Hospitals' spending on N95 masks is up 715% since March 2020, although they have more inventory than during last year's COVID-19 spikes, a new Premier analysis finds.
One year into the devastating global pandemic, the supply chain for personal protective equipment has recovered somewhat from the catastrophic weeks of March 2020, but remains strained, with hospitals continuing to pay more than they did pre-pandemic. Those higher prices contributed to hospitals' to lower operating margins in 2020.
Premier, a publicly traded group purchasing organization and consultancy with a network of more than 4,100 member hospitals and health systems, focused its March 2021 study on N95 masks, surgical masks, isolation gowns and exam gloves. Hospital staffers reported reusing all four of those items in a December 2020 survey, despite the fact that they're intended to be used once.
Charlotte, N.C.-based Premier declined to comment beyond the report but said its data cover roughly 2,500 hospitals.
N95 respirators were among the most difficult pieces of equipment for providers to obtain early in the crisis. Most health systems had 23 days of N95s on hand during COVID's first wave. Those with active COVID patients had just three days' worth on average.
Last month, that was up to 200 days, despite N95 usage nearly quadrupling between April and December 2020. Premier said that's because hospitals have improved their ability to stockpile.
Most hospitals now have 45 days of surgical masks on hand, compared with lows of 30 days in July and December 2020, Premier said.
By mid-April 2020, Premier's member hospitals reported that isolation gowns had surpassed N95s as their top PPE shortage concern. That's because manufacturers had prioritized expanding their capacity to make N95s, compressing their gown production. By May 2020, most hospitals reported having just 20 days of isolation gowns on hand. As of March 2021, that had bounced back to about 40 days.
On the glove front, Premier said it expects supply to be constrained into 2023. The company said global demand for nitrile exam gloves currently exceeds capacity by 40%. That's because of a lack of raw materials as well as port closures, delays and higher demand.
Premier's members said in January 2021 that access to exam gloves was their second greatest challenge in caring for COVID patients behind staffing. The 30 days of gloves hospitals had on hand as of March 2021 was up from a low of 15 days in September 2020.
Hospital spending on PPE remains elevated, but has come down from its 2020 highs. Premier said purchase order spending for N95s was up 14,302% in March 2020 year-over-year. That spending was up 715% in March 2021 year-over-year. Purchase order spending is affected by both price and volume.
Surgical mask spending had spiked 1,310% in March 2020 year-over-year, compared with 93% in March 2021. Spending on isolation gowns was up 428% in March 2020, compared with 96% in March 2021.
Hospitals' spending on exam gloves has gone the opposite direction, however. That category was up 51% in March 2020 year-over-year, compared with 225% in March 2021.
Early research is showing that shortages of crucial PPE in the U.S. cost lives. A University of California, Berkeley study found that at least 35% of California healthcare and other essential workers who contracted COVID were infected at work amid PPE shortages.
PPE-producing factories in Asia shut down as COVID cases began to multiply in the U.S., cutting off an important source of supplies. The federal government told Americans not to wear masks to preserve the limited supply for healthcare workers.
Massive upticks in global demand have driven up the price of raw materials, which in turn increases the prices providers have to pay. The American Hospital Association estimates the added costs of buying PPE for hospitals was $2.4 billion over just four months, from March through June 2020, or about $600 million per month.