Chapter 3:Utilization and Volume

Utilization and Volume

2Chartbook 2000

Community hospital acute care admissions declined 15 percent between 1980 and 1994 and then began slowly trending upward. After declining sharply in the 1980s and more modestly in the early 1990s, admissions per thousand have been flat. Average length of stay has dropped more than a day and a half (or 20 percent) between 1980 and 1998, but the pace of decline has slowed over the last three years. Length of stay by state varies from a high of 11.2 days in Montana to a low of 4.5 days in Oregon and New Mexico. Although inpatient days and days per thousand continue to decline, the rate of decrease has slowed as well (Charts 3.1 - 3.6).

Meanwhile outpatient visits have more than doubled since 1980, and outpatient utilization rates continue to increase at a rapid clip. Outpatient surgeries now represent nearly 60 percent of all surgeries (Charts 3.7 - 3.9).

Chapter 3:Utilization and Volume

Utilization and Volume

3Chartbook 2000

0

20

40

60

80

100

120

140

160

180

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

27

28

29

30

31

32

33

34

35

36

37

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Chart 3.1:Inpatient Admissions in Community

Hospitals1980 - 1998

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals

Chart 3.2:Inpatient Admissions per 1,000 Persons

1980 - 1998

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals and US Census Bureau data

Mill

ions

Utilization and Volume

4Chartbook 2000

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals

Chart 3.3:Average Length of Stay in Community

Hospitals1980 - 1998

0

1

2

3

4

5

6

7

8

9

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

7.5

6

7.6

4

7.6

4

7.5

6

7.3

0

7.0

7

7.0

9

7.1

8

7.2

1

7.2

5

7.2

5

7.1

7

7.1

2

7.0

2

6.7

4

6.4

6

6.2

3

6.1

0

6.0

2

Days

Chart 3.4:Average Length of Stay in Community

Hospitalsby State

1998

5.0 to 6.9 Days7.0 to 8.9 Days

4.0 to 4.9 Days

> 9 Days

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1998 for community hospitals

RI 5.63 DaysDE 6.04 DaysDC 6.97 Days

Utilization and Volume

5Chartbook 2000

Chart 3.5:Total Inpatient Days in Community

Hospitals1980 - 1998

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals

0

50

100

150

200

250

300

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Mill

ions

Chart 3.6:Inpatient Days per 1,000 Persons

1980 - 1998

0

200

400

600

800

1,000

1,200

1,400

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals and US Census Bureau data

Utilization and Volume

6Chartbook 2000

Chart 3.7:Total Hospital Outpatient Visits

in Community Hospitals1980 - 1998

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals

0

50

100

150

200

250

300

350

400

450

500

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Mill

ions

Chart 3.8:Hospital Outpatient Visits per 1,000

Persons1980 - 1998

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals and US Census Bureau data

Per

Thou

san

d

Utilization and Volume

7Chartbook 2000

0%

20%

40%

60%

80%

100%

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 - 1998 for community hospitals

Chart 3.9:Percentage Share of Inpatient vs. Outpatient Surgeries

1980 - 1998

OutpatientSurgeries

InpatientSurgeries