Survey: US hospital patient volumes move back towards 2019 levels

In mid-2021, McKinsey surveyed leaders at 100 private-sector hospitals across the United States to understand how COVID-19 continued to impact hospital volume.

We repeated the survey in October 2021, and found that, overall, hospital volumes are near 2019 levels, but continue to be impacted by waves of COVID-19. Of note: emergency department visits are above 2019 levels across all regions, and procedural volumes across all regions are close to their 2019 baseline.

The flat operating-room volumes appear to be partially driven by relatively lower outpatient clinic volumes. Eight of the 10 specialties with the lowest relative clinic volumes are surgical specialties, with plastic surgery and ENT clinic volumes still between 8 percent and 12 percent below 2019 levels.

Lower specialty clinic volumes appear to be due to capacity constraints, as a majority of respondents report access to care being worse now than pre-COVID-19. While most practices are trying to address access issues, the primary barrier is clinical staffing challenges. Ninety percent of respondents said staffing challenges are impacting elective procedure capacity, with plastic surgery, orthopedic surgery, and dermatology having some of the longest wait times for care.

Nursing in 2021: Retaining the healthcare workforce when we need it most

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Update: August 12, 2021

McKinsey surveyed leaders at 100 private sector hospitals across the United States in late July to examine how COVID-19 continued to impact hospital volume. Emergency department and inpatient volumes have returned to 2019 levels, with respondents noting they expect it to be roughly 5 to 6 percent higher in 2022. Outpatient and procedural volumes were 3 to 4 percent above 2019 levels in July, and are expected to be 6 to 8 percent higher in 2022.

More than a third of provider respondents said they expected patient demand to exceed capacity in psychiatry and orthopedic surgery in the next six months. Roughly a fourth said they expect the same challenge in cardiology and gastroenterology. Plastic surgery and ophthalmology continue to have large decreases in outpatient volume when compared to 2019. To address these challenges, more than 50 percent of hospital respondents said they would expand their clinic hours to increase outpatient access. Other provider responses include hiring more physicians, increasing physician productivity expectations, hiring more clinical support staff, increasing marketing to patients, and proactively calling patients who have delayed care. Some COVID-19-related challenges, however, remain, including a shortage of nurses and clinical support staff, and some patients continuing to delay care.

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