Hospitals' inpatient volumes rebounded faster than emergency departments: TransUnion

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Research published by TransUnion Healthcare this week found hospital volumes rebounded in June compared to early losses of the pandemic.(Getty/ ~UserGI15994093)

The steep losses in volumes experienced by hospitals in the early days of the COVID-19 pandemic began to reverse in June, according to new research from TransUnion Healthcare. 

The analysis from TransUnion of more than 500 hospitals across the U.S. also found outpatient volumes were down 7% during the week of June 21. That represented an 88% recovery of the volumes lost since the week of April 5.

Inpatient volumes are down about 8% compared to pre-COVID volumes, a 75% rebound from early April.

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While emergency department visits also rebounded, the recovery was more muted, said Jonathan Wiik, principal of healthcare strategy at TransUnion Healthcare and author of the newly released book “Healthcare Evolution: Helping Providers Get Paid in an Era of Uncertainty."

Emergency department visits were about 25% from pre-COVID-19 volumes, the research from TransUnion found. They were recovered 51% from lows reached at the beginning of April near the beginning of the pandemic.

When looking at patient admitting diagnoses within emergency department settings at the beginning of March and again in mid-June, TransUnion Healthcare’s research found adult visit volumes for less acute diagnoses have returned at a slower pace than more acute diagnoses.

Visit volumes for coughs and ear pain—typically considered low-acuity diagnoses—remain down 82% and 40%, respectively. Higher-acuity diagnoses such as throat/chest pain have seen a greater return in volumes, down 24% compared to pre-COVID-19 volumes. 

That might not be all bad, Wiik said, as they could be indicating changes in behavior of how patients seek care post-COVID in less acute settings that could result in lower healthcare costs.

"An optimistic point of view is patients may be seeking care at alternative levels," Wiik said. "They may be using virtual visits or primary care or urgent care clinics where for these non-acute diagnoses like ear pain or cough. Chest pain is certainly the kind of thing EDs were designed for. But if you talk to most emergency departments, they’ll tell you there’s a large proportion of patients who probably should’ve gone to another setting of care."

RELATED: Study finds slight rebound in patient volumes in May, but physicians still in danger financially

Among other trends observed: 

  • Adult volumes are returning more quickly to emergency departments (down 16% compared to pre-COVID volumes the week of June 21) than pediatric volumes (down 59%). "Children aren’t going to the ED for things as much as they did pre-COVID and I call that the ‘mama bear’ effect where parents are keeping their kids away from there because they don’t want to go to a place that was treating COVID patients. They’re trying home remedies, virtual visits or calling their primary care doctor," Wiik said.
  • Adult volumes are also driving the recovery for outpatient volumes and were down about 5% the week of June 21. In comparison, pediatric visits were down 34% in the same time period. 
  • Pediatric volumes have recovered more quickly in the inpatient setting. Inpatient volumes among children are down 6% compared to pre-COVID volumes. Meanwhile, adults are still down 9% in June compared to pre-COVID-volumes. 

Wiik said he doesn't expect inpatient, outpatient and ED volumes will return back to what they did for a while. In particular, he expects ED volumes may have a longer-term impact on business.

"I hope the trend will stay that way because in the end that means there are going to be less ED visits but maybe there should’ve been the whole time," Wiik said. "Hospitals and providers are going to have to pivot to that."

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