HCA Holdings, the biggest for-profit hospital chain in the U.S., reported lower earnings than expected Monday.
And one of the reasons might surprise you: some people appear to be forgoing surgery, in part, because of hard economic times.
When the company looked at surgical admissions hospital by hospital, it found they declined 1.6 percent in the U.S. in the second quarter compared to the same period last year. Inpatient surgeries took a bigger hit than outpatient cases, but both were down.
By contrast, admissions to HCA hospitals for all reasons increased about 1.9 percent in the quarter, when measured on a same-hospital basis. And visits to emergency rooms were up even more, rising 4.5 percent in the quarter.
Medicare payments to the company were down 1.3 percent per case, a decline that was due to fewer surgeries.
"Executives listed a handful of causes for the surgical weakness including economic softness," the Wall Street Journal reported. While a decline in market share was another possible explanation, the Journal said the HCA doesn't think that's the reason.
"What I'm particularly worried about is that this could be another systemic issue related to the economy that could spell trouble..." Arthur Henderson, an analyst at Jefferies & Co., told Bloomberg News. He said it wasn't entirely clearly if the economy was to blame or patients went to other hospitals. Earnings reports from other hospitals in the next few weeks could provide the answer.