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Health Care Statistics:National Hospital Discharges-Part I of a IV Part Series

(8/8/07)- In order to make viable decisions about costs, it would seem obvious that there is always a need for basic data to establish the a basis for making the decision. This would be especially true in the area of health care. Figures abound about the cost of this coverage. This site is intent to find accurate figures on all aspects of health care. We believe this could help our readers make competent decision about the nature of a national health care program.

In the early 1980s, there was a shift in Medicare reimbursements for hospitals from a cost-based to a prospective payment system. Those years also saw a greater development and coverage of post-acute care alternatives to hospitalization, a growth in utilization review programs, an increased enrollment in managed care plans, and other cost containment programs. Concomitant with this were advances in technology and drug therapy, which resulted in less invasive surgical interventions, and earlier diagnosis and treatment of acute conditions. We decided to explore the effect these interventions, cost containments, managed care plans etc., had on hospital discharge rates trend analysis. We were encouraged in our search for figures by finding the July 12, 2007 (No. 385) publication of the CDC National Center for Health Statistics called "Advance Data from Vital and Health Statistics". This publication reported on the 2005 National Hospital Discharge Survey.

The National Hospital Discharge Survey (NHDS) is the longest continuously running representative survey of hospital utilization. The particular publication noted above contains 11 pages of tables that are a goldmine of information for anybody willing to wade through the actual numbers. These figures are for discharges of inpatients from nonfederal hospitals. It excludes newborn infants. The diagnostic groupings and code numbers are based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The titles of the tables are:

  1. Number, rate, and average length of stay for discharge from short-stay hospitals by age, region, and sex: United states 2005.
  2. Number of discharge from short-stay hospitals by first-listed diagnosis: United States, 2005
  3. Rate of discharge from short-stay hospitals by age and first-listed diagnosis: United States, 2005
  4. Average length of stay for discharges from short-stay hospitals by age, and first-listed diagnosis: United States, 2005
  5. Number of discharges from short-stay hospitals by sex and first-listed diagnosis: United States, 2005
  6. Rate of discharge from short-stay hospitals by sex and first-listed diagnosis: United States, 2005
  7. Average length of stay for discharges from short-stay hospitals by sex and first-listed diagnosis: United States, 2005
  8. Number of all-listed procedures for discharges from short-stay hospitals by procedure category and age: United States, 2005
  9. Rate of all-listed procedures for discharges from short-stay hospitals by procedure category and age: United States, 2005
  10. Number of all-listed procedures for discharge from short-stay hospitals by procedure category and sex: United States, 2005
  11. Rate of all-listed procedures for discharge from short-stay hospitals by procedure category and sex: United States, 2005.

The figures indicate that the utilization of nonfederal short-stay hospitals has declined significantly. "In 2005, the average length of stay for all inpatients was 4.8 days, compared with 7,8 days in 1970." The decline held up for all age groups except for those under 15 years of age. About 34.7 million inpatients were discharged in 2005 from nonfederal short-stay hospitals. Of these patients, 38 percent were over 65 years. Males tended to have a longer stay than females (5.2 days compared to 4.5 days). The longest average length of stay was in the Northeast (5.4 days). Interestingly, 45 percent of those who spent less than 3 days were those aged 65 years and over.

Heart disease accounted for the most procedures (4.2 million), compared to malignant tumors, which accounted for 1.2 million procedures. There was a significant increase in the rate of hospitalization for septicemia in those aged 65 years and older from 61.7 per 10,000 population in 200 to 90.8 per 10,000 in 2005. The elderly (over 65 years) accounted for about one-half of the hospital discharges for fractures, with average length of stay 5.7 days.

During 2005, 45 million procedures were performed on hospital inpatients. Males had more cardiovascular procedures than females, while females had more operations on the digestive system.

Please see: Health Care Statistics: Part II-Ambulatory Medical Care
Health Care Statistics: Part III- Assessing Health Care in the U.S.
Hospital Death Statistics: Part IV- Deaths

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "How to Select a Nursing Home"

Harold Rubin, MS, ABD, CRC, Guest Lecturer
posted August 8, 2007

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e-mail: hrubin12@nyc.rr.com or allanrubin4@gmail.com

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