- The omicron variant walloped hospitals in the final month of 2021, driving up both adjusted patient volumes and expenses as the number of COVID-19 cases surged to new highs for the pandemic, according to Kaufman Hall's latest flash report.
- Patient days rose nearly 4% in December compared to November, while emergency department visits jumped more than 7% as patients came in with COVID-19 symptoms. Omicron's rapid spread drove a 98% jump in COVID-19 hospitalizations over the course of the month, Kaufman Hall said, citing Centers for Disease Control and Prevention data.
- The second full year of the pandemic was marked by an increase in severely ill patients requiring longer hospital stays compared to the first year, the report also found.
Before omicron's emergence, hospitals in the fall were finally experiencing a break from the pressures of treating large numbers of COVID-19 patients. In October, Kaufman Hall found average length of stay and patient days declined for the first time in months. Both measures were down in November as well, as hospitals braced for the variant's arrival.
In Kaufman Hall's latest analysis, based on December data from more than 900 hospitals, the numbers show health systems across the country once again caring for large numbers of COVID-19 patients.
Hospital volumes climbed throughout the month as the highly contagious variant spread rapidly.
The seven-day moving average of new COVID-19 cases jumped from 86,975 on Dec. 1 to 394,407 on Dec. 31, hitting its highest level for the pandemic, according to CDC data. By month’s end, the seven-day moving average of new daily admissions for infected patients rose to 13,083.
Throughout 2021, adjusted patient days were up nearly 12%, and average length of stay increased 3.5%, compared to 2020. Operating room minutes rose 8% and emergency visits were up 11% from the previous year, Kaufman Hall reported.
December's surge in COVID-19 patients came as hospitals nationwide continued to face severe labor shortages and supply chain challenges. Total expense per adjusted discharge decreased 1.8% from November to December but was up 3.5% for the year compared to 2020, with labor expenses contributing largely even with reduced staffing levels.
Labor costs rose amid tight competition for qualified healthcare workers.
"As we enter the third year of the pandemic, hospital and health system leaders face worsening labor shortages that are driving up costs across healthcare,” said Erik Swanson, senior vice president of data and analytics with Kaufman Hall. "Organizations are having to pay high salaries to attract the workforce they need, while also paying more for drugs and other supplies."
Total expense per adjusted discharge was up 20% for the year versus the pre-pandemic levels from 2019, and labor expense per adjusted discharge was up 19% over the same period. Non-labor expense per adjusted discharge increased 20% for 2021, compared to before the pandemic.
Hospital revenues remained elevated for a 10th consecutive month, the report said. Compared to 2020, gross operating revenue excluding coronavirus federal relief funding was up 4.4% from November and up almost 15% for all of 2021.
Still, many organizations ended 2021 in a stronger position compared to lows seen in 2020. Kaufman Hall said hospital leaders have learned to better navigate the pandemic’s volatility. Hospital margins remained thin, but above 2020 levels. Overall hospital performance, however, was stuck below pre-pandemic levels on most metrics, the report said.