March 2020
Volume
Volume by Region *
Discharges were up year over year across all regions. The Great Plains saw the biggest increase at 1.7 percent, while the Northeast/Mid-Atlantic saw the lowest increase at just 0.3 percent. Three of five regions also fell below budget, with the exceptions of the South and Great Plains.
Adjusted Discharges followed a similar pattern, with all regions at or above February 2019 levels. The Great Plains again saw the largest increases, up 9.1 percent year over year and 4.0 percent to budget. The South was up 2.4 percent year over year and 0.7 percent to budget. The Midwest was essentially flat year over year, but -1.9 percent below budget.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days increased year over year and compared to budget in four of five regions. The Northeast/Mid-Atlantic saw the largest increase at 10.8 percent year over year, but was only 0.2 percent to budget. The Midwest had the greatest positive variance to budget at 2.3 percent, and was up 4.9 percent year over year. The Great Plains was the outlier, as the only region to fall year over year (-1.8 percent) and to budget (-3.2 percent). The Northeast/Mid-Atlantic saw the biggest year-over-year increase in Average LOS at 7.2 percent, but was down -6.7 percent to budget. The South, Midwest, and West all were up year over year and compared to budget. The Great Plains was down -3.7 percent year over year and up slightly 0.5 percent to budget. ED Visits rose year over year and to budget in four of five regions. The Great Plains had the biggest year-over-year increase at 12.3 percent, and was 1.9 percent to budget. The South was the only region to see a decrease in ED Visits, down -1.4 percent year over year and -1.1 percent to budget. By contrast, OR Minutes were down year over year and compared to budget in the Great Plains, Northeast/Mid-Atlantic, and South. The Midwest and West both saw year-over-year increases in OR Minutes, but were below budget expectations. The West had the biggest year-over-year increase of 6.8 percent, while the Northeast/Mid-Atlantic had the biggest year-over-year decrease at -2.0 percent.
National Volume Observations
The nation’s hospitals saw volumes increase across all measures in February compared to the same period in 2019, but decrease across most measures compared to January 2020. Discharges were up 1.1 percent, Adjusted Discharges rose 2.7 percent, and Adjusted Patient Days were up 6.3 percent. Average Length of Stay (LOS) rose 1.9 percent compared to February 2019, while Emergency Department (ED) Visits were up 3.0 percent, and Operating Room (OR) Minutes increased just 0.7 percent.
Month over month, Discharges were down -8.3 percent, while Adjusted Discharges and Adjusted Patient Days both fell -7.6 percent. ED Visits were down -8.6 percent compared to January and OR Minutes were down -9.7 percent. Average LOS was the only volume metric to see a slight month-over-month increase of 0.7 percent.
Even so, most metrics performed above budget expectations. The exceptions were Discharges, which fell -1.1 percent to budget, and OR Minutes, which were -2.7 percent below budget. Adjusted Discharges, Adjusted Patient Days, ED Visits, and Average LOS all were above budget, with Average LOS seeing the largest increase to budget of 2.1 percent.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(1.1%)
(8.3%)
1.1%
discharges.svg
Adjusted Discharges
0.1%
(7.6%)
2.7%
adjusted_discharges.svg
Adjusted Patient Days
0.4%
(7.6%)
6.3%
adjusted_patient_days.svg
Average Length of Stay
2.1%
0.7%
1.9%
average_length_of_stay.svg
ED Visits
1.3%
(8.6%)
3.0%
ed_visits.svg
Operating Room Minutes
(2.7%)
(9.7%)
0.7%
operating_room_minutes.svg
Volume by Bed Size
Discharges were flat or up year over year for five of six bed-size cohorts. The largest hospitals of 500 beds or more saw the biggest increase, up 5.6 percent year over year and 2.2 percent to budget. The smallest hospitals of 0-25 beds were the only cohort to see a year-over-year decrease, falling -7.9 percent, and performing -8.7 percent compared to budget.
Adjusted Discharges and Adjusted Patient Days rose year over year across all bed-size cohorts. Hospitals with 26-99 beds saw among the biggest year-over-year increases, up 6.0 percent for Adjusted Discharges, and 7.7 percent for Adjusted Patient Days. Hospitals with 100-199 beds saw the least increase for Adjusted Discharges at just 0.2 percent, while hospitals with 500 beds or more saw the least increase for Adjusted Patient Days at 3.3 percent.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Average LOS increased year over year and compared to budget in February for five of six bed-size cohorts. Larger hospitals with 300-499 beds saw the biggest year-over-year increase at 4.3 percent. Smaller hospitals with 26-99 beds also were up year over year at 3.2 percent, but was the only cohort to perform below budget at -0.8 percent.
ED Visits also were up year over year across all bed-size cohorts, but half of cohorts fell below budget for this metric while half performed above budget. The smallest hospitals of 0-25 beds saw the greatest increases, up 5.4 percent year over year and 4.2 percent to budget.
OR Minutes were more varied, with three cohorts up year over year but below budget, two cohorts down year over year and below budget, and just one cohort—hospitals with 500 beds or more—up slightly year over year and to budget.
©2020 Kaufman, Hall & Associates, LLC
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