UVa Hospital sees fewer procedures

The University of Virginia Medical Center is admitting fewer patients than expected, largely because patients are increasingly choosing to delay expensive medical procedures during the economic downturn.

As of January, UVa’s hospital saw its total patient admissions drop by 4.5 percent to date in fiscal 2009 when compared with the same period a year earlier.

“The majority of our drop in admissions has to do with the economy,” said Larry Fitzgerald, the UVa Health System’s chief financial and business development officer. “The economy seems to be making potential patients pause before they are admitted.”

The drop-off carries financial implications for the hospital, as new patient admissions bring in a significant portion of its revenue. As a result of the reduced number of patients, the hospital is facing an $18 million revenue shortfall in the current year’s budget.

Yet that figure, Fitzgerald said, is only 3 percent below projections in the hospital’s current operating budget. And revenue is still 5 percent higher than the previous fiscal year.

“Our revenue is $18 million behind our budget, but it’s not that our revenue is down in the truest sense of the word,” Fitzgerald said.

UVa is apparently performing better than many other similarly sized hospitals, Fitzgerald said. A survey of 300 teaching hospitals during the fourth quarter of 2008 found that other institutions were experiencing much bigger declines in patient admissions.

“No one is doing particularly well,” he said.

UVa’s revenue shortfall has not yet forced the medical center to make budget cuts. Instead, Fitzgerald said, administrators are scrutinizing spending and finding efficiencies.

For example, the hospital slashed spending on pharmaceuticals and medical supplies by more than $10.9 million after it negotiated better prices with suppliers.

Adding to UVa’s financial problems is that many patients are staying a bit longer, meaning that beds are sometimes hard to come by. As of January, patients were staying an average of 6.16 days, whereas the hospital had budgeted for 5.8 days.

The hospital generally collects the most revenue on the first day of a patient’s stay. A typical patient undergoes a procedure on the first day, while the following days are for recovery and observation.

UVa is adding a 72-bed tower on the front of the hospital and building a 50-bed long-term acute care facility on Ivy Road. The two projects will help alleviate space concerns at the medical center, said Ed Howell, UVa vice president and medical center CEO.

“We’re taking steps to improve patient volume,” Howell said.

Another reason patient admissions are down, Fitzgerald said, is because the flu season was not as bad as in recent years.

Cardiology admissions were down by 24.2 percent at UVa as of January, when compared with the previous fiscal year to date. Fitzgerald said that community hospitals — such as Martha Jefferson — are increasingly taking on routine cardiology cases across the country.

Pediatric admissions, meanwhile, had fallen by 9.9 percent as of January. Fitzgerald said he expects pediatric admissions will rise by the end of the year.

Psychiatric admissions, however, had increased 9.4 percent above expectations as of January. The reason, Fitzgerald said, is that the region has seen its number of psychiatric beds decline, so more patients are being sent to UVa.

Martha Jefferson Hospital is reporting that it has seen no decline in either patient admissions or revenue.

“We’re right on track with where we were last year,” said Abigail Rich, Martha Jefferson’s communications coordinator. “We’re trucking right along as usual.”