Hospital Volumes Slashed by More Than Half During Pandemic

What your doctor is reading on Medscape.com:

MAY 11, 2020 — As US hospitals begin to reopen for elective procedures, a new report outlines the damage that the COVID-19 pandemic has done to the facilities’ patient volumes and revenues.

The study, by Strata Decision Technology, a Chicago-based financial analytics firm, suggests that across all service lines and in every region of the country, there was an average decrease of 54.5% in the number of unique patients who sought care in a hospital setting during a 2-week period in March and April.

The findings suggest how much pent-up demand will hit hospitals when they start to admit non–COVID-19 patients who need procedures that have been prohibited by temporary state bans on nonurgent hospital admissions.

Strata researchers mined the company’s database to compare patient encounters during those two weeks to the comparable period last year. The analysis of over 2 million patient visits and encounters from 228 hospitals in 40 states provides a detailed view of the level of reduction in patients accessing healthcare.

Patients with life-threatening illnesses were among those who could not access care because of COVID-19 restrictions. In the context of clinical service lines, there was a 57% drop in cardiology volume, a 55% decline in breast health volume, and a 37% decline in cancer care.

Other high-volume procedural service lines experienced even larger declines: Ophthalmology fell by 81%; spine, 76%; gynecology, 75%; orthopedics, 74%; ENT, 72%; endocrine, 68%; dermatology, 67%; gastroenterology, 67%; rheumatology, 66%; neurosciences, 66%; urology, 62%; vascular, 59%; and hepatology, 58%.

Most of the top 10 hospital procedures also took major hits, the report found. These included primary knee replacement (-99%), lumbar/thoracic spinal fusion (-81%), primary hip replacement (-79%), diagnostic catheterization (-65%), other diagnostic procedures (-60%), percutaneous coronary intervention (-44%), and fracture repair (-38%).

The number of regular births and cesarean births, on the other hand, increased by 1% and 2%, respectively. And, not surprisingly, the use of mechanical ventilation jumped by 24%.

The report noted that inpatient procedures and surgeries account for the majority of hospital revenues, and that the top 10 procedures generate over 50% of the total payments made to hospitals.