Chartbook 2005

Utilization and Volume

Chapter 3:Utilization and Volume

Chartbook 2005

Utilization and Volume

3-2

Chart 3.1:Inpatient Admissions in Community

Hospitals1980 - 2003

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 99 00 01 02 03

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals.

Mill

ions

Chartbook 2005

Utilization and Volume

3-3

100

120

140

160

180

200

220

240

260

280

300

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals.

Chart 3.2:Total Inpatient Days in Community

Hospitals1980 - 2003

Mill

ions

Chartbook 2005

Utilization and Volume

3-4

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 99 00 01 02 03

Chart 3.3:Inpatient Admissions per 1,000

Persons1980 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals and US Census Bureau: State and County QuickFacts, 2003 population estimate data derived from Population Estimates, 2000 Census of Population and Housing

Per

Thousa

nd

Chartbook 2005

Utilization and Volume

3-5

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 99 00 01 02 03

Chart 3.4:Inpatient Days per 1,000

Persons1980 - 2003

Per

Thousa

nd

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals and US Census Bureau: State and County QuickFacts, 2003 population estimate data derived from Population Estimates, 2000 Census of Population and Housing

Chartbook 2005

Utilization and Volume

3-6

7.6

7.6

7.6

7.6

7.3

7.1

7.1

7.2

7.2

7.2

7.2

7.2

7.1

7.0

6.7

6.5

6.2

6.1

6.0

5.9

5.8

5.7

5.7

5.7

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 99 00 01 02 03

Chart 3.5:Average Length of Stay in Community

Hospitals1980 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals

Days

Chartbook 2005

Utilization and Volume

3-7

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 2003, for community hospitals

5.0 to 6.9 Days

4.0 to 4.9 Days

7.0 to 8.9 Days

> 9 Days

RI 5.4 DaysDE 6.2 DaysDC 6.7 Days

Chart 3.6:Average Length of Stay in Community Hospitals

by State2003

Chartbook 2005

Utilization and Volume

80

85

90

95

100

105

110

115

90 91 92 93 94 95 96 97 98 99 00 01 02 03

3,500

3,700

3,900

4,100

4,300

4,500

4,700

4,900

5,100

5,300

3-8

Chart 3.7:Emergency Department Visits

and Emergency Departments(1) in Community Hospitals

1990 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1990 – 2003, for community hospitals

(1) Defined as hospitals reporting ED visits

Num

ber

of

ED

V

isit

s(M

illio

ns)

Em

erg

ency

Depart

ments

ED Visits Emergency Departments

Chartbook 2005

Utilization and Volume

3-9

250

270

290

310

330

350

370

390

90 91 92 93 94 95 96 97 98 99 00 01 02 03

Per

Thousa

nd

Chart 3.8:Hospital Emergency Department

Visits per 1,000 Persons

1990 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1990 – 2003, for community hospitals and US Census Bureau: State and County QuickFacts, 2003 population estimate data derived from Population Estimates, 2000 Census of Population and Housing

Chartbook 2005

Utilization and Volume

3-10

ED is “At” Capacity

ED is “Over” Capacity

Chart 3.9: Percent of Hospitals Reporting

Emergency Department Capacity Issues by Type of Hospital

2004

Source: American Hospital Association 2004 Survey of Hospital Leaders

24%

23%

34%

18%

29%

24%

21%

43%

12%

35%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

All Hospitals

Non-teachingHospitals

Teaching Hospitals

Rural Hospitals

Urban Hospitals

30%

64%

77%

44%

48%

Chartbook 2005

Utilization and Volume

3-11

Source: American Hospital Association 2004 Survey of Hospital Leaders

46%

43%

68%

20%

69%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

All Hospitals

Non-teaching

Teaching

Rural

Urban

Chart 3.10:Percent of Hospitals Reporting Time

on Ambulance Diversion in Last 12

MonthsJanuary 2004

Percentage of Hospitals

Chartbook 2005

Utilization and Volume

3-12

Source: American Hospital Association 2004 Survey of Hospital Leaders

5%

9%

19%

20%

39%

0% 10% 20% 30% 40% 50%

Lack of SpecialtyPhysician Coverage

Staff Shortages

ED Overcrowded

Lack of GeneralAcute Care Beds

Lack of Critical CareBeds

Percentage of Hospitals

Chart 3.11:Conditions Hospitals Reported as

Number One Factor Contributing to Ambulance Diversions

2003 – 2004

Chartbook 2005

Utilization and Volume

3-13

0

100

200

300

400

500

600

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03

Mill

ions

Chart 3.12:Total Hospital Outpatient Visits in Community

Hospitals1980 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals

Chartbook 2005

Utilization and Volume

3-14

0

500

1,000

1,500

2,000

2,500

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03

Per

Thousa

nd

Chart 3.13:Hospital Outpatient Visits per 1,000

Persons1980 - 2003

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1990-2003, for community hospitals and US Census Bureau: State and County QuickFacts, 2003 population estimate data derived from Population Estimates, 2000 Census of Population and Housing

Chartbook 2005

Utilization and Volume

3-15

Chart 3.14:Percentage Share of Inpatient vs. Outpatient Surgeries

1980 - 2003

0%

20%

40%

60%

80%

100%

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03

Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1980 – 2003, for community hospitals

OutpatientSurgeries

InpatientSurgeries