While the overall number of admissions in U.S. hospitals has rebounded since historic lows experienced early on in the COVID-19 pandemic, it hasn't been enough to make up for the overall loss in business, according to a new Kaiser Family Foundation analysis.
Overall, total hospital admissions dropped as low as 69% of predicted levels during the second week of April as stay-at-home orders required elective surgeries to be canceled, according to electronic medical record data from the Epic Health Research Network.
The analysis looked at inpatient hospital admission volume from 27 healthcare organizations in the U.S. from the beginning of 2018 through Aug. 8, 2020. The data, which involved 22 million patients who were either discharged or died as of Sept. 13, represented 162 hospitals across 21 states.
As restrictions eased, admissions rebounded to a high of more than 94% in early July but dipped slightly by August to admissions of about 91% of predicted levels.
If admissions remain at about 90% of projected levels for the rest of the year, total admissions will be about 10.5% below the predicted volume for 2020, the analysis found. If restrictions are put on elective procedures again in the latter part of the year, the share of "lost" admissions will be higher, the analysis said.
"It could have serious consequences both for hospitals’ financial stability and the health of patients," authors of the report wrote.
The report also found:
- Hospitals were impacted in particular when it came to non-COVID-19 admissions among patients 65 and older and had about half as many admissions in late March and April compared to projections. Their admissions have stabilized closer to normal levels at about 80% to 85% of their predicted volumes.
Admissions for patients younger than 65 were about 90% of predicted levels during the same period. That could actually provide a positive change in payer mix for some hospitals as the majority of younger patients have private insurance, which reimburses at a higher rate than Medicare and could help mitigate some revenue decline from admissions, the authors wrote.
- Non-COVID-19 admissions for both men and women dropped to about 60% of predicted admissions in April before rebounding. But admissions for female patients remained about 20% higher than for male patients, largely due to women's admissions for childbirth, the analysis said.
- Hospitals in the Northeast experienced the biggest drop in non-COVID-19 admissions, with admissions falling to a low of roughly 50% of predicted admissions in April. But they have since increased to nearly 90% of predicted levels in August. In the West, hospitals did not see as big of a drop in admissions but also did not see as much of a rebound. In August, admissions were at 83% of predicted levels.