Healthcare Facilities

Project Title:

Protecting Public Health and Preserving the Financial Viability of North Carolina’s Critical Health Care Facilities during Infectious Disease Outbreaks

Summary:

Decisions by hospitals to curtail non-emergency procedures in order to retain open bed capacity in advance of an anticipated surge in COVID patients resulted in significant revenue losses. Alternative approaches, involving more carefully calibrated curtailments, can be used to more cost-effectively manage future events while still protecting public health.

The top chart shows daily admission changes compared to the 2018-2019 baseline. It includes COVID-19 and non-COVID-19 admissions under different transmission scenarios (low, high, no action, and observed) using lines and shaded regions.

The middle chart illustrates ICU capacity, showing available ICU beds and COVID-19 ICU patients across transmission scenarios. A shaded area indicates where patients were turned away from the ICU.

The bottom chart presents daily revenue loss as a percentage change from 2019, detailing losses under low, high, and no-action scenarios, along with the cumulative annual revenue change (right y-axis).

The visual captures the effects of COVID-19 on hospital resources, admissions, and financial impacts over time, highlighting peaks in transmission and revenue changes — Actual (2020) and simulated admissions (2021), ICU capacity, and revenue losses for the Research Triangle hospital system in response to different COVID-19 community transmission scenarios. Results assuming hospital action to cancel elective and non-emergency procedures in early February 2021 is compared to a scenario of no action.

Description:

This research was designed to quantify the revenue losses resulting occurred when hospitals canceled non-essential procedures in anticipation of a surge of COVID-19 patients and subsequently faced reduced demand for hospital inpatient procedures during the pandemic. In this natural experiment, data on changing admissions patterns related to the COVID-19 pandemic caused total gross revenues across nine hospitals in the Research Triangle region of North Carolina to fall by $660 million (5.2% of the annual total) over the period March 2020 – February 2021. Results suggest that, in the future, carefully calibrated actions by hospitals might reduce these losses while still protecting public health.

Collaborators:

Dr. Nicholas DeFelice, Icahn School of Medicine at Mount Sinai, New York
Dr. Bethany Percha, Mount Sinai Health System, New York

Related Publications:

[superscripts denoting graduate students (^M = masters; ^D = doctoral) and Post-doctoral Researchers (^P) or Researchers (^R)) working in CoFiRES]

Zeff, H. B.^R, DeFelice, N., Su, Y.^D, Percha, B and G. W. Characklis, “Protecting Public Health and Preserving the Financial Viability of North Carolina’s Critical Health Care Facilities during Infectious Disease Outbreaks” (in prep)

Funding Support:

North Carolina Collaboratory
UNC Institute for the Environment