Dive Brief:

• As COVID-19 cases surged last fall, non-COVID-19 hospital admissions fell substantially, particularly in the Midwest and West, according to a new analysis by the Kaiser Family Foundation of 2020 inpatient admission data from electronic medical records through Dec. 5.
• The analysis also highlights admission trends by age and sex, and found that patients 65 and over — those most at risk of complications from the novel coronavirus  —  delayed care at greater rates than those under 65 again in the fall. Still, the discrepancy between visits based on age was more pronounced in the spring.
• On average, males and females had almost identical admission patterns throughout the entire year. Though looking at the raw numbers, women's total admissions trended above their male counterparts, which researchers attributed to childbirth.

Dive Insight:

Although the KFF analysis does not break down admissions by procedure, it does give a broad picture of how the COVID-19 pandemic influenced admission trends throughout 2020.

As hospitals were hit by the pandemic throughout 2020, both in lower admission and procedure volumes, the effects rippled out to the medtech industry. Companies like Medtronic, Stryker and Boston Scientific saw businesses take steep declines in the spring as patients stayed out of hospitals. Procedure volumes then rebounded in the second and third quarters.

In recent earnings calls, however, medtech CEOs reported that procedure volumes once again dropped throughout November and December as COVID-19 cases surged across the globe and hospitals were stressed. Zimmer CEO Bryan Hanson, among other executives, said that declining volumes are expected to spill into the first half of 2021.

The latest analysis from the think tank provides a fuller picture of how the COVID-19 pandemic influenced admission trends throughout 2020.

Overall, total admissions bottomed out in April and March but have remained near normal, or above 90% of expected admissions since June, according to electronic medical record data from the Epic Health Research Network, which pools information from 20 million patients across 97 hospitals in the U.S.

However, while total admissions — which includes those sick with COVID-19 — remained near normal, the pattern differed when zeroing in on non-COVID-19 admissions, or those admitted who did not have the virus.

Non-COVID-19 admissions started to fall again in November and by Dec. 5 they fell to 80% of expected volume, which is likely to put financial pressure on hospitals, particularly those with smaller reserves of cash on hand, Kaiser noted.

The decline was steepest in the Midwest and West, dropping to about 76% of expected volume between early November and December.

Researchers fear the drop in non-COVD-19 admissions may have long-term consequences.

"The levels of non-COVID-19 admissions seen in the fall of 2020 suggest that people may be delaying care in ways that could be harmful to their long-term health," according to the study.

Insurers observed similar patterns of depressed volume in the fourth quarter.

Humana, which largely covers seniors in Medicare plans, noted non-COVID-19 volume dropped the last two months of the quarter after previously returning to near normal. It led Humana to report a loss in the fourth quarter as COVID-19 testing and treatment accelerated. Centene, which reported a Q4 loss, echoed a similar pattern.