covid hospitalization & ed visit trends

COVID Hospitalization & ED Visit Trends

April 2021

VHHA | Data Analytics

Data Sources● Data Source:

○ VHHA Inpatient Database: 91 Hospitals; 100% submission rate.○ VHHA ED Database (Voluntary): 81 Hospitals; 90% submission rate.

● Timeframes: ○ Inpatient volumes: 2017-2020○ ED volumes: 2019-2020○ COVID Trends: 2020

● A COVID flag was added to the patient record starting in the Q2 2020 dataset● COVID hospitalizations sample size by quarter:

○ Q2 2020: 8,731 COVID Hospitalizations; 77 hospitals○ Q3 2020: 7,938 COVID Hospitalizations; 82 hospitals○ Q4 2020: 13,793 COVID Hospitalizations; 83 hospitals

Virginia Hospital & Healthcare Association | Data Analytics

Approach• Field questions from various VHHA member committees and;

• Examine VHHA discharge data to examine trends in the following areas:• Impact of COVID on hospital & ED volumes• Impact of COVID on Major Diagnostic Categories (Inpatient) • Race distribution for COVID Hospitalizations & ED visits• Payer distribution for COVID Hospitalizations & ED visits• COVID hospitalization discharge disposition distribution• COVID length of stay• Patient comorbidities and chronic conditions


Impact of COVID on Hospital Volumes

Despite a Rebound in Q3, Inpatient Discharge Volumes are Down 10% in 2020 Relative To Previous Years


The Impact of COVID Across Inpatient Payer Categories Was Not Uniform


Inpatient COVID Volumes by Major Diagnostic Category (MDCThe Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses into 25 mutually exclusive diagnosis areas. The diagnoses in each MDC correspond to a single organ system or etiology and in general are associated with a particular medical specialty.

• MDC 1 to MDC 23 are grouped according to principal diagnoses.• Patients are assigned to MDC 24 (Multiple Significant Trauma) with at least two

significant trauma diagnosis codes (either as principal or secondaries) from different body site categories.

• Patients assigned to MDC 25 (HIV Infections) must have a principal diagnosis of an HIV Infection or a principal diagnosis of a significant HIV related condition and a secondary diagnosis of an HIV Infection.

Click here to see a table of MDCs by DRG

https://en.wikipedia.org/wiki/Major_Diagnostic_Category

The Impact of COVID Across Inpatient Services Was Not Uniform


ED Volumes Did Not Recover in Q4ED Volumes are Down 30% since April 2020 Relative To Previous Quarters


The Impact of COVID Across ED Payer Categories Was Not Uniform


COVID ED Visits by Payer CategoryApril-December 2020

Payer Category Description % of Total ED Visits


COVID ED Visits by DateApril-December 2020

ED Visit Date [2020]


COVID ED Visits by Patient OriginApril-December 2020

50,6671,800+

Non -ResidentsRanging across 43 states and DC Total COVID ED Visits


COVID ED Visits by Patient OriginApril-December 2020

50,667COVID ED Visits


COVID ED Visits by RaceApril-December 2020

Race Description % of Total ED Visits


COVID Hospitalization Trends

(April-December 2020)

COVID Hospitalizations by Patient OriginApril-December 2020

30,4621,300+

Non -ResidentsRanging across 40 states and DC Total Hospitalizations


COVID Hospitalizations by Patient OriginApril-July 2020

8,731Q2 COVID Hospitalizations


COVID Hospitalizations by Patient OriginJuly-September 2020



COVID Hospitalizations by Patient OriginSeptember-December 2020



Spread of COVID Hospitalizations by Patient OriginMonthly Animation


7-day Average of Discharged COVID HospitalizatioApril-December 2020

Discharge Date [2020]


Virginia Healthcare Alerting Status System (VHASS) Confirmed Discharge Comparison

*30,710 total cumulative COVID discharges reported on September 30, 2020

VHHA Discharge Data vs. VHASS Daily Data

30,462Total Hospitalizations


COVID Hospitalizations by Payer CategoryApril-December 2020

Payer Category Description Discharges


COVID Hospitalizations by RaceApril-December 2020

Race Description Discharges


COVID Hospitalizations by Age and SexApril-December 2020

Age (in years)


Total Hospitalizations with Chronic Condition(s) (CCW) April-December 2020

Chronic Conditions Warehouse (ccw) flag methodology: https://www2.ccwdata.org/web/guest/home/*Only top ccw conditions shown, displayed categories do not add up to 100%

Chronic Condition *


COVID Hospitalizations by Length of StayApril-December 2020

Length of Stay (in days)Virginia Hospital & Healthcare Association | Data Analytics

COVID Hospitalizations Length of Stay has Fluctuated Over the Past YearApril-December 2020

Length of Stay (in days)

COVID Discharges


Discharge Disposition and In-Hospital Mortality

(April-December 2020)

COVID Hospitalizations by Discharge DispositionQ2 2020

*13/29 discharge disposition categories shown, displayed categories do not add up to 100%

Discharge Disposition Category *




Discharge Disposition Category*


COVID Hospitalizations by Discharge DispositionQ2 2020 – Q4 2020


3,671COVID Hospitalizations

Expired In Hospital


Patients Who Died In-Hospital Due to COVID were Significantly OldApril-December 2020


Patients Who Died In-Hospital Due to COVID Were Significantly SickApril-December 2020


Although the Virginia Hospital & Healthcare Association (VHHA) attempts to provide the most timely andaccurate data, VHHA makes no representation as to the accuracy or completeness of any datacontained in this report. The information contained in this report is intended for informational purposes,but not as the sole basis upon which any specific action is to be recommended or undertaken.Furthermore, VHHA makes no warranty, including any warranty of accuracy, fitness for a particular useor other guarantee, express or implied, with regard to the data contained herein and assumes noliability for users’ reliance upon or use of these data in any manner whatsoever.

For Questions Contact Julian [email protected]

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