How COVID-19 Has Impacted Top Clinical Service Lines at Hospitals

Year over year clinical service line volumes continue to drop further across most major specialties as inpatient and outpatient volumes still experience declines from the COVID-19 crisis, according to updated data from Strata Decision Technology.

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In its original report, using data from the National Patient and Procedure Volume Tracker, Strata found that the number of unique patients who sought hospital care decreased by an average of 54.5 percent in March and April as a result the cancellation of elective procedures and other concerns during the COVID-19 crisis.

Hospital volumes across the board were still down as of May 9, 2020, the updated report revealed. Specifically, compared to the previous 30 days, hospitals saw average declines in daily emergency visits by 22.62 percent, daily outpatient visits by almost 10.72 percent, daily inpatient admissions by about 7.94 percent, and daily observation visits by 7.67 percent.

Inpatient admissions, emergency visits, and outpatient visits declined at a greater rate in hospitals located in COVID-19 hotspots. In hotspot areas, inpatient admissions were down by 43.9 percent, emergency visits were down by 59.5 percent, and outpatient visits fell by 46.1 percent in the last 30 days, compared to 2019 volumes, Strata reported.

These dramatic decreases in hospital volumes have significantly impacted the financial health of the organizations, resulting in up to $60 billion in losses a month, according to the updated report.

However, some specialties have been hit harder than others.

The original report revealed that clinical service lines experiencing the sharpest drops in patient encounters included those with life-threatening illnesses. For example, cardiology saw a 57 percent decline in volume in March and April, while breast health and cancer care saw declines of 55 and 37 percent, respectively.

The majority of the top ten inpatient procedures and surgeries – which account for over 50 percent of total payments made to hospitals – also saw dramatic reductions in volume. The original report found that, in March and April:

• Primary knee replacements fell by 99 percent
• Lumbar/thoracic spinal fusions fell by 81 percent
• Primary hip replacements fell by 79 percent
• Diagnostic catheterizations fell by 65 percent
• Diagnostics fell by 60 percent
• Percutaneous coronary interventions fell by 44 percent
• Fracture repairs fell by 38 percent

Childbirth services and mechanical ventilation were the only top inpatient procedures and surgeries to experience a boost in volume, the report showed.

Many of the clinical service lines seeing dramatic declines in volume continue to report drops in patient encounters, Strata said in the updated report.

Specifically, breast health experienced one of the largest drops in weekly volume, with a 24.6 percent decline compared to late March and early April. Nephrology also saw a 24.6 percent decline in volume during the period.

Additionally, behavioral health, cancer, ENT, orthopedics, pulmonology, spine, and vascular all saw weekly volume declines over 15 percent. Meanwhile, allergy and immunology, gastroenterology, general medicine, hepatology, infectious disease, and neurosciences saw drops of at least 10 percent.

Notably, cardiology saw a less severe drop in volume at 7.1 percent, while ophthalmology and dermatology were the only specialties analyzed that experienced a slight boost in patient encounters.

The updated data revealed severe volume and revenue losses for hospitals in May, but the information also hinted at a recovery, Strata stated.

“We see early signs in the raw data that May volumes may show some recovery but the pace will be slow,” the company said in the updated report.

However, the trend of crucial care being missed continued into May, which could create issues as preventable diseases exacerbate without proper care.