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Economic Impact AnalysisSanta Clara County Hospitals
July 2012
Prepared for: Prepared by:
ALHlECONALH Urban & Regional Economics
in association with
Economic Impact AnalysisSanta Clara County Hospitals
July 2012
Economic Impact Analysis
Santa Clara County Hospitals
July 2012
Prepared for:
Prepared by:
ALH l ECON
ALH Urban & Regional Economics
In association with
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | i
TABLE OF CONTENTS I. EXECUTIVE SUMMARY ........................................................................................................... 1
Introduction................................................................................................................................................................. 1
Summary of Findings ............................................................................................................................................... 1
II. HOSPITAL OVERVIEW ............................................................................................................ 4
Hospital Distribution ................................................................................................................................................ 4
Key Operational Data .............................................................................................................................................. 5
Hospital Descriptions ............................................................................................................................................... 6
III. ECONOMIC CONTEXT ......................................................................................................... 15
Healthcare Sector Dominance ........................................................................................................................... 15
Employment Opportunities ................................................................................................................................ 15
IV. HOSPITAL ECONOMIC IMPACTS .......................................................................................... 20
Methodology and Data Resources .................................................................................................................. 20
Operational Impacts .............................................................................................................................................. 22
Tax Revenue Impacts ............................................................................................................................................ 25
Long-Term Construction Impacts .................................................................................................................... 25
V. HOSPITAL COMMUNITY BENEFITS ........................................................................................ 28
Definition of Community Benefits ................................................................................................................... 28
Value of Community Benefits ............................................................................................................................ 28
VI. LONG TERM CARE FACILITY IMPACTS ................................................................................... 30
Operating Impacts ................................................................................................................................................. 30
Revenue Impacts .................................................................................................................................................... 30
VII. CONCLUSION ................................................................................................................... 32
ASSUMPTIONS AND GENERAL LIMITING CONDITIONS ................................................................ 33
APPENDIX A: TECHNICAL APPENDIX
APPENDIX B: STUDY RESOURCES
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
ii | ALH Urban & Regional Economics
List of Figures
Figure 1: Hospitals and Hospital Campuses in Santa Clara County
Figure 2: Health Care and Social Assistance versus Total Private Industry
List of Tables
Table 1: Select Hospital Descriptive Data
Table 2: Sectoral Employment, Santa Clara County, 2000 and 2010
Table 3: Sectoral Employment, Health Care and Social Assistance and Total Private Industry,
Santa Clara County, 2000–2010
Table 4: Occupational Employment and Wage Estimates, Healthcare Practitioners and Technical
Occupations and Healthcare Support Occupations, San Jose-Sunnyvale-Santa Clara
Metropolitan Area and the State of California, May 2011
Table 5: Annual Operations Impacts of All Santa Clara County Hospitals
Table 6: Annual Impact of Local Purchasing
Table 7: Significant Impacts to Select Industry Sectors
Table 8: Annual Indirect Tax Revenue Impacts
Table 9: Five-Year Construction Expenditures Estimates
Table 10: Construction Impacts of Santa Clara County Hospitals, 2012–2016
Table 11: Annual Operations Impacts, Santa Clara County Long Term Care Facilities
Table 12: Annual Indirect Revenue Impacts
ALH Urban & Regional Economics | 1
I. EXECUTIVE SUMMARY
Introduction
This study is an economic impact analysis
focusing on the hospitals in Santa Clara
County. The study was commissioned by the
Hospital Council of Northern and Central
California, a nonprofit hospital and health
system trade association representing
hospitals in 50 of California’s 58 counties,
from Kern County to the Oregon border. The
purpose of the study is to demonstrate the
importance of hospitals to the Santa Clara
County community and their importance to
the economic well-being of the county. The
study tasks focused on identifying the direct,
indirect, and induced impacts of the hospitals,
as well as employment, taxes generated, and
value of community benefits provided by the
hospitals to the communities they serve. Due
to data availability, most hospital findings
reflect 2010 operations, expressed in 2011
dollars.
Summary of Findings
Santa Clara County’s hospitals generate
substantial economic impacts to the benefit
of the county’s economy, benefiting workers
through job creation and income earnings,
business output, and the local tax base. These
benefits are all in addition to the hospitals’
incomparable health benefits. Highlights of
these findings are as follows:
The healthcare and social assistance
sector is a very strong, dominant sector in
Santa Clara County, and is strengthening
over time. The healthcare and social
assistance sector has emerged to be the
third largest private industry sector in all
of Santa Clara County, totaling 10.1% of
the county’s employment base. The only
private industry sectors with more
employment are manufacturing at 19.9%
of the employment base and professional,
scientific, and technical services at 13.9%.
The retail sector is tied for third with
healthcare and social assistance.
The strength of Santa Clara County’s
healthcare and social assistance sector is
the result of almost year over year growth
over the 2000 to 2010 decade, with
employment growing 25.1% versus all
private industry employment declining by
almost 20%.
The jobs supported by the healthcare
industry provide opportunities for
employees at a variety of skill levels. On
average, healthcare workers throughout
Santa Clara County earn 45% more than
the average worker employed in the
county. Healthcare workers throughout
Santa Clara County also earn 11% to 22%
more than healthcare workers throughout
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
2 | ALH Urban & Regional Economics
California. Because of these higher wages,
hospitals in Santa Clara County have the
potential to recruit and retain more
experienced and skilled workers plus
create a greater local economic impact
than hospitals in many other California
locations.
Santa Clara County’s hospitals reflected in
this study employed 23,359 full-time
equivalent people. Their wages total over
$2.6 billion, reflecting average annual
earnings of $113,320 per person. Hospital
spending totaled $7.2 billion. These
wages and spending are the catalyst for
the hospital economic impacts, driving
economic growth and strength in Santa
Clara County.
The combined operations of Santa Clara
County’s hospitals create an annual
economic impact of $14.3 billion. The
hospitals directly and indirectly support
almost 64,000 jobs and $5.9 billion in
annual payroll. These total economic
impacts include jobs, payroll, and output
at the hospitals directly, as well as impacts
at other local businesses that are
supported by hospital and employee
spending impacts.
While the hospitals in Santa Clara County
provide critical healthcare services, they
also play an important role in supporting
other types of businesses and jobs
outside of healthcare. The sectors with the
greatest local impacts include banking,
restaurants, medical and diagnostic labs,
doctors and other health practitioners,
telecommunications firms, and
wholesalers.
Tax revenues are also a source of impacts
associated with the hospitals. This
includes property taxes paid by the for
profit hospitals as well as tax revenues
generated by employees living in Santa
Clara County and the indirect employees
of other local businesses. Estimated
annual property, sales, and personal
income tax revenues total at least $609.7
million, with $130.2 million specifically
benefitting city and county governments.
