July 2020
Volume
Volume by Region *
Hospitals in all regions saw volumes reduced year-over-year and compared to budget for the fourth consecutive month across Discharges, Adjusted Discharges, Adjusted Patient Days, and ED Visits; however, the variance in performance across regions continues to grow as recovery differs geographically. Hospitals in the Midwest saw the greatest decreases in Discharges, falling 16% both compared to June 2019 and to budget. Those in the South saw the smallest decreases at about 3% year-over-year and 10% below budget.
For Adjusted Discharges, the Northeast/Mid-Atlantic had the greatest year-over-year decrease of 17%, while the Midwest had the greatest decrease to budget at 15%. Hospitals in the South again saw the smallest decreases at just 1% year-over-year and 6% below budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Four of five regions saw year-over-year decreases of 8% or greater for Adjusted Patient Days. The Great Plains had the greatest decline with Adjusted Patient Days falling 14% year-over-year and 6% below budget. ED Visits fell 13% or more across all regions year-over-year. Hospitals in the Midwest had the greatest decreases for this metric, falling about 25% compared to June 2019 and to 21% budget.
Operating Room Minutes varied significantly. The Great Plains saw the largest year-over-year increase at 15% but fell 2% below budget. The Northeast/Mid-Atlantic was down 7% year-over-year and 15% below budget. Hospitals in the Midwest, South, and West all were up about 4-7% year-over-year, but the Midwest fell below budget while the South and West were slightly above budget.
Average LOS results also varied greatly. The Northeast saw the greatest year-over-year increase at 3%, and the Midwest was the only region to fall slightly below budget. Hospitals in the Northeast/Mid-Atlantic and West were up year-over-year and compared to budget, while those in the South and Great Plains were slightly above budget but down compared to the same period last year.
National Volume Observations
Hospital volumes continued to demonstrate some recovery from May but continued their four-month trend being diminished from last year and below budget across most metrics. Operating Room Minutes saw the greatest month-over-month increases, having initially been reduced the greatest during the peak of shutdown, and was the only volume metric to see a year-over-year increase as hospitals across the country continued to regain surgery volumes. Operating Room Minutes increased 40% month-over-month and 5.5% year-over-year, but still fell 3% below budget.
Discharges increased 8% month-over-month, but remained 7% below last year and fell 13% below budget. Adjusted Discharges were up 18% month-over-month, but were also down 7% year-over-year and were 9% below budget, while Adjusted Patient Days increased 13% compared to May 2020, but were down 8% and 7% compared both to June 2019 and to budget respectively.
Emergency Department (ED) Visits rose 14% month-over-month, but fell 19% year-over-year and 20% below budget. Average Length of Stay (LOS) was the only volume metric to decrease month-over-month, falling 3%. Average LOS also declined slightly year-over-year at 1%, and fell about 2% below budget expectations.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(12.6%)
8.2%
(7.7%)
discharges.svg
Adjusted Discharges
(9.4%)
17.8%
(7.2%)
adjusted_discharges.svg
Adjusted Patient Days
(6.7%)
12.8%
(7.5%)
adjusted_patient_days.svg
Average Length of Stay
2.1%
(3.3%)
(0.7%)
average_length_of_stay.svg
ED Visits
(19.0%)
14.1%
(19.1%)
ed_visits.svg
Operating Room Minutes
(2.9%)
40.6%
5.5%
operating_room_minutes.svg
Volume by Bed Size
Similarly, hospitals of all sizes saw decreases both year-over-year and compared to budget for Discharges, Adjusted Discharges, Adjusted Patient Days, and ED Visits.
The nation’s smallest hospitals of 0-25 beds saw the greatest decreases in Discharges, falling 16% year-over-year and 19% below budget. For Adjusted Discharges, hospitals with 200-299 beds saw the greatest year-over-year decrease of 11%, while hospitals with 0-25 beds saw the greatest decrease to budget, at 12%. Hospitals with 100-199 beds had the greatest year-over-year decrease in Adjusted Patient Days at 10%, while hospitals with 200-299 beds saw the greatest decrease to budget, also at 10%.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Hospitals of all sizes saw year-over-year decreases in ED Visits of 16% or more, with 100-199 bed hospitals seeing the biggest decrease at 22%. Hospitals with 100-199 beds also had the greatest decrease to budget for ED Visits at 22%.
Operating Room Minutes rose year-over-year in four of six bed-size cohorts, with the smallest hospitals of 0-25 beds seeing the greatest increase at 28%. Meanwhile, the largest hospitals of 500 beds or more fell the greatest both year-over-year (0.5%) and below budget (9%).
Average LOS was down year-over-year in five of six bed-size cohorts, with decreases ranging from less than 1% for hospitals with 200-299 beds to 5% for those with 26-99 beds. Hospitals with 300-499 beds were the only cohort to see increases, rising 1.5% year-over-year and 2% above budget for this metric.
©2020 Kaufman, Hall & Associates, LLC
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