Utilization Report-September 2019

Overview & Observations

The total annual number of inpatient psychiatric admissions in acute care hospitals has been decreasing (Fig 1). Further analysis demonstrates that most of that decline is likely due to the closure of a psychiatric unit at Providence Hospital in October 2017. As Providence discontinued the psychiatric inpatient service, the number of admissions for the Psychiatric Institute of Washington and acute care hospitals, other than Providence, as a group increased (Fig 2). MedStar Washington Hospital Center, United Medical Center, and Howard University Hospital all had increased volume, while other hospitals were relatively unchanged, with none showing marked decreases. The admission rate for St. Elizabeths Hospital was also relatively constant with occupancy rates consistently near or over 90%.

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October 2019 Utilization Report

Overview & Observations
DCHA routinely reports occupancy rates for several specialized patient care unit types (pages 15–23 of the report). Occupancy rates are expressed as the monthly average census as a percentage of designated beds. These rates only show occupancy volume as “within hospital.” In the graphs below, we illustrate the “within-hospital” and the “between hospital” occupancy volume. For example, MedStar Georgetown University Hospital has the highest Med-Surg Occupancy rate, yet averages 270 (54%) fewer Med-Surg patients than MedStar Washington Hospital Center (Fig 1). Similarly, Howard University Hospital has a slightly lower ICU occupancy rate than does The George Washington University Hospital (GWUH); yet averages 24 (53%) fewer ICU patients than GWUH (Fig 2). Differences in volume by unit are important to understand as you look at the overall occupancy of a hospital to explore questions such as, why some patients may experience longer wait times before being moved to an inpatient unit.

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Utilization Report-December 2019

Overview & Observations

DCHA will be making improvements to the monthly utilization report starting in January 2020. One improvement will be to analyze total admissions, discharges and patient days separately for acute care facilities (ACFs) and skilled nursing facilities (SNFs).

Currently, the only DC ACFs that have SNFs are Sibley Memorial Hospital, United Medical Center, and both Bridgeport Capitol Hill and National Harbor Hospitals. By earlier agreement, volume metrics have combined acute care data with SNF data. The combination makes it difficult to compare acute care metrics between facilities. For example, total patient days for facilities with SNFs is 50% greater than the total for acute care alone. The graph shows total patient days by facility for CY2019 as currently reported by hospitals, with a distinction for acute care and SNF data evident.

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