Over the next five years substantial
hospital construction projects are
planned, totaling $4.0 billion in spending.
These construction expenditures will
result in a total construction impact of
$6.2 billion on the Santa Clara County
economy, 39,530 temporary jobs in
construction and related supplier
industries, and $2.8 billion in payroll over
the next five years.
The combined hospital construction costs
are greater than the costs for any other
major construction project in Santa Clara
County, including such high visibility
projects as the new San Francisco 49ers
Stadium in Santa Clara and the BART
Warm Springs Extension in Fremont. Thus,
hospital construction impacts are greater
than any other construction impacts in all
of Santa Clara County.
As the largest source of construction in
Santa Clara County, the hospitals are
fueling growth of the county’s
construction sector. Because of the nature
of hospital construction it is dominated by
specialized building trades, resulting in
jobs supported by the hospitals that are
well paid with strong employee benefits.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 3
Santa Clara County’s hospitals provide an
extensive array of community benefits to
economically disadvantaged populations
and the broader community. In a given
year these benefits are valued at $600
million, with $375 million including free or
subsidized medical care through charity
care or under-compensated costs of
government-funded programs, such as
Medi-Cal. These benefits represent
substantial additional impacts generated
by the hospitals that go far beyond
economic impacts, affecting the quality of
life for Santa Clara County’s residents and
especially vulnerable populations.
These findings indicate that Santa Clara
County’s hospitals are a great source of
economic and quality-of-life enrichment for
all of Santa Clara County.
4 | ALH Urban & Regional Economics
II. HOSPITAL OVERVIEW
Hospital Distribution
There are 11 hospitals operating in Santa
Clara County. As shown in Figure 1, the
hospitals are distributed throughout the
county, with most clustered in the more
heavily populated areas in the northern part
of the county. The northernmost hospitals
include Lucile Packard Children’s Hospital and
Stanford Hospital and Clinics in Palo Alto
while the southernmost hospital is Saint
Louise Regional Hospital in Gilroy.
While there are 11 hospitals in the county, the
map in Figure 1 includes the location of 12
hospitals or hospital campuses. This is
because El Camino Hospital has two
campuses, one in Mountain View and one in
Los Gatos. Although there are two campuses,
El Camino Hospital operates under one
license.
The county’s hospitals serve a wide
population, with each hospital having a
distinct affiliation or ownership structure, as
follows:
Non-Profit—Kaiser Permanente, Lucile
Packard Children’s Hospital, and Stanford
Hospital and Clinics
Church—O’Connor and Saint Louise
Regional Hospital
Public—El Camino, Santa Clara Valley
Medical Center, and Veteran’s
Administration Palo Alto Health System
For Profit—Good Samaritan and
Regional Medical Center of San Jose
Because of these differences in ownership
structure, the hospitals represent a variety of
business models, with each providing a
specific mix of patient services and serving a
range of patient population groups. This
diversity of ownership and business models is
a strong asset to the economy, contributing
to the relative stability of the healthcare
sector. A community with only one hospital or
that is over reliant on its County hospital can
be more at risk because there is only one
predominant business model. As a result, if
that hospital falters or fails, it will drag down
the entire healthcare sector in that
community. Thus, the diversity of hospitals
available in Santa Clara County is a source of
strength and resilience for the county’s
economy.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 5
FIGURE 1
Hospitals and Hospital Campuses in Santa Clara County
Key Operational Data
Santa Clara County’s hospitals have the
demonstrated capacity to provide critical
healthcare services to the county’s
population. The 11 hospitals have a total of
4,653 licensed beds, as shown in Table 1.
During the approximate 2010 timeframe, they
collectively provided services for almost 1.0
million census patient days, with another 3.5
million outpatient visits. Net patient revenue
derived from these visits totals more than
$5.6 billion. Through these revenues the
hospitals fund large volumes of charity care
and other community benefits widely
provided by the hospitals (see Chapter V).
Following are descriptions of each hospital
and some of the unique medical services they
provide, showing the wide range of medical
specialties and services available throughout
Santa Clara County.
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
6 | ALH Urban & Regional Economics
TABLE 1
Select Hospital Descriptive Data
Hospital Licensed
Beds Total Census Patient Days
Outpatient Visits
Net Patient Revenue
El Camino Los Gatos & Mountain View 542 81,758 283,557 $629,872,280
Good Samaritan 429 82,942 125,399 $522,631,961
Kaiser Permanente Santa Clara1 327 88,874 105,661 NA
Kaiser Permanente San Jose1 242 50,285 70,280 NA
Lucile Packard Children's Hospital 311 81,670 164,139 $835,673,867
O'Connor 358 52,611 152,630 $297,654,892
Regional Medical Center of San Jose 247 56,433 391,713 $340,789,410
Santa Clara Valley Medical Center 574 122,599 856,486 $860,159,651
Saint Louise Regional Hospital 93 12,830 66,718 $93,881,902
Stanford Hospital and Clinics 613 134,394 569,889 $2,001,865,826
Veteran's Administration Palo Alto Health System2 917 228,334 725,807 $19,980,696
TOTAL 4,653 992,730 3,455,036 $5,602,510,484
Notes: 1
Net patient revenue data for Kaiser Permanente hospitals are not available. 2
Includes beds for services not provided by other hospitals in Santa Clara County, such as skilled nursing care, mental health and substance abuse treatment, and rehabilitation care.
Hospital Descriptions
El Camino Hospital, Mountain View
and Los Gatos
El Camino Hospital is an acute-care, 443-bed,
not-for-profit and locally governed
organization with campuses in Mountain
View and Los Gatos. The original Mountain
View Hospital was opened in 1961 in
response to the community’s need to ease
overcrowding in hospitals to the north and
south. The hospital acquired the Los Gatos
campus in 2009 and simultaneously reopened
a state-of-the-art, seismically compliant
facility in Mountain View, referred to at the
time by Popular Science magazine as “the
most technologically advanced in the world.”
The hospital is recognized as a national
leader in the use of health information
technology and wireless communications,
and has been awarded the Gold Seal of
Approval from The Joint Commission as a
Primary Stroke Center as well as back-to-back
ANCC Magnet Recognitions for Nursing Care.
It also received U.S. News & World Report’s
2011-2012 “Best Regional Hospital—San Jose
Metro Region” recognition for its orthopedics
program.
The hospital’s Mountain View campus
provides a wide range of inpatient and
outpatient services, including the El Camino
Surgery Center, Breast Health Center, Oak
Dialysis Center, and Cyberknife Center. It
opened the first Women’s Hospital in
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 7
Northern California, which encompasses
Maternal Child Health Services and many
other female-specific clinical services,
including pioneering use of the da Vinci®
Surgical System, a robotic tool for performing
hysterectomies and other gynecological
procedures. The hospital’s Heart & Vascular
Institute became the first Chest Pain Center in
the region to be certified by the Society of
Chest Pain Centers in 2008 and it is
consistently in the top 10 percent of
cardiovascular programs in the United States.
