atlantic saw Operating Room Minutes fall year-over-year but perform above budget, while hospitals in the West were flat year-over-year but slightly above budget.
Average LOS increased both year-over-year and compared to budget in all regions. The Great Plains saw the greatest increase to budget at 8% and was up 11% year-over-year. Hospitals in the Northeast/Mid-Atlantic saw the greatest year-over-year increase at 12% and were up 5% compared to budget.
National Volume Observations
Hospitals across the country again saw volumes decline across most measures in August, marking the sixth consecutive month of volumes falling below 2019 performance and below budget. Discharges are down 11% since the start of the year compared to January-August 2019. In August, Discharges fell 9% year-over-year, 2% month-over-month, and 10% below budget expectations.
Adjusted Discharges are down 13% year-to-date, and fell 12% year-over-year, 3% month-over-month, and were 8% below budget in August. Adjusted Patient Days are down 10% year-to-date. While they were essentially flat month-over-month, Adjusted Patient Days declined 6% year-over-year and fell 4% below budget for the month.
Emergency Department (ED) Visits continue to be hit particularly hard, declining 16% from January-August compared to the same period in 2019. ED Visits saw the greatest year-over-year declines in August, falling 16% compared to both prior year performance and to budget. ED Visits also were down 2% month-over-month.
Operating Room Minutes are down 14% year-to-date and fell 6% year-over-year and month-over-month in August, but were less than 1% below budget expectations. Average Length of Stay (LOS) was the only volume metric to see a year-over-year increase at 6%, and was up 3% month-over-month and 5% above budget for the month.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(10.0%)
(1.9%)
(8.7%)
discharges.svg
Adjusted Discharges
(8.0%)
(3.1%)
(11.5%)
adjusted_discharges.svg
Adjusted Patient Days
(3.5%)
(0.1%)
(5.5%)
adjusted_patient_days.svg
Average Length of Stay
4.7%
3.0%
6.1%
average_length_of_stay.svg
ED Visits
(15.8%)
(1.5%)
(15.8%)
ed_visits.svg
Operating Room Minutes
(0.5%)
(5.5%)
(6.4%)
operating_room_minutes.svg
Volume by Bed Size
Hospitals in five of six bed-size cohorts saw Discharges and Adjusted Discharges fall year-over-year and compared to budget in August. For Discharges, the nation’s smallest hospitals of 0-25 beds saw the greatest decreases at 14% year-over-year and 19% below budget. Hospitals with 200-299 beds saw the greatest decreases for Adjusted Discharges, falling 15% compared to the same period last year and 11% below budget. The largest hospitals with 500 beds or more were the only cohort to see Discharges and Adjusted Discharges perform above budget at less than 1% and 4%, respectively.
Adjusted Patient Days were down year-over-year and compared to budget in four of six bed-size cohorts. Hospitals with 100-199 beds saw the greatest decreases, falling 9% for both measures. Smaller hospitals with 0-25 and 26-99 beds both performed above budget for the month, but were down 3% and 5% year-over-year, respectively.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
ED Visits were down year-over-year and compared to budget for all bed-size cohorts. Hospitals with 300-499 beds saw the greatest decreases, down 20% year-over-year and 25% below budget. Hospitals with 0-25 beds saw the least decreases at 13% year-over-year and 8% below budget. Year-over-year decreases in all other cohorts clustered between 15-16%.
Operating Room Minutes fell year-over-year for hospitals of all sizes, but two cohorts were below budget and three cohorts were above budget. Hospitals with 200-299 beds saw Operating Room Minutes fall 7% year-over-year, but it was the only cohort to perform in line with budget expectations. The smallest hospitals of 0-25 beds had the greatest year-over-year decrease in Operating Room Minutes at 9% but were 5% above budget.
Average LOS rose year-over-year and above budget for all bed-size cohorts. The smallest hospitals with 0-25 beds saw the greatest increases at 10% year-over-year and 7% above budget, while the largest hospitals of 500 beds or more saw the least year-over-year increase of just 1% and were 6% above budget for Average LOS.
©2020 Kaufman, Hall & Associates, LLC
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