Inpatient volumes are down in three major metropolitan areas: Boston, Indianapolis and Newark, New Jersey, according to a new report from Kaufman Hall.
To compile the report, Tufts Medical Center in Boston, Barnabas Health in Newark and Community Health Network in central Indiana analyzed inpatient use from 2010 to 2012 in their respective regions. Their analysis found:
In Eastern Massachusetts, inpatient volumes fell 5 million, declining most among Medicare-eligible patients (10 percent) and patients aged 0-17 (8 percent). Inpatient services for cardiovascular care fell more than any other service line (14 percent).
In Newark, inpatient utilization declined 4.3 percent. As in the Massachusetts cohort, the biggest drop was among the oldest and youngest demographics, with general cardiology (17 percent) and interventional cardiology (26 percent) dropping more than any other service line.
Inpatient utilization in central Indiana fell 2.5 percent overall, with the largest decline among patients aged 0-14 (6 percent). The largest service-line volume decrease occurred in gynecology, falling 28 percent.
The consulitng firm's report indicates that most of the reductions were the result of cases moving from inpatient to ambulatory settings where appropriate, according to the report. For example, 35 percent of the Massachusetts inpatient decline and 30 percent of the Newark decline were due to reduced one-day stays, suggesting more patients moved to observation status or outpatient facilities.
Ambulatory care sensitive admissions (ACSA), or cases where outpatient attention to chronic conditions can avert hospitalization, also declined significantly, according to the report. "In Central Indiana, for example, utilization for ACSAs in the cardiovascular care service line decreased 24.1 percent compared with an 8.1 percent decrease for other cases in the service line," the report stated. "In Eastern Massachusetts, utilization for ACSAs in the cardiovascular surgery service line decreased 15 percent compared with a 4.4 percent decrease for other cases in the service line."
Healthcare experts project inpatient volumes will continue to fall for the rest of the year due in large part to shifts to other settings, FierceHealthcare previously reported.
To learn more:
- here's the report