The Melchor Pavilion is home to the world-
renowned Fogarty Institute, Taft Center for
Clinical Research, Genomic Medicine Institute,
and Cancer Center, which strives to guarantee
a consult with patients within 48 hours
following a cancer diagnosis.
El Camino Hospital Los Gatos offers a leading
orthopedic subspecialty, including the
Orthopedic Pavilion, a new postoperative
facility designed exclusively for orthopedic
patients. It also offers one of the Bay Area’s
leading urology programs for both men and
women, and has a new Men’s Health Clinic
that focuses on male health issues. The Los
Gatos campus is home to a 30-bed acute
inpatient Rehabilitation Center that provides
services to patients who have experienced
strokes, brain injuries, multiple sclerosis,
Parkinson’s disease, spinal cord injuries, or
complex orthopedic disorders.
Good Samaritan Hospital
Good Samaritan Hospital is a 429-bed for
profit community hospital located in San
Jose, California. Good Samaritan Hospital
provides acute and tertiary services including
cardiology, cardiovascular surgery, oncology,
obstetrics and gynecology, orthopedics,
neurosciences, inpatient rehab, behavioral
health, emergency care and advanced wound
care with hyperbaric chambers. The hospital is
a leader in neurosciences, and is one of the
first five JCAHO designated Primary Stroke
Centers in the nation. The hospital just
opened a new Neurosciences Intensive Care
Unit to focus on conditions including stroke,
epilepsy, and Parkinson’s disease. This 21-bed
facility is the second ICU in Northern
California developed solely to treat serious
neurological conditions, with the first one
located at UC-Davis Medical Center in
Sacramento. Good Samaritan Hospital is also
the first northern California hospital to receive
CARF accreditation for stroke specialty and
the first community hospital in California to
use tPA and the Merci™ clot-retrieval device.
Good Samaritan Hospital is also certified as a
Community Hospital Comprehensive Cancer
Center by the American College of Surgeons
Commission on Cancer. The hospital received
the Outstanding Achievement Award (OAA)
for quality services and outcomes for cancer
patients in 2004, 2007, 2010 and is one of
only 13 hospitals in the nation to earn the
OAA three times.
Good Samaritan Hospital has advanced
cardio-vascular programs, including state-of-
the-art cardiac cath labs, active CV surgery
program, and dedicated CVICU. The hospital
has an Accredited Chest Pain Center, County-
designated STEMI receiving center, and was
the first hospital in San Jose to implant drug
eluting stents. The hospital is also State of
California Children’s Medical Services certified
for Level III Neonatal Intensive Care Unit and
Pediatric Surgery.
Kaiser Foundation Hospital—San Jose
This full service, 242 licensed-bed hospital,
located in the Coyote Valley of South San
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
8 | ALH Urban & Regional Economics
Jose, is part of the Kaiser Permanente San
Jose Medical Center campus. The campus
also has an outpatient surgery center, a family
health center, a large emergency care facility,
and multiple medical office buildings. Kaiser
Permanente’s unique approach to health care
- integrating physicians, hospitals, services
and insurance in one place- makes it easy for
members to connect with their caregivers and
support services, whether in-person, online,
or by phone.
For the second year in a row Kaiser
Foundation Hospital-San Jose was named a
Top U.S. Hospital by The Leapfrog Group, an
independent national nonprofit run by
employers and other large purchasers of
health benefits. This year The Leapfrog Group
also gave Kaiser Foundation Hospital-San
Jose an “A” Hospital Safety Score. The
Hospital Safety Score uses publicly available
hospital safety data to rate a hospital’s overall
capacity to keep patients safe from infections,
injuries, and medical and medication errors.
Kaiser Foundation Hospital-San Jose is
certified by the Joint Commission as a
Primary Stroke Center, and was recognized in
2012 by the American Heart Association and
American Stroke Association with the Get
with the Guidelines—Stroke Gold Plus
Achievement Award.
The Medical Center provides a multitude of
specialized services including chronic pain
management, a regional sleep-disorder clinic,
chemical dependency treatment, weight-loss
management services, chronic conditions
management, home health and hospice, and
palliative care services. The facility also has
maternal child services for uncomplicated
deliveries, a comprehensive Orthopedics
department specializing in total joint
replacement, spine surgery, and sports
medicine. Kaiser Permanente-San Jose is also
known for its regional Genetics department
and Autism Spectrum Disorder regional
referral center.
In the State of California, Kaiser Permanente
is the only health care plan that for the past
four years has received the highest rating of
four stars from the California Office of the
Patient Advocate. In addition, Kaiser
Permanente’s Medicare health plans in
California received an overall rating of 5 stars
for parts C and D, the highest rating from The
Centers for Medicare & Medicaid Services for
2012.
Founded in 1945, Kaiser Permanente currently
serves more than 9 million members in nine
states and the District of Columbia. Kaiser
Permanente is dedicated to care innovations,
industry-leading technology advances and
tools, state-of-the-art care delivery, world-
class chronic disease management, clinical
research, health education, and the support
of community health.
Kaiser Foundation Hospital—Santa Clara
Kaiser Foundation Hospital-Santa Clara is an
acute care facility with 327 licensed beds,
including a 26-bed neonatal intensive care
unit. The new hospital, opened in 2007, is
located on the main campus of the Kaiser
Permanente Santa Clara Medical Center in
Santa Clara. Additional medical offices are
located in the cities of Mountain View,
Milpitas, Cupertino, Campbell, and Sunnyvale.
In addition to primary care and emergency
services, Kaiser Permanente Santa Clara offers
centers where physician specialists focus on
one particular area of medicine, including
cardiovascular services, an inpatient pediatric
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 9
care center, a behavioral health center, and
an inclusive labor and delivery facility with
Level III neonatal intensive care. Using the da
Vinci® Surgical System, surgeons are able to
perform minimally invasive robotic assisted
laparoscopic prostatectomies and
hysterectomies. The hospital is certified by
The Joint Commission as a Primary Stroke
Center, and was recognized in 2012 by the
American Heart Association and American
Stroke Association with the Get With The
Guidelines—Stroke Gold Plus Achievement
award.
Kaiser Permanente Santa Clara’s state-of-the-
art cancer treatment center is a regional
referral facility. The center specializes in
pediatric cancer treatment and offers
innovative, breakthrough techniques for
inpatient and outpatient care.
In 2012 the Kaiser Permanente Santa Clara
hospital was honored with an “A” Hospital
Safety Score by The Leapfrog Group, an
independent national nonprofit run by
employers and other large purchasers of
health benefits. The Hospital Safety Score
uses publicly available hospital safety data to
rate a hospital’s overall capacity to keep
patients safe from infections, injuries, and
medical and medication errors.
