February 2020
Volume
Volume by Region *
Hospitals across all regions fell below budget expectations for Discharges in January. The South had the least variance to budget at -0.3 percent, but the greatest year-over-year increase at 5.1 percent. The Midwest had the greatest variance to budget of -7.6 percent and was up 1.9 percent year over year. The West, Northeast/Mid-Atlantic, and Great Plains all fell both below budget and down year over year.
Adjusted Discharges varied widely among different regions. The Northeast/Mid-Atlantic was the only region to see Adjusted Discharges increase both year over year (3.0 percent) and to budget (3.6 percent). The South and Midwest both were up year over year, but below budget. Meanwhile, hospitals in the West were down year over year and below budget, and hospitals the Great Plains were down year over year, but above budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Hospitals in four of five regions were up year over year for Adjusted Patient Days. The Great Plains had the biggest year-over-year increase at 7.6 percent. The Midwest was the only region to see a drop in Adjusted Patient Days at -2.6 percent, down -1.3 percent to budget.
Average LOS was above January 2019 levels in the Northeast/Mid-Atlantic, West, and Great Plains, with the Great Plains seeing the biggest increase at 4.3 percent.
Hospitals in the South and Midwest were down about -3.0 percent year over year, falling -2.4 percent and -1.9 percent below budget, respectively.
ED Visits were up year over year and above budget in the Great Plains, Northeast/Mid-Atlantic, Midwest, and West. The South also saw a year-over-year increase in ED Visits at 2.9 percent, but fell slightly below budget at -0.4 percent.
OR Minutes also were up in four of the five regions, with the Great Plains seeing the most significant jump of 21.8 percent year over year. The Northeast/Mid-Atlantic was the only region to see a year-over-year decline of -3.8 percent, falling -4.8 percent below budget.
National Volume Observations
The nation’s hospitals saw increases across most volume metrics in January, both year over year and month over month. Even so, most metrics fell below budget expectations. Discharges were up 2.5 percent year over year and 3.8 percent month over month, but fell -3.3 percent below budget. Adjusted Discharges rose 4.0 percent year over year and 3.4 percent month over month, but were -1.4 percent below budget.
Adjusted Patient Days increased 2.1 percent over January 2019 and 3.1 percent over December 2019, and were close to budget at 0.8 percent. Average Length of Stay (LOS) was the only volume metric to see a slight year-over-year decline of -0.9 percent and was -0.6 percent to budget, but rose 0.9 percent month over month.
Emergency Department (ED) Visits saw the biggest year-over-year increase of 4.1 percent. ED Visits also increased 2.6 percent month over month, and were 2.1 percent to budget. Operating Room (OR) Minutes were up 2.0 percent year over year and 1.8 percent month over month, but fell slightly below budget at -0.8 percent.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(3.3%)
3.8%
2.5%
discharges.svg
Adjusted Discharges
(1.4%)
3.4%
4.0%
adjusted_discharges.svg
Adjusted Patient Days
0.8%
3.1%
2.1%
adjusted_patient_days.svg
Average Length of Stay
(0.6%)
0.9%
(0.9%)
average_length_of_stay.svg
ED Visits
2.1%
2.6%
4.1%
ed_visits.svg
Operating Room Minutes
(0.8%)
1.8%
2.0%
operating_room_minutes.svg
Volume by Bed Size
Volume performance across different bed-size cohorts was more consistent. Five of the six cohorts saw increases in both Discharges and Adjusted Discharges compared to the same period last year. The smallest hospital cohort of 0-25 beds was the outlier for both metrics, falling -3.0 year over year and -11.1 percent to budget for Discharges, and -1.4 percent year over year and -7.6 percent to budget for Adjusted Discharges.
Hospitals of all sizes saw Adjusted Patient Days rise compared to January 2019, with increases ranging from a low of 0.9 percent for 0-25 bed hospitals, to a high of 3.0 percent for hospitals with 300-499 beds.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Average LOS declined year over year for most bed-size cohorts, with mid-sized hospitals of 200-299 beds seeing the biggest drop at -6.32 percent. Hospitals with 300-499 and 0-25 beds both saw a slight year-over-year increase in Average LOS, but the larger hospitals fell below budget while the smaller hospitals were 6.7 percent above budget.
ED Visits increased both year over year and compared to budget across all bed-size cohorts, with 300-499 bed hospitals experiencing the biggest increases at 6.6 percent compared to January 2019 and 4.9 percent to budget.
OR Minutes increased for all but one bed-size cohort. The smallest hospitals of 0-25 beds saw the biggest jump, up 13.2 percent year over year but -11.1 percent to budget. The 100-199 bed cohort was the only one to see a drop in OR Minutes, down -2.6 percent year over year and -1.2 percent to budget.
©2020 Kaufman, Hall & Associates, LLC
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