Photo: ER Productions Limited/Getty Images
Three hospital systems in the Cleveland area — Cleveland Clinic, University Hospitals and MetroHealth — will postpone some surgeries due to a spike in COVID-19 cases in the area, turning the clock back to the peak of the pandemic as many facilities freeze electives procedures.
According to a joint announcement, the organizations said they are experiencing an “unprecedented demand” for inpatient care, with many facilities operating at near-full capacity.
Unvaccinated patients make up the bulk of new hospital admissions. Statistics released by the three systems show that more than 90% of COVID-19 patients in intensive care are unvaccinated. Most vaccinated patients who are hospitalized have underlying health conditions that put them at greater risk.
While Cleveland Clinic and the Metrohealth system have seen a significant increase in hospitalized COVID-19 patients, university hospitals have been hit particularly hard, reportedly a “record high count” of such patients.
The increase has prompted organizations to adjust the scheduling of non-emergency surgeries in certain locations, with a view to freeing up resources for patients “with immediate and life-threatening needs.”
The move will also meet the demands of primary care providers, the systems said.
WHAT IS THE IMPACT?
Delaying non-emergency and elective surgeries was a common tactic used by hospitals during the height of the first wave of the pandemic in 2020. Then, as now, spikes in COVID-19 patients strained and forced hospital staff. many to re-prioritize their resources.
Cleveland Clinic is temporarily suspending scheduling of additional non-emergency surgeries in all Ohio locations, except for Euclid and Lutheran hospitals, from today and will continue through January 3, 2022. Essential and urgent surgeries, as well as heart, cancer, pediatric and transplant surgeries, and outpatient surgeries that do not require a hospital bed, remain planned.
University hospitals are currently rescheduling certain non-emergency surgeries at UH Cleveland Medical Center that require short-term hospitalization. For the time being, the hospital will continue to perform urgent and outpatient surgeries and procedures without overnight stays.
University Hospitals will continue to perform all types of surgeries and procedures in the community hospitals, although the situation is fluid and subject to change, the system said. University hospital doctors see patients as they always have, and UH labs and testing centers are open.
MetroHealth, meanwhile, is postponing some elective surgeries to free up space and is also exercising other options, such as encouraging greater use of the Hospital in the Home program, to meet the latest increase in patients.
THE BIGGER TREND
If the move to delay some procedures is a harbinger of what will happen nationally, hospital finances could be significantly impacted. In July 2020, Rick Pollack, president and CEO of the American Hospital Association, based on data from Kaufman Hall, said the cancellation of elective surgeries was one of the factors contributing to an industry-wide loss of $120 billion from July alone. to December 2020. When data from earlier in the pandemic is factored in, losses are expected to be in the vicinity of $323 billion.
Most hospitals have adjusted their costs to mitigate some of the financial blow. Even some of the larger systems, such as the 92-hospital nonprofit Trinity Health in Michigan, took measures such as firing and firing employees and reducing working hours for some of the staff.
An analysis by Kaufman Hall last week found that labor costs are stubbornly high. Total labor costs increased by 2.7% from September to October; 12.6% compared to October 2020; and 14.8% compared to October 2019. At the same time, the number of full-time equivalents per modified occupied bed decreased by 4.5% year-on-year compared to 2020 and 4.1% compared to 2019, indicating higher salaries as a result of increasing nationwide labor shortages labor costs, rather than an increase in the workforce.
That data, which is from October, is consistent with a recent report from Fitch Ratings that found that labor shortages and supply chain challenges pose a growing threat to profit margins for healthcare and pharmaceutical companies. Scarcity of workers is likely to put pressure on some issuers’ margins in the near term, but is unlikely to lead to credit cuts, the report said.
Multiple factors contribute to the workload, including burnout of staff due to the pandemic and a general shortage of qualified help, which has led to higher costs of hiring temporary staff, as well as wage inflation.