In the State of California, Kaiser Permanente
is the only health care plan that for the past
four years has received the highest rating of
four stars from the California Office of the
Patient Advocate. Kaiser Permanente’s
Medicare health plans in California received
an overall rating of 5 stars for parts C and D,
the highest rating from The Centers for
Medicare & Medicaid Services for 2012.
Founded in 1945, Kaiser Permanente currently
serves more than 9 million members in nine
states and the District of Columbia. Kaiser
Permanente is dedicated to care innovations,
industry-leading technology advances and
tools, state-of-the-art care delivery, world-
class chronic disease management, clinical
research, health education, and the support
of community health.
Lucile Salter Packard Children’s Hospital
at Stanford (Packard Children’s)
Lucile Packard Children’s Hospital is a 311-
bed, not-for-profit hospital located in Palo
Alto, California. In the 2012-2013 U.S. News &
World Report survey of America’s Best
Children’s Hospitals, Packard Children’s is
ranked as the only San Francisco Bay Area
and Northern California pediatric hospital
with care programs in the nation’s Top 10,
with five programs in the Top 20. Devoted to
the care of babies, children, adolescents and
expectant mothers, Packard Children’s is the
pediatric teaching hospital of the Stanford
University School of Medicine and one of the
most important child health research facilities
in the U.S.
A free-standing children’s hospital with a
separate license and provider number,
Packard Children’s has its own Board of
Directors, with Stanford University as the sole
corporate member. This affiliation, including
the Stanford University School of Medicine,
makes Packard Children’s one of America’s
top training grounds for future pediatricians
and obstetricians.
The hospital opened in June 1991 and
immediately had an impact as the only
children’s hospital in California serving both
expectant mothers and children. The
hospital’s staff, medical staff, volunteers and
auxiliary members are dedicated to the
mission of providing the best in family-
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
10 | ALH Urban & Regional Economics
centered care for families. Packard Children’s
is also recognized for its forward-thinking
commitment to quality and safety, and its
research, programs, and services attract
patients from around the world.
As a mission-driven organization, the hospital
is committed to advocacy, outreach,
education, and research. Packard Children’s
continually reaffirms its commitment to the
community by developing innovative
programs to enhance its own and the
community’s capacity to care. Additionally,
the hospital has an extensive network of
community and outreach services in dozens
of locations around the San Francisco Bay
Area, Northern California and the U.S.
Western Region. Making it easier for children
and mothers to access the care they need is
one of the hospital’s primary missions.
To further provide this world-class access,
Packard Children’s is currently preparing for a
new, 500,000 sq. ft. expansion that will
include additional patient beds and
diagnostic capabilities to create the most
family-friendly children’s hospital in America.
The expansion will open in 2016.
O’Connor Hospital
O’Connor Hospital is 358-bed acute care, not-
for-profit, Catholic community hospital
located in San Jose, California. Established in
1889, O’Connor Hospital was built by area
philanthropists and operated by the
Daughters of Charity of St. Vincent de Paul.
O’Connor Hospital and the Daughters of
Charity have served Santa Clara County
longer than any other hospital in the region.
Today, O’Connor Hospital continues to thrive,
providing medical care with a special focus on
the needs of low-income, underserved
populations. O’Connor sponsors the Health
Benefits Resource Center, the Pediatric Center
for Life, a Parish Nursing program, the Family
Health Center and the Stanford-affiliated
Family Medicine Residency Program. Key
services include cardiology, oncology,
mother-baby care, orthopedic and joint
replacement services, vascular care, wound
care, and emergency services. O’Connor
Hospital is a Joint Commission Certified
Center of Excellence for Hip and Knee
Replacement, Wound Care, and an Advanced
Primary Stroke Center. Additionally, the
hospital is fully accredited by The Joint
Commission, the California Department of
Public Health, and the Center for Medicare
and Medicaid Services.
O’Connor Hospital provides quality
healthcare to the community, welcoming all
patients regardless of their financial
circumstances. The hospital provides
comprehensive healthcare services without
delay or limitations and without regard to the
patient’s ability to pay. O’Connor Hospital is a
leader in the community in serving the
underserved and marginalized. The hospital
responds to the needs of the community and
adapts to provide care and services in unmet
areas. O’Connor Hospital is guided by the
mission to serve the sick and those living in
poverty.
O’Connor Hospital is a member of the
Daughters of Charity Health System. The
health system comprises six hospitals and
medical centers that span the California coast
from Daly City to Los Angeles. For more than
375 years, the hospital’s sponsors, the
Daughters of Charity of St. Vincent de Paul,
have been serving the sick and the poor
through healing ministries around the world.
O’Connor Hospital operates with the Mission
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 11
Statement, Vincentian Values, and vision of
the Daughters of Charity Health System as an
integral part of every gathering, policy, and
decision.
Regional Medical Center of San Jose
The Regional Medical Center of San Jose is a
for profit acute care facility that was
established in 1965 and provides 247 licensed
beds to the Santa Clara County community.
As an affiliate of a national healthcare
provider, HCA, Regional Medical Centers are
part of an extensive network of hospitals and
surgery centers throughout the United States
and England. The Regional Medical Center of
San Jose hospital facility is undergoing an
extensive $300 million expansion. This
expansion broke ground in 2005 and is
estimated to be completed in 2013. When
completed, the facility will be a state-of-the-
art hospital with an elevated helipad and
extensive upgrades to the existing facilities.
The Regional Medical Center of San Jose
provides inpatient and outpatient services
and specializes in 21 fields of medicine,
dentistry, and podiatry. The Regional Medical
Center of San Jose features six Centers of
Excellence, specializing in Emergency and
Level II Trauma, Cardiovascular, Women and
Children’s Health, Neurosciences, Cancer
Care, and Medical/Surgical Services. Regional
Medical Center of San Jose also provides
specialty services such as Certified Stroke
Center, accredited Level II Chest Pain Center,
Cancer Care in Your Community, Breast Care
Center, research and clinical trials,
rehabilitation services, and Wound Care. In
addition, The Regional Medical Center San
Jose offers care using innovative technology
including da Vinci® Robot Assisted Surgery.
The vision of Regional Medical Center of San
Jose is stated as, “to be recognized as a
comprehensive, state-of-the-art, tertiary care
hospital that exceeds expectations of
excellence through the provision of
compassionate, quality care for the local
community and beyond.”
U.S. News & World Report listed Regional
Medical Center of San Jose as a top
performing hospital in the San Jose
metropolitan area. Leapfrog Group graded
Regional Medical of San Jose in the top
quartile for patient safety. In addition,
Regional Medical Center of San Jose plays an
active role in the community by providing
classes on items such as exercise,
breastfeeding, cancer support, and what to
do after a stroke.
