November 2019
Volume
Volume by Region *
Volume performance varied significantly across regions in October. For example, Discharges were down -8.8 percent year over year in the Great Plains, but rose 3.8 percent in the South. Both the Midwest and Northeast/Mid-Atlantic performed close to October 2018 levels for Discharges.
For Adjusted Discharges, the Great Plains was down -3.5 percent year over year, but up about 7.7 percent to budget. Both the South and West saw significant year-over-year increases of about 5.1 percent. The Midwest saw the lowest performance to budget at -2.4 percent for this metric, and was essentially flat year over year.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
All regions were up year over year and above budget for Adjusted Patient Days and OR Minutes. The Great Plains saw the greatest variance for Adjusted Patient Days, rising 8.4 percent year over year and 14.6 percent to budget. The Northeast/Mid-Atlantic saw the least variance, up just 0.8 percent year over year and 1.7 percent to budget. For OR Minutes, the Midwest had the biggest year-over-year increase at 7.2 percent, while the Great Plains had the biggest variance to budget at 16.2 percent.

Average LOS was mixed across regions. The West was -13.7 percent below budget and down -3.7 percent year over year, while the Great Plains performed 7.9 percent above budget, with Average LOS increasing 11.2 percent year over year. Most regions saw year-over-year increases for ED Visits. The exceptions were the Northeast/Mid-Atlantic, which fell -1.9 percent year over year, and the South, where ED Visits were down -1.62 percent year over year.
National Volume Observations
Volume performance was somewhat mixed in October, but improved both year over year and month over month across most metrics. Discharges rose 1.5 percent year over year and 4.8 percent month over month, but performed close to budget expectations at 0.3 percent. Adjusted Discharges increased 2.9 percent year over year and 6.3 percent month over month, and were 1.4 percent above budget.
Adjusted Patient Days saw increases of 3.5 percent year over year and 5.1 percent month over month, and rose 3.6 percent above budget. Operating Room (OR) Minutes, however, saw the greatest variances, jumping 14.9 percent month over month and 4.7 percent year over year, and performing 5.6 percent above budget expectations.
Meanwhile, Average Length of Stay (LOS) and Emergency Department (ED) Visits fell. Average LOS was down -0.8 percent year over year and -1.1 percent month over month, but performed 1.2 percent to budget. ED Visits fell slightly -0.1 percent year over year and -1.1 percent month over month, and performed -1.7 percent 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
0.3%
4.8%
1.5%
Discharges.svg
Adjusted Discharges
1.4%
6.3%
2.9%
Adjusted_Discharges.svg
Adjusted Patient Days
3.6%
5.1%
3.5%
Adjusted_Patient_Days.svg
Average Length of Stay
1.2%
(1.1%)
(0.8%)
ALOS.svg
ED Visits
(1.7%)
(1.1%)
(0.1%)
ED_Visits.svg
Operating Room Minutes
5.6%
14.9%
4.7%
Operating_Room_Minutes.svg
Volume by Bed Size
Volume performance also varied widely across different bed-size cohorts. For Discharges, hospitals with 26-99 beds saw the lowest performance to budget at -3.7 percent, but were essentially flat compared to October 2018. The nation’s smallest hospitals of 0-25 beds saw the biggest year-over-year drop at -8.3 percent, while the largest hospitals were up 5.9 percent year over year.
All bed-size cohorts were up year over year for Adjusted Discharges, and most performed above budget. The largest hospitals of 500 beds or more were the exception, rising 1.6 percent year over year, but performing -2.1 percent below budget. The smallest hospitals with 0-25 beds were an outlier for Adjusted Patient Days. The cohort was up 12.4 percent to budget and 12.7 percent year over year, while all other cohorts saw year-over-year performance of less than 4 percent.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Year-over-year performance on Average LOS ranged from -2.7 percent for hospitals with 300-499 beds to 3.7 percent for hospitals with 26-99 beds. Hospitals with 0-25 beds had the greatest variance to budget at 10.8 percent for Average LOS.
Year-over-year performance on ED Visits ranged from -3.4 percent for hospitals with 500 beds or more, to 2.2 percent for those with 0-25 beds. Most bed-size cohorts were above budget and up year over year for OR Minutes. Mid-sized hospitals with 200-299 beds were the exception, falling slightly -0.3 percent year over year, but still 1.7 percent above budget expectations.
©2019 Kaufman, Hall & Associates, LLC
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