June 21, 2023 – Sg2, a Vizient company, released its 2023 Impact of Change Forecast, projecting hospital capacity challenges will continue into the next decade, driven by higher patient acuity and staffing shortages. In addition, pharmaceutical and technological advancements will continue to push care delivery, including bariatric surgery, to outpatient status and sites throughout the next decade. Access Sg2 2023 Impact of Change Forecast.
Case mix index, a measure reflecting the diversity, complexity, and severity of patient illnesses, is up 5% since 2019, the year before the pandemic. At the same time average length of stay for patients admitted to a hospital has risen 10%, driven by the increasingly complex nature of the patient population further exacerbating workforce challenges and the closure of 30,000 patient beds between 2019 and 2022. The Forecast projects continued rises in patient acuity, which will strain capacity across sites of care.
Provider organizations also face mounting pressure to redesign care delivery models as pharmaceutical and technological advancements impact procedure types and locations. For example, the report projects nearly 12,000 fewer bariatric surgeries by 2033, a 4% decline, driven by anti-obesity pharmaceuticals entering the market.
Other notable findings in the Forecast include:
- Emerging service lines for infusion therapy: In addition to bariatric surgery, pharmaceuticals will continue to enable medical management of select patient populations, which will increasingly shift case volumes to the outpatient setting over the next decade. This will drive growth in outpatient infusion therapy for several service lines, including rheumatology, with a 48% growth rate; gastroenterology, 37%; endocrine, 23%; and dermatology, 18%.
- Outpatient surgical volumes to continue growing: Overall, outpatient surgical volumes are expected to grow 18% by 2033 to 109.5 million cases, led by total joint replacement, lumbar/thoracic spinal fusion and knee replacement, as volumes for these and other procedures move to lower-cost sites of care including ambulatory surgery centers, procedural offices and patient homes.
- Care-at-home innovation drives increased utilization: Home care volume will increase 20%, driven by a culmination of advances in remote monitoring and digital health capabilities, more favorable payment and lower acuity care shifting to the home setting, enabling reduced patient length of stay and cost avoidance.
- Virtual visits to grow: Sg2 expects 28% of 1.67 billion new and established evaluation and management (E&M) visits to occur virtually by 2033, despite payment and investment headwinds.