Santa Clara Valley Health &
Hospital System
Santa Clara Valley Medical Center (SCVMC) is
the flagship hospital of the Santa Clara Valley
Health & Hospital System, which includes the
Public Health Department, Mental Health
Department, and Department of Alcohol &
Drug Services. The mission of SCVMC is to
provide quality and comprehensive care from
community based prevention services to
primary and acute care to the transition of
maintaining health at home.
SCVMC includes an acute care inpatient
hospital with 574 licensed beds, 8 regional
clinics providing primary care, and a specialty
center offering a wide-range of specialty
services. SCVMC is considered a health care
“safety net” provider, serving a
disproportionate amount of low-income
income and culturally diverse individuals and
families.
SCVMC has the county’s busiest Emergency
Department (ED) with over 75,000 visits and is
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
12 | ALH Urban & Regional Economics
accredited by The Joint Commission. The ED
is a Level 1 Trauma Center for both adults
and children, and is home to the county’s
only Sexual Assault Response Team. The
community’s only public hospital collaborates
with other public agencies to prepare for
disasters that may affect all residents of the
community.
Founded in 1876, SCVMC has been rebuilt
over the years and construction is underway
for a 168-bed building to meet State
earthquake standards. The Seismic Safety
Project is working to obtain Leadership in
Energy and Environmental Design
certification for green building design,
construction, operations, and maintenance.
SCVMC has a nationally recognized and
accredited Rehabilitation Center, providing
care for complex brain and spinal cord
injuries and strokes. The Burn Center leads in
providing comprehensive care from injury to
rehabilitation, and is verified by the American
College of Surgeons and the American Burn
Association.
Regional specialty services provided by
SCVMC include women’s and children’s
health: labor and delivery, neonatology, and
pediatrics. Health coverage for low income
children is provided through the Healthy Kids
program and SCVMC is approved as a
California Children’s Services provider.
For over 50 years SCVMC has served as a
major teaching institution training interns,
residents, and fellows. SCVMC is affiliated
with Stanford University and UC medical
schools, and has free-standing approved
residency programs and major residency
rotations in a multitude of medical specialties.
SCVMC educates a large number of
undergraduate and graduate nursing
students through affiliations with San Jose
State University, Samuel Merritt University,
USF, and Evergreen/SJCC District.
Saint Louise Regional Hospital
Saint Louise Regional Hospital is a Catholic
community hospital and is part of the
Daughters of Charity Health System. As one
of the Daughters of Charity Health System
hospitals, Saint Louise Regional is part of a
regional healthcare system that spans the
State of California offering state-of-the-art
medical technology and holistic care.
Performance improvement leader, Press
Ganey, ranked Saint Louise Regional Hospital
in the top 15 percent of hospitals nationally
for inpatient satisfaction.
Saint Louise originally opened its doors in
Morgan Hill in 1989, moved to Gilroy in 1999,
and currently provides 93 licensed beds as an
acute care hospital with strong community
ties in Santa Clara County through programs
such as the Saint Louise Regional Hospital
Foundation, which offers financial aid and
provides programs such as teaching the
community how to grow a garden, Meals on
Wheels, bilingual educational programs,
support groups, outpatient counseling, online
resources, and free health fairs and
screenings.
Saint Louise Regional Hospital facilities are
state-of-the-art offering CALSTAR emergency
helicopter transport, minimally invasive
surgical procedures, hyperbaric medicine
oxygen chambers, ACR accredited BreastCare
Center with advanced methods of cancer
detection, bone density screening with an
advancement in technology with the recent
FDA approval of a bone-conserving
procedure, CONSERVE® Plus Total Hip
Resurfacing System, developed by orthopedic
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 13
surgeon Harlan Amstutz, MD, a stroke
program, and advanced medical imaging
technology through MRIs and Ultrasounds.
Other specialty services include maternal and
child health services, wound care, and the De
Paul Urgent Care Center. Saint Louise has the
busiest Emergency Department in the South
County.
Stanford Hospital & Clinics
Stanford Hospital & Clinics is a non-profit
facility with 613 licensed beds dedicated to
providing leading edge and coordinated care
to each and every patient. It is internationally
renowned for advanced treatment and
expertise in areas such as cancer treatment,
neuroscience, surgery, cardiovascular
medicine and organ transplant, as well as for
translating medical breakthroughs into
patient care. Throughout its history, Stanford
has been at the forefront of discovery and
innovation, as researchers and clinicians work
together to improve health on a global level.
For the 10th time since 2000, Stanford was
ranked by U.S. News & World Report in 2011
among the top 20 hospitals in the U.S. on its
prestigious list of “Americas Best Hospitals.”
The magazine also ranked Stanford as the
best hospital in the San Jose metropolitan
area, and listed 12 of Stanford’s medical
specialty programs as national bests.
Stanford was the fourth hospital in the U.S. to
achieve the highest possible distinction in
electronic medical record implementation
from the Healthcare Information and
Management Systems Society. This year, for
the fourth year in a row, and the fifth time
since the creation of the Leapfrog Group’s
annual class of top hospitals, Stanford was
named as a top U.S. hospital for its record of
patient safety, quality, efficiency and
transparency. Stanford was also honored this
year to be redesignated as a Magnet hospital
by the American Nursing Credentialing
Center (ANCC). Only 7 percent of the nation’s
hospitals have achieved Magnet designation,
widely recognized as the pinnacle of nursing
excellence.
The advanced technology and state-of-the-
art care at Stanford is boosted by its
affiliation with the Stanford School of
Medicine, the oldest medical school in the
Western United States. The hospital’s
physician-scientists drive an aggressive
bench-to-bedside movement of new
knowledge supported by robust research.
Stanford patients also have access to care
through more than 300 clinical trials testing
the most innovative treatment protocols.
In 2011, Stanford began preparation for the
construction of a new 824,000-square-foot
facility that will offer more than 600 beds in
modular patient rooms designed for family-
centered care, a Level 1 Trauma Center and
emergency department tripled in size and
hybrid operating rooms incorporating new
technology and innovations. It is set to open
in 2018.
VA Palo Alto Hospital
The VA Palo Alto is a non-profit hospital
offering the community primary care with 917
licensed beds and an extensive amount of
specialty services. The VA Palo Alto Health
Care System (VAPAHCS) comprises three
inpatient facilities located in Palo Alto, Menlo
Park, and Livermore and seven outpatient
clinics throughout the Bay Area.
Specialty medicine that is provided by
VAPAHCS includes a regional Polytrauma and
Comprehensive Rehabilitation Center, Spinal
Cord Injury Center, a Traumatic Brain Injury
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
14 | ALH Urban & Regional Economics
Center, the Western Blind Rehabilitation
Center, a Geriatric Research Educational and
Clinical Center, and a National Center for
Post-Traumatic Stress Disorder (PTSD). In
addition, other specialties include surgery,
psychiatry, dentistry, neurology, geriatrics,
oncology, and extended care.
