COVID-19’s surges disrupted hospital occupancy, elevating inpatient and ICU rates while reducing surgical occupancy. The study, analyzing 2020 data from 3,960 hospitals across 45 states, highlights fluctuating trends. Low COVID-19 admission weeks dominated, with spikes lasting less than a month. Inpatient occupancy plunged during low admission periods and surged during high admission weeks. ICU occupancy mirrored this, escalating during surges. Financially, hospitals suffered losses, affecting revenues and operating margins. The study underscores the strain on healthcare systems due to COVID-19’s fluctuating impact on hospital occupancy and financial stability.
The study examines COVID-19’s influence on hospital occupancy across the United States. Analyzing 2020 data from a multitude of hospitals, it identifies trends in inpatient, ICU, and surgical occupancy rates. The erratic nature of COVID-19 admissions led to significant fluctuations, impacting hospitals financially and operationally. These fluctuations posed challenges in maintaining care quality and financial stability. Understanding these dynamics is crucial to devising strategies for resilient healthcare systems amidst ongoing pandemic uncertainties.
COVID-19’s Dynamic Impact
Researchers delved into the repercussions of COVID-19 surges using data sourced from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project State Inpatient Databases from 2019 and 2020 across 45 states. The study encompassed 3,960 hospitals, evaluating 393,580 hospital weeks for inpatient occupancy and 2,703 hospitals, examining 268,416 hospital weeks for ICU occupancy.
The findings revealed that the majority of weeks in 2020 witnessed low or relatively low COVID-19 admission rates, accounting for almost two-thirds of the hospital weeks. In contrast, periods characterized by high COVID-19 admissions, particularly those between 10 to 14 weekly admissions or 15 or more weekly admissions, constituted less than one-fifth of the hospital weeks.
Notably, most phases of heightened COVID-19 admissions endured for less than a month. The initial half of the pandemic encountered frequent low COVID-19 admissions (30.5 percent of hospital weeks) compared to high admissions (6.1 percent). However, in the latter half of the year, hospital weeks with low COVID-19 admissions reduced to 12.3 percent, while those with high admissions increased to 9.2 percent.
During weeks marked by low COVID-19 admissions, inpatient occupancy plummeted by 9.3 percentage points per 100 beds (12.7 percent) relative to the mean. This decline was more pronounced in the first half of 2020 (11.6 percentage points) than in the latter half (5.2 percentage points). Conversely, during weeks with high COVID-19 admissions, inpatient occupancy surged by 5.8 percentage points per 100 beds (7.9 percent), intensifying to 9.1 percentage points (12.6 percent) in the latter half of the year.
ICU occupancy exhibited a contrasting trend, declining by 5.4 percent during low COVID-19 admission weeks and escalating by a staggering 67.8 percent during high admission weeks. These fluctuations extended to various service lines, with notable decreases observed during weeks with high COVID-19 admissions, particularly in surgical patients (8.5 percentage points decrease).
The surge in ICU occupancy, although indicative of increased COVID-19 cases, strained ICU staff, potentially impacting care quality and resulting in higher in-hospital mortality rates. Moreover, reduced occupancy in surgical services, alongside patients deferring care, likely contributed to increased mortality rates.
Financially, hospitals suffered losses due to fluctuating occupancy rates, experiencing diminished operating margins, net patient revenues, and net operating income beyond COVID-19 relief funds. The instability in occupancy necessitated an increased reliance on travel nursing, a more costly resource for hospitals, further exacerbating financial challenges.
COVID-19’s waves induced volatile occupancy shifts, impacting hospitals financially and operationally. The study emphasizes the strains on ICU staff, potential care quality issues, and increased mortality rates. Financially, hospitals faced losses, necessitating reliance on costlier resources. Addressing these challenges demands strategic planning to maintain quality care amid fluctuating occupancy rates. Adapting to these uncertainties requires robust measures to bolster healthcare systems’ resilience, ensuring optimal care provision amidst COVID-19’s unpredictable impacts.
