July 2019
Volume
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Volume by Region ?
Discharges, ED Visits, and Adjusted Discharges varied across regions. While Discharges in the Midwest, South, and Northeast/Mid-Atlantic regions were essentially flat compared to prior year, they were below budget expectations. The Great Plains and West exceeded prior year Discharges by 2 percent and 4.5 percent, respectively, matching budget expectations in the West and exceeding expectations in the Great Plains. Year-over-year Adjusted Discharges were lower in all regions except the West, but these results exceeded budget expectations in all regions except for the Northeast/Mid-Atlantic. ED Visits exceeded both prior year volumes and budget expectations in the Great Plains and West, and were below prior year volumes and budget expectations in all other regions.
Average Length of Stay was higher than prior year across all regions, contributing to Adjusted Patient Days that exceeded prior year and budget expectations. Operating Room Minutes were flat to below budget and year over year in all regions.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
National Volume Observations
June volumes were lower than May across almost all measures, although they were generally stronger compared to the prior year. These two factors produced mixed results relative to budget. With the exception of Average Length of Stay, all measures were down by 5 percent to 7 percent compared to May. In comparison to the prior year, however, Discharges, Adjusted Patient Days, and Average Length of Stay were higher, while Adjusted Discharges, ED Visits, and Operating Room Minutes were lower. These dynamics resulted in Discharges, ED Visits, and Operating Room Minutes missing budget. Operating Room Minutes were the furthest below budget with a 4.4 percent variance. Nationwide, hospitals continue to be overly optimistic about inpatient volumes, while underestimating the increase in ambulatory care.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(1.9%)
(5.5%)
1.1%
discharges.svg
Adjusted Discharges
0.6%
(5.1%)
(1.5%)
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Adjusted Patient Days
2.5%
(5.3%)
2.6%
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Average Length of Stay
0.5%
0.4%
4.4%
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ED Visits
(2.9%)
(5.4%)
(0.8%)
ed_visits.svg
Operating Room Minutes
(4.4%)
(7.0%)
(1.8%)
or_minutes.svg
By Region
By Bed Size
National Observations
Volume by Bed Size
Although Discharges for hospitals of all sizes were equal to or higher than prior year, only hospitals with 200-299 beds exceeded Discharge budget estimates. Adjusted Discharges were essentially flat to down compared to prior year. Hospitals with 300-499 beds and more than 500 beds were unfavorable to budget, while hospitals in the smaller bed-size cohorts were favorable to budget.
ED Visits for hospitals of all sizes underperformed budget expectations and were lower compared to prior year, with the exception of hospitals with 100-199 beds. Average Length of Stay was higher than prior year across hospitals of all bed sizes, and Adjusted Patient Days exceeded prior year and budget expectations. Finally, Operating Room Minutes were flat to below budget and prior year in hospitals of all bed sizes.
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
©2019 Kaufman, Hall & Associates, LLC
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