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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