Inpatient volumes, surgeries continue to lag amid COVID-19

WHILE PATIENT VOLUMES have started to rebound from the sharp drop at the beginning of the COVID-19 pandemic, many specialties haven’t returned to 2019 levels, according to a new analysis.

Even where patient volumes are approaching 2019 levels, many encounters seemingly lost during the early spring haven’t been recovered, according to the report from financial analytics company Strata Decision Technology.

Strata analyzed data from 275 U.S. hospitals across 58 systems.

Outpatient visit volumes have recovered more strongly than inpatient volumes, according to the findings.

While outpatient volume was down 56% in April, it was up 15% year-overyear in August. Early data for September, however, suggests a 7% dip.

Inpatient volume, down 27% in April, is still down 5% as of August. Medical service lines have rebounded more than surgical service lines, suggesting returning inpatients have focused on chronic, preventive and screening care, according to the report. The data showed inpatient procedures and surgeries are still down 18.6% cumulatively, but service lines like breast care, cancer and cardiology are nearing 2019 levels.

It’s possible inpatient volumes won’t ever fully recover, with a so-called “new normal” at 90% to 95% of previous volumes, said Dan

Michelson, Strata’s CEO. For hospitals already operating on thin margins, that “can be pretty devastating.”

That patient volume change, as well as uncertainty around when the pandemic will subside, could accelerate a shift to value-based care, he said.

Other analyses of healthcare utilization have also shown that patient volumes are still below pre-pandemic levels.

An analysis of visit volume data from customers of Phreesia’s patient intake software published by the Commonwealth Fund last month found weekly visits at ambulatory practices have plateaued at 10% below the volume seen in early March. That’s up from the initial 60% drop identified in early April but suggests a substantial number of lost visits since the spring.

In Phreesia’s dataset, visits to specialties including dermatology, ophthalmology, adult primary care, oncology and OB-GYN had most closely returned to pre-pandemic rates. Pediatrics, pulmonology and orthopedics experienced

● the biggest lag behind baseline rates.