August 2020
Volume
Volume by Region *
Discharges were down both year-over-year and compared to budget for hospitals in the West, Midwest, and Northeast/Mid-Atlantic. The Northeast/Mid-Atlantic saw the most significant year-over-year decrease in Discharges at 16% but the least decrease compared to budget at just 2%, while hospitals in the West saw the greatest decrease to budget at 13% but the least year-over-year decrease of 3%. Hospitals in the South were up slightly year-over-year but below budget for Discharges, while hospitals in the Great Plains were down year-over-year but slightly above budget.
Adjusted Discharges were down year-over-year and compared to budget for hospitals in the West, Midwest, and South. Hospitals in the Great Plains and Northeast-Mid-Atlantic also saw Adjusted Discharges decrease year-over-year, but both regions were 4% above budget for the month.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Results were more varied for Adjusted Patient Days, with hospitals in the South and Midwest seeing decreases both year-over-year and compared to budget, while hospitals in the West and Northeast-Mid-Atlantic were down year-over-year but essentially flat compared to budget. Hospitals in the Great Plains, however, saw a 2% year-over-year increase and were 22% above budget for Adjusted Patient Days.
ED Visits were down year-over-year and compared to budget across all regions for the fifth consecutive month. Hospitals in the Northeast/Mid-Atlantic saw the greatest year-over-year decrease at 22% and were 8% below budget, while hospitals in the Midwest had the greatest budget decrease, falling 16% both compared to budget and year-over-year.
Hospitals across all regions also saw Operating Room Minutes decrease year-over-year in July, but hospitals in the Great Plains were below budget, while hospitals in the South were essentially in line with budget. Hospitals in the Midwest, West, and Northeast/Mid-Atlantic all were above budget.
Average LOS was up year-over-year and compared to budget in the South, West, and Great Plains. The Midwest and Northeast/Mid-Atlantic both saw Average LOS increase year-over-year but fall in line with budget expectations.
National Volume Observations
Hospitals nationwide saw a fifth consecutive month of volumes falling below 2019 performance and below budget across most metrics. Even so, July volumes continued to show some signs of recovery month-over-month.
Discharges and Adjusted Discharges both were down 7% year-over-year, but up 6% month-over-month. Discharges fell about 8% below budget and Adjusted Discharges were 6% below budget. Adjusted Patient Days were down 4% year-over-year, but essentially in line with budget and up 7% month-over-month. Looking at year-to-date performance, Discharges and Adjusted Patient Days are down 11% compared to the same seven-month period in 2019, while Adjusted Discharges are down 13%.
Emergency Department (ED) Visits continued to show the most significant declines. Since the start of the year, ED Visits have fallen 17% compared to the same seven-month period in 2019. In July, ED Visits fell 17% compared to the same period last year and 13% below budget. July marks the fifth consecutive month of double-digit year-over-year declines in ED Visits for hospitals nationwide. Even so, ED Visits showed some gains compared to June, rising 10% month-over-month.
Operating Room Minutes are down 15% year-to-date compared to the first seven months of 2019. In July, they fell 1% year-over-year, but rose 3% month-over-month and were 4% above budget expectations. Average Length of Stay (LOS) rose across all measures, up 3% both year-over-year and to budget, and up 1% month-over-month.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(7.5%)
6.2%
(6.7%)
discharges.svg
Adjusted Discharges
(5.8%)
6.1%
(6.8%)
adjusted_discharges.svg
Adjusted Patient Days
(0.4%)
6.5%
(3.6%)
adjusted_patient_days.svg
Average Length of Stay
2.9%
1.0%
3.4%
average_length_of_stay.svg
ED Visits
(13.1%)
9.7%
(16.8%)
ed_visits.svg
Operating Room Minutes
4.0%
3.2%
(0.8%)
operating_room_minutes.svg
Volume by Bed Size
Hospitals in five of six bed-size cohorts saw Discharges and Adjusted Discharges decrease both year-over-year and compared to budget in July. For Discharges, the nation’s smallest hospitals of 0-25 beds saw the greatest decreases, down 16% across both measures. The largest hospitals of 500 beds or more saw Discharges increase slightly at 2% year-over-year, performing 7% above budget—making it the only cohort to see increases for this metric.
For Adjusted Discharges, hospitals with 300-499 beds saw the greatest year-over-year decrease at 9% and were 5% below budget. Hospitals with 500 beds or more again were the outlier, falling 6% year-over-year but rising 5% above budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days were down year-over-year and compared to budget for hospitals with 100-199, 200-299, and 300-499 beds. Smaller hospitals with 0-25 and 26-99 beds were down year-over-year but above budget, while hospitals with 500 beds or more were up across both measures.
ED Visits decreased both year-over-year and compared to budget for hospitals of all sizes. Larger hospitals with 300-499 beds saw the greatest decreases, down 21% year-over-year and 17% below budget. The smallest hospitals with 0-25 beds saw the least decreases, down 12% compared to July 2019 and 8% below budget.
Operating Room Minutes varied widely across bed-size cohorts in July. Larger hospitals with 300-499 beds were down slightly both year-over-year and compared to budget, while those with 26-99 beds and 500 beds or more were down year-over-year but above budget. Hospitals with 200-299 beds were flat compared to July 2019 but above budget, and hospitals with 0-25 and 100-199 beds were up year-over-year and above budget. The smallest hospitals of 0-25 beds saw the greatest year-over-year increase for this metric at 17%, while the largest hospitals of 500 beds or more saw the greatest increase to budget at 10%.
Average LOS rose year-over-year and compared to budget in four of six bed-size cohorts: hospitals with 0-25, 100-199, 200-299, and 300-499 beds. Hospitals with 26-99 beds saw Average LOS decrease compared to the same period last year and to budget, while hospitals with 500 beds or more fell year-over-year but performed about 3% above budget.
©2020 Kaufman, Hall & Associates, LLC
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