September 2019
Volume
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Volume by Region *
Volume performance by region varied widely in August. Looking at Discharges, for example, the West and Great Plains both were above budget and up year over year, while the Midwest was under budget and down year over year. The South was essentially at budget, and up about 1.0 percent year over year for Discharges, while the Northeast/Mid-Atlantic was slightly above budget but down -5 percent year over year.
The West saw increases across the most measures, performing both above budget and up year over year for Discharges, Adjusted Discharges, Adjusted Patient Days, and Operating Room Minutes. The West also was up 3.1 percent year over year for ED Visits, but was just below budget at -0.6 percent for this measure. For Average Length of Stay, the West was flat year over year, but -7.6 percent below budget.
All other regions performed below budget and down year over year for ED Visits and Operating Room Minutes. The Midwest saw the greatest year-over-year declines for these measures, down -5.1 percent for ED Visits and -5.3 percent for Operating Room Minutes. The Midwest also had the lowest year-over-year performance for Adjusted Discharges at -2 percent, and for Adjusted Patient Days at -0.9 percent. All other regions were above budget and up year over year for Adjusted Patient Days.
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
Adjusted Patient Days
Adjusted Discharges
ED Visits
OR Minutes
National Volume Observations
The nation’s hospitals saw mixed volume performance in August, following higher volumes in July. Discharges were down -1.5 percent year over year and -0.3 percent compared to budget, but relatively flat at 0.6 percent month over month. Adjusted Discharges were down -1.2 percent year over year, but up 1.8 percent month over month and 1.0 percent above budget expectations. Average Lengths of Stay rose 2.1 percent year over year and were 0.7 percent above budget, but were down slightly -0.3 month over month.
Both Emergency Department (ED) Visits and Operating Room Minutes declined in August, performing -2.8 percent and -2.6 percent compared to budget, respectively. ED Visits saw the greater month-over-month decline of the two measures, at -2.2 percent compared to a relatively flat -0.2 percent month over month for Operating Room Minutes. Year-over-year performance was flipped, however, with Operating Room Minutes seeing the greater decline at -2.6 percent compared to -1.6 percent for ED Visits. The data suggest a possible continued increase in either overall outpatient surgery or ambulatory volumes.
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%)
0.6%
(1.5%)
Discharges.svg
Adjusted Discharges
1.0%
1.8%
(1.2%)
Adjusted_Discharges.svg
Adjusted Patient Days
2.9%
1.1%
1.6%
Adjusted_Patient_Days.svg
Average Length of Stay
0.7%
(0.3%)
2.1%
ALOS.svg
ED Visits
(2.8%)
(2.2%)
(1.6%)
ED_Visits.svg
Operating Room Minutes
(2.6%)
(0.2%)
(2.6%)
Operating_Room_Minutes.svg
By Region
By Bed Size
National Observations
Volume by Bed Size
Volume performance across hospitals of various sizes also was mixed in August, but generally more clustered compared to regional cohorts. All bed-size cohorts were below budget and down year over year for Operating Room Minutes. For ED Visits, all cohorts were down year over year, and most were below budget. Mid-sized hospitals of 100-199 beds were the exception, at about 0.5 percent above budget for ED Visits.
Most cohorts also were down year over year for Adjusted Discharges, except 200-299 bed hospitals—which were essentially flat at 0.2 percent. All cohorts were above budget and up year over year for Adjusted Patient Days. The nation’s smallest hospitals of 0-25 beds saw the largest year-over-year increase at 5.5 percent, while hospitals with 100-199 beds had the greatest variance to budget, at nearly 6.5 percent above expectations.
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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