October 2019
Volume by Region *
Volume performance by region varied widely in September. All regions grew Discharges year over year but most failed to meet budget, except for the Great Plains.
The Great Plains saw the strongest performance across volume measures, performing above budget and up year over year for Discharges, Adjusted Discharges, and Adjusted Patient Days. Hospitals in the region exceeded budget in those categories by 2.4, 5.0, and 9.4 percent, respectively. For Average Length of Stay, the Great Plains performed -4.3 percent below budget.
Hospitals in most regions were up year over year and above budget expectations for both Adjusted Discharges and Adjusted Patient Days. The Midwest was the outlier at -4.2 percent to budget and -0.6 percent year over year for Adjusted Discharges, and 3.1 percent to budget and down -0.7 percent year over year for Adjusted Patient Days. Average LOS was essentially flat for most regions, except for a -3.1 percent decline in the Midwest.
Most regions are up year over year for ED visits and OR Minutes. The Great Plains was the exception here, staying essentially flat for ED Visits and seeing a significant -12.6 percent drop for OR Minutes. The Northeast/Mid-Atlantic experienced below budget ED visits while all other regions exceeded budget by 2.9 percent to 5.2 percent. The South and West both saw increases in ED Visits and OR Minutes exceeding budget and up year over year.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
National Volume Observations
Volume performance at hospitals across the country was mixed in September, with most measures increasing year over year, but down month over month. Discharges were down -3.8 percent month over month and -1.1 percent compared to budget, but up 2.8 percent year over year. Adjusted Discharges saw a decline of -5.5 percent month over month but were up 2.9 percent year over year, and 0.9 percent above budget. Average Length of Stay (LOS) declined slightly at -0.4 percent year over year, but increased 1.0 percent month over month, performing just 0.4 percent above budget expectations. Adjusted Patient Days were up 4.0 percent year over year and 3.7 percent above budget, but down -3.5 percent month over month.
Emergency Department (ED) Visits were up across the board, rising 2.7 percent year over year, 0.6 percent month over month, and 3.4 percent above budget. Operating Room (OR) Minutes had the most significant variances among volume metrics, up 5.7 percent year over year, but down -6.6 percent compared to August, and -1.0 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)
Adjusted Discharges
Adjusted Patient Days
Average Length of Stay
ED Visits
Operating Room Minutes
Volume by Bed Size
Volume performance across hospitals of various sizes also was mixed, but showed more consistencies than regional performance. All bed-size cohorts saw year-over-year increases in Discharges, Adjusted Discharges, ED Visits, and OR Minutes.
Hospitals with 300-499 beds were the only cohort to exceed Discharge budget estimates at 2.0 percent. While median Adjusted Discharges were up by as much as 8.1 percent, hospitals with 500 beds or more were below budget while all other size cohorts were flat or above budget.
All cohorts also were above budget for Adjusted Patient Days in September, and most were up year over year. The largest hospitals of 500 beds or more were the only ones to see a slight year-over-year decline in Adjusted Patient Days, at -0.6 percent.
Performance on Average LOS varied widely. The smallest hospitals of 0-25 beds saw the greatest year-over-year increase at 3.5 percent, but performed -1.2 percent below budget. Hospitals with 300-499 beds saw Average LOS fall -2.6 percent below budget and -3.2 percent year over year, while hospitals with 200-299 beds were up 3.9 percent to budget, but just 1.0 percent year over year.
ED Visits for hospitals of most size cohorts (except >500 beds) exceeded budget expectations, and all were higher than prior year.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
©2019 Kaufman, Hall & Associates, LLC
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