May 2019
Volume
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Volume by Region ?
Hospitals in the Great Plains region exhibited relatively large budget variances across nearly all measures, both positive and negative, relative to the rest of the country. Adjusted Patient Days were an exception. Year-over-year Discharges increased across most of the country, except in the Great Plains and Midwest, where they remained the same and fell slightly, respectively.
The largest gaps between year-over-year changes in Discharges and Adjusted Discharges occurred in the Midwest, Great Plains, and West. Discharges and Adjusted Discharges both greatly exceeded budget expectations in the Great Plains, by 17 percent and 16 percent, respectively. Adjusted Patient Days saw the largest year-over-year increase of 5.5 percent in the Great Plains, and the greatest increase over budget of about 7 percent in the South. Average Length of Stay fell most significantly year over year in the West and the Great Plains regions, and to a lesser extent in the South. ED Volumes fell below budget expectations in all regions except the West, with the largest decrease occurring in the Great Plains.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
National Volume Observations
Volumes generally were up year over year on a national basis, but down month over month. Adjusted Discharges rose 5.4 percent year over year in April, and were 3.4 percent above budget. Adjusted Patient Days were up 1.5 percent year over year, and 2 percent above budget. Both indicators, however, were down compared to March.
Discharges for the month of April stayed in line with budget expectations, but decreased 4.1 percent compared to the prior month, suggesting a possible increase in outpatient volumes. ED Visits were 2.6 percent lower than budget expectations and down 3.7 percent month over month, but increased 1.7 percent year over year. This suggests a potential increase in either outpatient surgery or ambulatory volumes. Average Lengths of Stay decreased across the board. Operating Room Minutes increased significantly—up 4.6 percent over the prior month—and were slightly over budget, but remained in line with prior year.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Discharges
(0.1%)
(4.1%)
2.0%
discharges.svg
Adjusted Discharges
3.4%
(0.9%)
5.4%
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Adjusted Patient Days
2.0%
(3.3%)
1.5%
adj_patient_days.svg
Average Length of Stay
(0.7%)
(2.7%)
(2.9%)
av_length_stay.svg
ED Visits
(2.6%)
(3.7%)
1.7%
ed_visits.svg
Operating Room Minutes
0.9%
4.6%
0.1%
or_minutes.svg
By Region
By Bed Size
National Observations
Volume by Bed Size
Hospitals with 25 beds or less saw the largest decrease in overall Length of Stay at 10 percent compared to both budget and prior year. This cohort also experienced a decrease in ED Visits of 2.5 percent compared to prior year and 8 percent compared to budget. These hospitals—many of which qualify as Critical Access Hospitals—also saw a large 7.5 percent year-over-year decrease in Operating Room Minutes, yet Operating Room Minutes still vastly exceeded budget expectations by 18 percent.
The difference in year-over-year Discharges and Adjusted Discharges was greatest for hospitals with 25 beds or less, and hospitals with 500 beds or more. This suggests that these hospitals experienced the greatest increase in ambulatory and outpatient volumes over prior year. Relative to both prior year and budget, hospitals with 26-99 beds saw the largest increase in Adjusted Patient Days, at roughly 4 percent and 7 percent, respectively.
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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