Revenues grew over $1.1 billion, or 8.7% as compared to the prior year.
Inpatient revenues increased by 12%.
The acuity within our inpatient business was higher as reflected in both the case mix index, which increased 7% and length of stay which grew by 6%.
Additionally, commercial admits inside of our domestic operations represented 29% of total admits, compared to 26.5% last year.
These two factors combined explain the 17% increase in inpatient revenue per admissions.
The total -- the total admits were down 4.2% year over year.
In comparison to 2019, admits were down approximately 3%, which was -- which was in line with our expectations.
In the quarter, we treated almost 50,000 COVID-19 inpatients, which represented 10% of total admissions.
January with 17%, February was 8%, and March was down to almost 5%.
Outpatient revenues increased 4.7% as compared to the prior year.
This result is better performance than the previous two quarters in which outpatient revenue was down approximately 5%.
But March, which had one additional weekday this year, increased by 30% as outpatient surgery and other procedures recovered strongly.
Same facility outpatient surgery volumes grew 2.3% as compared to last year.
As compared to 2019, they declined 3%.
E.R. visits declined 18%.
visits were down 19% compared to 2019.
Diluted earnings per share, excluding losses and gains on sales as well as losses on debt retirement, increase 78% to $4.14.
As a result of the strong operating performance in the quarter, our cash flow from operations was $1.99 billion, as compared to $1.375 billion in the first quarter of 2020.
Capital spending for the quarter was $654 million and we completed just over $1.5 billion of share repurchases during the quarter.
We have approximately $7.3 billion remaining on our authorization and consistent with our year-end discussion.
Our debt to adjusted EBITDA leverage was 2.85 times and we had approximately $5.6 billion of available liquidity at the end of the quarter.
We expect revenue to range between $54 billion and $55.5 billion.
We expect full-year EBITDA to range between $10.85 billion and $11.35 billion.
We expect full-year diluted earnings per share to range between $13.30 and $14.30.
And our capital spending target remains at approximately $3.7 billion.

Summary:
The total -- the total admits were down 4.2% year over year.
Diluted earnings per share, excluding losses and gains on sales as well as losses on debt retirement, increase 78% to $4.14.
We expect revenue to range between $54 billion and $55.5 billion.
We expect full-year diluted earnings per share to range between $13.30 and $14.30.