Hospitals are grappling with higher emergency department and inpatient volumes, which are poised to strain capacity.
Hospitals have continued to treat more patients over the past year, boosting their finances but also limiting access to care in certain markets. That trend is expected to continue through the next decade as the population ages.
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Here are three hospital capacity issues to watch for, based on data from the latest Kaufman Hall National Hospital Flash Report and the 2024 Impact of Change report from Sg2, a data analytics firmed owned by group purchasing organization Vizient.
Year-to-date emergency department visits per day grew 4% from April 2023 to April 2024, while adjusted discharges rose 6% over that span, according to Kaufman Hall data.
Those increases have helped boost operating margins 21% over that same period, Kaufman Hall data show.
“Growth on the inpatient side we view as credit-positive,” said Mark Pascaris, senior director at credit rating agency Fitch Ratings. Hospital profit margins have slowly increased from the depths of 2022, he added.
ED visits were back up to pre-2020 levels as of April, putting pressure on hospitals and health systems, Kaufman Hall analysts wrote in the report.
Emergency department visits are expected to grow 4% from 2024 to 2034, while inpatient volume is projected to grow 3% over the next decade, according to Sg2 data.
Still, inpatient capacity constraints will diminish as more care moves to outpatient settings and as average length of stay continues to decline.
“Reducing length of stay is like free capital spending,” Pascaris said. “The more you can reduce your length of stay, the more more bed capacity you have and it lessens the need to expand.”
Home health volumes are projected to grow 22% over the next decade, while hospital outpatient and ambulatory surgery center utilization is expected to increase 14% and office visits are expected to increase 8% over that span, according to Sg2 data.
Over the next decade, hospital-based high acuity and quaternary care, which is the most specialized care, is expected to increase 13% and 18%, respectively, the Sg2 report estimates.
Growth in complex care is expected to pinch academic medical centers and hospitals that are referral centers for specialized procedures.
“The theme of academic medical centers and very high acuity level providers partnering with community hospitals will accelerate as the academics are near or at capacity,” Pascaris said.
Hospital-based medium and low acuity care are expected to grow 9% and 4%, respectively, over the next decade, according to Sg2 data.
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