VAPAHCS serves as a teaching hospital with
state-of-the-art technology, research, and
medical training education for residents,
interns, and students through its affiliation
with Stanford University School of Medicine.
With prevalent research centers in HIV
research, spinal cord regeneration,
Alzheimer’s disease, geriatrics, schizophrenia,
mental health, Rehabilitation Research and
Development Center, and a Health Economics
Resource Center, the VAPAHCS is one of the
top three research programs in the VA. In
addition, the VAPAHCS has received many
awards and recognitions; among the many
include the 2011 California Award for
Performance Excellence Eureka Silver Award,
being listed by the Hospitals and Health
Networks as one of the Nation’s Most Wired
Hospitals for excelling in IT, and the 2011
Performance Achievement Carey Award for
outstanding patient care, satisfaction, quality,
safety, and business practices.
ALH Urban & Regional Economics | 15
III. ECONOMIC CONTEXT
Healthcare Sector Dominance
The healthcare sector in Santa Clara County,
including social assistance, is a very strong,
dominant sector in Santa Clara County, and is
strengthening over time. In 2000, healthcare
and social assistance employment comprised
6.5% of all county employment (see Table 2).
By 2010, this sector grew to equal 10.1% of all
county employment.
The healthcare and social assistance sector
has emerged to be the third largest private
industry sector in all of Santa Clara County,
following manufacturing at 19.9% of the 2010
private industry employment base and
professional, scientific, and technical services
at 13.9% of the employment base. Retail
trade is tied at 10.1% with the healthcare and
social assistance sector.
The strength of Santa Clara County’s
healthcare and social assistance sector is the
result of almost year over year growth over
the decade versus steep annual declines or
modest growth among all industries (see
Table 3). Healthcare and social assistance
employment grew from 61,219 in 2000 to
76,559 in 2010, growth of 25.1% over the
decade. In contrast, all private industry
employment declined by almost 20% and
total employment including government
declined by 18.5%.
The diverging trends in employment are
especially noticeable in Figure 2, which shows
the cumulative percent change in
employment over the decade in the
healthcare and social assistance sector and
total private industry employment.
Employment Opportunities
The healthcare industry offers a wide range of
job opportunities, with an equally wide range
of earnings potential. A number of these
occupations are included in Table 4, many of
which comprise hospital-based job
opportunities.
The jobs supported by the healthcare industry
provide opportunities for employees at a
variety of skill levels. Regardless of
occupation, healthcare job opportunities in
Santa Clara County tend to provide higher
wages than throughout California, and
healthcare jobs in general provide much
higher wages than all occupations. These
higher wages are a strong contributor to the
economic base of Santa Clara County as
employee spending helps fuel the economy.
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
16 | ALH Urban & Regional Economics
TABLE 2
Sectoral Employment Santa Clara County, 2000 and 2010
Industry1 2000 2010
Percentage Growth
Average Annual Growth
Manufacturing 253,690 150,370 -40.7% -5.1%
Professional, Scientific, and Technical Services 127,419 105,516 -17.2% -1.9%
Retail Trade 91,699 76,602 -16.5% -1.8%
Health Care and Social Assistance 61,219 76,559 25.1% 2.3%
Accommodation and Food Services 61,351 61,927 0.9% 0.1%
Administrative and Support and Waste Management and Remediation
77,991 46,484 -40.4% -5.0%
Information 42,511 43,661 2.7% 0.3%
Wholesale Trade 41,689 34,598 -17.0% -1.8%
Construction 48,317 31,349 -35.1% -4.2%
Other Services (except Public Administration) 25,411 30,781 21.1% 1.9%
Educational Services 23,059 28,751 24.7% 2.2%
Finance and Insurance 18,805 17,922 -4.7% -0.5%
Real Estate and Rental and Leasing 15,337 13,367 -12.8% -1.4%
Arts, Entertainment, and Recreation 10,365 12,072 16.5% 1.5%
Transportation and Warehousing 15,373 9,987 -35.0% -4.2%
Management of Companies and Enterprises 21,956 9,637 -56.1% -7.9%
Agriculture, Forestry, Fishing and Hunting 5,089 3,597 -29.3% -3.4%
Not Classified 0 1,756 100.0% —
Utilities 2,061 1,484 -28.0% -3.2%
Mining 215 166 -22.8% -2.6%
TOTAL PRIVATE INDUSTRY 943,342 756,420 -19.8% -2.2%
Government 95,700 90,600 -5.3% -0.5%
TOTAL ALL SECTORS 1,039,042 847,020 -18.5% -2.0%
Note: 1Data are based on two-digit NAICS codes. Industry sectors defined by California EDD.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 17
TABLE 3
Sectoral Employment Health Care and Social Assistance and Total Private Industry
Santa Clara County, 2000–2010
Year
Health Care and Social Assistance
Total Private Industry
Amount Percent Change Amount
Percent Change
2000 61,219 — 943,574 —
2001 63,597 3.9% 911,126 -3.4%
2002 65,823 3.5% 811,779 -10.9%
2003 65,438 -0.6% 761,788 -6.2%
2004 65,746 0.5% 757,166 -0.6%
2005 66,874 1.7% 766,343 1.2%
2006 69,725 4.3% 788,144 2.8%
2007 70,587 1.2% 806,515 2.3%
2008 74,291 5.2% 815,500 1.1%
2009 75,451 1.6% 760,343 -6.8%
2010 76,559 1.5% 756,587 -0.5%
FIGURE 2
Heath Care and Social Assistance versus Total Private Industry Cumulative Percent Change
Santa Clara County 2000–2010
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
18 | ALH Urban & Regional Economics
TABLE 4
Occupational Employment and Wage Estimates Healthcare Practitioners and Technical Occupations and Healthcare Support Occupations San Jose-Sunnyvale-Santa Clara Metropolitan Area and the State of California, May 2011
Occupation
Mean Annual Salary
Santa Clara County
State of California
Healthcare Practitioners and Technical Occupations1 $106,350 $87,260
Oral and Maxillofacial Surgeons $197,860 $204,050
Dietitians and Nutritionists $77,500 $66,690
Optometrists $122,510 $101,030
Pharmacists $122,520 $122,800
Anesthesiologists $167,130 $221,990
Family and General Practitioners $189,620 $174,530
Internists, General $143,530 $192,560
Obstetricians and Gynecologists $223,330 $222,960
Pediatricians, General $128,540 $166,500
Psychiatrists $139,100 $192,290
Surgeons $242,860 $216,350
Physicians and Surgeons, All Other $180,450 $182,260
Physician Assistants $98,100 $94,940
Registered Nurses $117,590 $90,860
Occupational Therapists $87,530 $84,750
Physical Therapists $88,990 $86,890
Radiation Therapists $99,820 $93,530
Recreational Therapists $54,920 $57,400
Respiratory Therapists $83,360 $69,930
Therapists, All Other $80,070 $48,880
Health Diagnosing and Treating Practitioners, All Other $87,970 $82,050
Medical and Clinical Laboratory Technologists $86,650 $78,400
Medical and Clinical Laboratory Technicians $54,570 $43,370
Cardiovascular Technologists and Technicians $70,210 $59,730
Diagnostic Medical Sonographers $104,130 $81,750
Nuclear Medicine Technologists $112,260 $92,080
Radiologic Technologists and Technicians $80,050 $68,650
Emergency Medical Technicians and Paramedics $55,080 $36,490
Dietetic Technicians $37,620 $36,590
Pharmacy Technicians $45,760 $38,380
Psychiatric Technicians $45,190 $52,280
Respiratory Therapy Technicians $40,920 $52,150
Surgical Technologists $60,990 $51,940
Licensed Practical and Licensed Vocational Nurses $57,010 $51,130
Health Technologists and Technicians, All Other $57,220 $45,110
HEALTHCARE SUPPORT OCCUPATIONS $34,440 $31,030
ALL HEALTHCARE AVERAGE $102,209 $99,448
ALL OCCUPATIONS AVERAGE $69,880 $51,910
Notes: 1Select occupations not included, but reflected in the averages.
