Hospital Patient Visits Unlikely to Return
to Pre-COVID-19 Levels in 2021

Jonathan Wiik, principal of healthcare strategy at TransUnion Healthcare


TransUnion Healthcare explores what’s ahead for healthcare utilization

As the COVID-19 pandemic continues to weigh on the healthcare industry, hospital patient visit volumes are expected to stay at lower levels than pre-COVID-19 volumes* in 2021. The latest analysis from TransUnion Healthcare (NYSE: TRU) indicates hospital visits stagnated below pre-COVID-19 levels in the last 25 weeks of 2020 and will likely remain around the new volume baseline that has emerged as a result of COVID-19.  

TransUnion Healthcare’s updated analysis of 500+ hospitals across the United States found emergency department visits were down 30% compared to pre-COVID-19 volumes during the week of December 13, 2020. Inpatient volumes were down 8%, and outpatient volumes increased to 1% during this same time period. 

“The challenges of COVID-19 in 2020 were widespread and hard felt within the healthcare industry, and these impacts are expected to persist well into 2021, particularly from a financial and operational standpoint,” said David Wojczynski, President of TransUnion Healthcare. “As we consider how patients, providers and payers may be affected by key trends such as healthcare consumerism, insurance disruptions, financial hardship and a new administration in the year ahead, our healthcare utilization analysis can provide helpful insights for organizations as they develop and implement strategies to enable trust with patients and influence profitability.” 

The latest analysis also looked at year-over-year (YoY) changes in hospital visits by treatment setting. Interestingly, outpatient visits were up 5% YoY from the weeks of June 28-July 4 through December 13-19 but still slightly below the gains experienced pre-COVID-19. For inpatient volumes, levels were already on a downward slope YoY – before the pandemic – as the industry moved more procedures from inpatient settings to outpatient settings.   


2020 vs. 2019 YoY Changes in Hospital Volume Levels by Treatment Setting

Treatment Setting Pre-COVID-19

2020 (1/5-2/29) vs. 

2019 (1/6-3/2)

COVID-19 Rise

2020 (3/1-3/14) vs. 

2019 (3/3-3/16)

Peak COVID-19

2020 (3/15-6/6) vs. 

2019 (3/17-6/8)

Levelling Out

2020 (6/7-6/27) vs. 

2019 (6/9-6/29)

New Baseline

2020 (6/28-12/19) vs. 

2019 (6/29-12/21)

Emergency Department +2% -4% -39% -23% -22%
Inpatient -3% -7% -23% -9% -7%
Outpatient +6% +7% -40% -1% +5%


“As the country continues to struggle with mitigating the spread of COVID-19, we’ll likely see continued volatility in hospital patient visit volumes over the next 12 months,” said Jonathan Wiik, principal of healthcare strategy at TransUnion Healthcare. “The management of vaccination distribution at scale will have positive impacts on hospital patient visits in 2021, though long-term recovery won’t occur for some time. Healthcare organizations will need to remain agile and innovative in their patient engagement, care delivery and operational strategies amid the uncertainty ahead.”   

Variables such as the number of COVID-19 cases, the potential to defer elective procedures, vaccine roll-out, and federal, state, and local executive orders will impact hospital patient visit volumes in 2021. Each region and state may experience different levels of patient visit volumes. Given the complexity of these factors, and the slow start to the vaccine rollout, overall patient visit volumes will likely sustain at pre-COVID-19 levels throughout 2021. The following are patient visit volume forecasts specific to each treatment setting:

  • Emergency Department: Visit volumes within the emergency department will remain laggard, with the second quarter of 2021 likely remaining around the new baseline that formed as a result of ongoing COVID-19 impacts. However, visits may gain some ground as patients become more comfortable returning to hospitals due to widespread vaccination administration.  
  • Inpatient: Inpatient volumes are likely to remain at a deficit around the new baseline and below pre-COVID-19 volumes, with visits expected to be consistently at similar, lower volumes throughout the year. 
  • Outpatient: For outpatient visit volumes, levels will likely experience the most volatility, reflecting surges in COVID-19 cases and deferred elective procedures. Outpatient visits experienced some instability heading into 2021, but volumes will likely snap back in the first quarter and level off around pre-COVID-19 volumes by the fourth quarter. 

TransUnion Healthcare also identified key trends that patients, providers and payers should watch for in 2021 which can be found here. 

For more information on the ongoing impacts of COVID-19 on the healthcare industry, as well as additional resources from TransUnion Healthcare, visit


*TransUnion Healthcare defines pre-COVID-19 volumes as the average weekly visits measured during the first 8 full weeks of the year, from the weeks of January 5-11 through February 23-29.