COVID-19 and the Financial Health of US Hospitals

Khullar, Dhruv; Bond, Amelia M.; Schpero, William L.

doi:10.1001/jama.2020.6269

Cited by 235 publications

(249 citation statements)

References 5 publications

(6 reference statements)

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“…Deferring nonurgent outpatient services and elective surgeries was the single most disruptive intervention, also adopted by many hospitals across the country per Centers for Disease Control and Prevention (3), American College of Surgeons (4), and American College of Radiology (5) recommendations. The impact of deferring large numbers of services has yet to manifest but has significant financial implications (6,7).…”

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confidence: 99%

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

et al. 2021

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Rationale and Objectives: Quantify changes in total and by-subspecialty radiology workload due to deferring nonurgent services during the initial COVID-19 pandemic, and describe operational strategies implemented due to shifts in priority. Materials and Methods: This retrospective, Institutional Review Board-exempt, study was performed between February 3, 2020 and April 19, 2020 at a large academic medical center. During March 9À15 (intervention period), nonurgent outpatient service deferments began. Five-week periods pre-(baseline) and postintervention (COVID) were defined. Primary outcomes were radiology volume (reports per day) overall and in 11 subspecialty divisions. Linear regression assessed relationship between baseline vs. COVID volumes stratified by division. Secondary outcomes included changes in relative value units (RVUs), inpatient and outpatient volumes. Results: There were 62,791 baseline reports vs. 23,369 during COVID; a 60% overall precipitous volume decrease (p < 0.001). Mean volume decrease pre-and during-COVID was significant (p < 0.001) amongst all individual divisions. Mean volume decrease differed amongst divisions: Interventional Radiology experienced least disruption (29% volume decrease), 7 divisions experienced 40%À60% decreases, and Musculoskeletal, Breast, and Cardiovascular imaging experienced >75% volume decrease. Total RVUs decreased 60% (71,186 baseline; 28,476 COVID). Both outpatient and inpatient report volumes decreased; 72% (41,115 baseline; 11,326 COVID) and 43% (12,626 baseline vs. 6,845 COVID), respectively. In labor pool tracking data, 21.8% (162/744) total radiology employees were reassigned to other hospital duties during the intervention period. Conclusion: Precipitous radiology workload reductions impacted subspecialty divisions with marked variation. Data-driven operational decisions during COVID-19 assisted workflow and staffing assignment changes. Ongoing adjustments will be needed as healthcare systems transition operations to a "new normal."

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confidence: 99%

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

et al. 2021

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“…Public financial reports often provide aggregate hospital costs but do not provide specific details on revenue or net income directly from elective orthopaedic surgery [6]. Several recent studies evaluating the financial implications on hospitals during the COVID-19 pandemic use data from the Healthcare Cost and Utilization Project (HCUP) for revenue predictions from decreased surgical volume [7][8][9][10]. However, the estimates referenced in these reports do not actually include any information on hospital revenue or profit, but rather only provide estimates of aggregate cost of inpatient procedures [9,11].…”

Section: Introductionmentioning

confidence: 99%

Economic implications of decreased elective orthopaedic and musculoskeletal surgery volume during the coronavirus disease 2019 pandemic

Best

Aziz

McFarland

et al. 2020

International Orthopaedics (SICOT)

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Purpose In order to reduce viral spread, elective surgery was cancelled in most US hospitals for an extended period during the COVID-19 pandemic. The purpose of this study was to estimate national hospital reimbursement and net income losses due to elective orthopaedic surgery cancellation during the COVID-19 pandemic. Methods The National Inpatient Sample (NIS) and the Nationwide Ambulatory Surgery Sample (NASS) were used to identify all elective orthopaedic and musculoskeletal (MSK) surgery performed in the inpatient setting and in hospital owned outpatient surgery departments throughout the USA. Total cost, reimbursement, and net income were estimated for all elective orthopaedic surgery and were compared with elective operations from other specialties.

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“…On the 30 th of January 2020 the World Health Organization (WHO) declared the disease caused by SARS-CoV-2 coronavirus (the COVID-19) a global pandemic. (1) Since then this novel coronavirus has spread rapidly and it has caused enormous repercussions on economic and health-systems worldwide (2)(3)(4). In Spain, due to the rapid increase of cases between February and March 2020, the Spanish Government declared a state of alarm on the 14 th of March and established a situation of strict con nement, severe restrictions and lockdown throughout the country (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…In Spain, the SARS-CoV-2 virus, responsible for COVID-19 disease (8,9), caused the saturation of the public health system, leading in certain autonomous communities to the collapse and saturation of hospitals and intensive care units, and causing extreme situations, due to a high number of patients and limitations in material and human resources (3,10). The efforts and changes made in order to meet the growing demand for COVID-19 cases, indirectly caused changes in the care and management of other NON-COVID pathologies.…”

Section: Introductionmentioning

confidence: 99%

ECIEN-2020 Study: the effect of COVID-19 on admissions for NON-COVID diseases

Ramos-Lacuey¹,

Moreno‐Galarraga²

2020

Preprint

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Introduction: The pandemic caused by SARS-CoV-2 coronavirus has had great effects on health systems worldwide, not only in relation to COVID-19 cases, but also affecting patients with other pathologies.Material and methods: ECIEN-2020 is an observational study conducted in a tertiary referral hospital in Navarra, Spain to describe the effect of COVID-19 in pediatric admissions for NON-COVID diseases. Admissions during March-June 2020 (first wave of the COVID-19 pandemic in Spain) are described and compared with the same period in 2019. A sub-analysis was performed delving into epidemiology. Patient characteristics (age, sex, medical history), disease characteristics (symptoms, duration of symptoms, previous consultation in Primary Care Health Center) and admission characteristics (place and average stay) were analyzed.Results: A 33% reduction in the number of admissions was observed, decreasing from 529 in 2019 to 353 in 2020, highlighting a 48% reduction in patients admitted for pulmonary diseases. There were no significant changes in age, average stay, admissions for other reasons, or Intensive Care Unit admissions. Percentage of patients admitted among those seen in the emergency department rose from 5.1% in 2019 to 10.9% in 2020, whereas the total number of consultations in the emergency department decreased a 68%.Conclusions: The pandemic and the measures adopted due to SARS-CoV-2 have significantly decreased pediatric admissions for NON-COVID diseases, especially due to a reduction in hospitalization for respiratory diseases.

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COVID-19 and the Financial Health of US Hospitals

Cited by 235 publications

References 5 publications

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

Economic implications of decreased elective orthopaedic and musculoskeletal surgery volume during the coronavirus disease 2019 pandemic

ECIEN-2020 Study: the effect of COVID-19 on admissions for NON-COVID diseases

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