Source: United States Bureau of Labor Statistics May 2011 Metropolitan and Nonmetropolitan Area Occupational Employment and Wage Estimates San Jose-Sunnyvale-Santa Clara and the State of California.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 19
As indicated in Table 4, the average salaries
of healthcare workers throughout Santa Clara
County are $106,350 for healthcare
practitioners and technical occupations,
$34,440 for healthcare support occupations,
and $101,222 across all healthcare jobs. This
includes the hospitals reflected in the study
as well as other healthcare facilities. These
figures contrast with $69,880 for the
countywide average annual earnings. This
indicates that healthcare jobs throughout
Santa Clara County are 45% more lucrative
than the average job in the county, greatly
boosting the county’s economy.
Not only are healthcare jobs relatively high
paying, but healthcare workers throughout
Santa Clara County tend to earn more than
the average healthcare worker in the State of
California. On average, healthcare workers
employed in Santa Clara County earn 11% to
22% more than the equivalent statewide
worker. Because of these higher wages,
hospitals in Santa Clara County have the
potential to recruit and retain more
experienced and skilled workers plus create a
greater local economic impact than hospitals
in many other California locations.
In addition to the strong wages, healthcare
workers typically enjoy strong benefit
packages. In Santa Clara County, standard
hospital employee benefits are very generous
and are appearing increasingly so over time,
as benefits in other sectors are cut back or
disappearing, such as in select private sector
sub-sectors and even government. This
includes the roughly 15% of hospital workers
in the county who are not unionized. While
there are minor benefit variations from
hospital to hospital, income-based employee
benefits can be as generous as 100%
employer paid health plan options, with some
also including family members, and 100%
employer paid defined benefit pension plans
and/or employer match for 401K equivalent
programs. These and other benefits are
funded through hospital overhead running in
excess of 35% for benefits.
20 | ALH Urban & Regional Economics
IV. HOSPITAL ECONOMIC
IMPACTS
Methodology and Data Resources
Approach to Economic Impact Analysis
The revenues received by Santa Clara
County’s hospitals translate into large
volumes of spending on wages, supplies, and
numerous other expenditures, which in turn
create expenditures in the local economy and
provide economic stimuli. This analysis
summarizes the economic impacts of the 11
hospitals located throughout Santa Clara
County. The economic impacts include both
on-going operations impacts as well as the
non-recurring construction impacts during
the study year and long-term construction
forecasts.
Economic impacts measure the effects of
expenditures in the local economy. These
impacts include direct and indirect jobs,
personal income, and economic activity, or
output that are generated by the hospitals.
Indirect impacts are the result of the
multiplier effect and capture supported
supplier and consumer businesses and their
employees in Santa Clara County that benefit
from purchases by the hospitals and their
employees.
Data Resources
Informational data about the hospital
operations was gleaned from reporting
provided by the hospitals to the State of
California. Many of the hospitals are required
to annually submit a report with descriptive
information about the hospitals, such as
number of beds, revenues, staffing, and
expenditures, among other operating
statistics. Other hospitals voluntarily submit
the reports, which are filed with the State of
California Office of Statewide Health Planning
and Development (OSHPD) on an annual
basis. The reporting periods vary, such that
not all reports are submitted at the same
time, nor are they measuring the same period
of time. The most recent reports available for
the hospitals that submit them reflect the
9/09 – 8/10 and 7/10 – 6/11 time periods. The
figures gleaned for the hospitals reflect these
time periods, with all financial data inflated to
a common point in time, approximating
average year 2011 dollars. Thus all dollar
figures cited reflect 2011 dollars, unless
otherwise stated.1
1 As of this report date, the most recent 2012 inflation
index reflects April, 2012. Thus, complete data are not
available for the purpose of adjusting dollars to 2012.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 21
For some hospitals the OSHPD reports do not
include all data points useful for the
economic impact analysis. In these cases
estimates were prepared based upon the
average findings for the reporting hospitals.
Metrics were developed and applied to
maximize the ability to fully analyze the
hospital data. These metrics included
methods of projecting hospital revenues,
hospital expenditures, and the pattern of
hospital expenditures. In other cases the
hospitals directly provided the necessary data
points. Individual hospital data were provided
for long-term construction plans, which are
not included in the OSHPD reports.
Economic Impact Modeling
The hospital operational data were
incorporated into an economic impact model
for Santa Clara County. The model is based
on software developed by economists at
IMPLAN (IMpact analysis for PLANning) and
geographic-specific economic data collected
by the U.S. Government, which is then
processed and packaged for use by IMPLAN.
The IMPLAN model is designed to generate
analysis regarding the economic impacts of a
range of economic catalysts.
The impact of Santa Clara County’s hospitals
on the county’s economy is greater than the
total of the hospitals’ direct spending on
payroll, purchases, and construction. This is
because money spent by the hospitals is
spent again by the hospital’s employees and
local businesses. Employees use their salaries
and wages to purchase goods and services
from other businesses. Businesses make their
own purchases and hire employees, who also
spend their salaries and wages throughout
the county. A chain reaction of indirect and
induced spending continues, with subsequent
rounds of additional spending gradually
diminished through savings, taxes, and
expenditures made outside the county. This
economic ripple effect is measured by what is
known as an “input-output” economic model,
which uses a series of “multipliers” to provide
estimates of the number of times each dollar
of “input,” or direct spending, cycles through
the economy in terms of “indirect and
induced output,” or additional spending,
personal income, and employment.
