December 2018
Volume
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Volume by Region ?
Hospitals in the West experienced increases in discharges and adjusted discharges, while hospitals in all other regions experienced discharge decreases. Western hospitals also experienced the greatest reduction in lengths of stay, which led to an overall decrease in adjusted patient days. Midwestern hospitals experienced the greatest reduction in OR minutes relative to prior year, while Northeast/Mid-Atlantic hospitals were the only geography to experience OR minute increases. ED visits were down in all regions.
The most striking feature of volume statistics over the past six months is a lack of a consistent month-over-month trend in several indicators. Average length of stay and OR minutes have been equally likely to rise relative to prior year as to fall. Discharges, ED visits, and patient days have established more of a predictable trend. Discharges and ED visits have declined relative to prior year in five of the past six months, while adjusted patient days have increased in five of the past six months. The relatively high volume variability reinforces the imperatives to continually flex staffing, and take longer-term views for planning and budgeting.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
National Volume Observations
November was a challenging month for hospitals, as all volume indicators underperformed compared to last month and prior year, resulting in underperformance relative to budget expectations. Both discharges and adjusted discharges have shown large swings month-over-month, with adjusted discharges experiencing a 6 percent decline relative to prior month, after experiencing an almost 8 percent increase over the month prior to it.
Length of stay increased relative to last month, but achieved a second month of declines relative to prior year (after two straight months of increases relative to prior year). Emergency Department (ED) visits and Operating Room (OR) visits were down relative to both prior year and prior month. OR minutes in particular have experienced large swings over the past six months—with two months of increases or decreases greater than 10 percent relative to the prior month, and the other four months experiencing a 5 percent or greater swing.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(4.6%)
(4.9%)
(4.4%)
Discharges.svg
Adjusted Discharges
(2.0%)
(5.9%)
(3.4%)
Adj_Discharges.svg
Adjusted Patient Days
0.3%
(5.0%)
0.1%
Adj_Patient_Days.svg
Average Length of Stay
0.4%
2.4%
(1.2%)
Av_Length_of_Stay.svg
ED Visits
(4.9%)
(6.3%)
(4.5%)
ED_Visits.svg
Operating Room Minutes
(2.7%)
(6.1%)
(2.1%)
OR_Minutes.svg
By Region
By Bed Size
National Observations
Volume by Bed Size
Large hospitals proved more resilient to volume swings this month than smaller hospitals. Hospitals above 300 beds experienced no loss in discharges and patient days relative to prior year. Only hospitals with greater than 500 beds provided more OR minutes than in the prior year (4 percent increase). Hospitals with fewer than 300 beds experienced a contraction of more than 2 percent.  Hospitals of all sizes experienced losses in ED visits, but the decreases were greatest in smaller hospitals.  Hospitals with more than 500 beds, however, experienced an almost 7 percent contraction in their adjusted discharges relative to prior year.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
By Region
By Bed Size
National Observations
©2018 Kaufman, Hall & Associates, LLC
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