The types of economic impacts measured by
multipliers can be defined in the context of
this study as follows: 2
Direct impacts refer to impacts from the
economic activities associated with Santa
Clara County’s hospitals.
Indirect impacts measure output (gross
sales), jobs, and labor income associated
with the businesses and organizations
that support the hospitals’ activities.
Induced impacts accrue when Santa
Clara County hospital employees and
indirect industry employees spend their
wages on local goods and services. These
expenditures in turn stimulate other
sectors in the local economy.
More technical information about economic
impact analysis and IMPLAN is presented in
Appendix B.
2 Indirect impacts are the changes in inter-industry
purchases as they respond to new demands of directly
affected industries. Induced impacts typically reflect
changes in spending from households as income
increases or decreases due to changes in production.
For more explanation of indirect and induced impacts,
see Appendix A.
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
22 | ALH Urban & Regional Economics
Operational Impacts
The operations of Santa Clara County’s 11
hospitals provide significant economic
benefits to Santa Clara County. The reported
and estimated data indicate that Santa Clara
County’s hospitals employed 23,359 full-time
equivalent people during the study period.
These jobs collectively represent 14% of the
combined healthcare and social assistance
and government sector jobs discussed earlier
(see Table 2), as the hospital jobs span both
those sectors given the varied ownership
structures, including government. The
hospital employee wages totaled over $2.6
billion, reflecting average annual earnings of
$113,320 per person. Hospital spending
totaled $7.2 billion. This includes spending on
salaries and wages, employee benefits,
physicians and other professional fees,
supplies, purchased services, construction,
leases and rentals, and other operating
expenses. These hospital wages and spending
are the catalyst for the hospital economic
impacts, driving economic growth and
strength in Santa Clara County. These positive
impacts include the following:
Overall Operations Impacts. The
combined operations of the 11 hospitals
included in this analysis create an annual
economic impact of $14.3 billion (see Table
5). The hospitals directly and indirectly
support almost 64,000 jobs and $5.9 billion
in annual payroll. These total economic
impacts include jobs, payroll, and output at
the hospitals directly, as well as impacts at
other local businesses that are supported
by local institutional spending and
employee spending impacts.
Jobs and Income. The hospitals directly
employ about 23,400 FTE employees with
a combined payroll of $2.6 billion
annually. Through the multiplier effect, an
additional 40,200 jobs and $3.2 billion in
annual payroll are created annually at
other businesses in Santa Clara County
that serve the hospitals, their employees,
and patients. These additional jobs and
payroll stem from indirect and induced
impacts of local spending by the hospitals
and their employees.
Additional Physician Jobs and Income.
In addition to the hospital jobs there are
numerous physicians who are not
hospital-based physicians that provide
services through the hospitals. These
physicians are not paid by the hospitals
but their highly compensated jobs and
associated medical staff provided further
economic impacts in Santa Clara County.
The hospital operations, jobs, and income
impacts are therefore minimum estimates
and are not inclusive of these additional
strong and important economic impacts.
TABLE 5
Annual Operations Impacts of All Santa Clara County Hospitals (2011 dollars)
Type of Impact Employment Income Output
Direct Impacts 23,359 $2,647,026,482 $7,234,766,184
Indirect Impacts (local purchasing) 31,416 $2,733,907,787 $5,497,907,056
Induced Impacts (employee spending) 8,784 $486,362,586 $1,538,452,185
TOTAL IMPACTS 63,559 $5,867,296,855 $14,271,125,425
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 23
Local Hospital Spending. The hospitals
make a variety of purchases for various
supplies and services such as security,
building maintenance,
telecommunications, laundry services,
insurance, medical supplies, and other
items. Based on the share of these
purchases that are expected to occur
locally, which totals $3.6 billion, the
economic impact of local hospital
spending on Santa Clara County is
estimated at $5.5 billion per year (see
Table 6).
Employee Spending. The 23,400 current
FTE employees of Santa Clara County’s
hospitals also make a significant amount
of local purchases. The effect of employee
purchases from current employees
generates a total economic impact of $1.5
billion on Santa Clara County each year
(see Table 5).
TABLE 6
Annual Impact of Local Purchasing (2011 dollars)
Type of Expenditure
Direct Expenditures
Total Impacts
Supplies Purchased Services Other Jobs Income Output
Medical Supplies Sold to Patients $330,841,189 $1,808,939 $0
2,589 $251,755,346 $497,543,132
Durable Medical Equipment $0 $0 $0
0 $0 $0
Drugs Sold to Patients $265,297,672 $0 $0
2,065 $200,781,847 $396,804,400
Printing and Duplicating $160,621 $2,412,674 $479,397
29 $1,636,244 $4,518,454
Non-Patient Food Services $7,904,590 $6,549,789 $147,709
283 $8,605,038 $22,376,660
Dietary $5,490,060 $3,518,460 $238,182
72 $6,998,063 $13,830,245
Laundry and Linen $4,318,748 $10,295,348 $4,542
293 $15,282,730 $24,706,801
Grounds $25,472 $57,053 $12,953
2 $63,837 $150,615
Security $339,840 $7,226,970 $389,544
208 $7,993,623 $13,502,120
Housekeeping $4,915,827 $8,347,574 $4,499,917
341 $11,876,460 $28,021,172
Plant Maintenance $6,324,490 $42,151,942 $13,773,471
1,196 $41,619,956 $98,197,603
Communications $220,286 $1,373,577 $6,571,505
41 $3,807,961 $13,107,234
Data Processing $8,323,153 $209,701,434 $12,617,646
1,096 $134,915,460 $331,202,080
General Accounting $220,891 $6,405,998 $3,164,918
121 $8,542,678 $15,568,193
Patient Accounting $737,781 $34,654,550 $3,366,212
481 $33,814,160 $61,622,993
Credit and Collection $22,170 $16,234,794 $430,203
386 $16,202,693 $29,813,846
Insurance—Hospital and Professional Malpractice
$0 $0 $34,252,865
457 $30,286,958 $65,072,079
Insurance—Other $0 $0 $13,316,058
178 $11,774,282 $25,297,258
Construction In Progress $0 $0 $489,436,449
4,876 $344,888,533 $768,376,100
Other Expenses $282,721,229 $1,103,527,582 $382,155,816
13,764 $1,338,359,077 $2,644,993,950
Physician's Professional Fees $0 $0 $98,706,139
1,260 $91,841,600 $167,900,740
Other Professional Fees $0 $0 $156,699,722
1,678 $172,861,245 $275,301,382
TOTAL $917,864,018 $1,454,266,684 $1,220,263,245 31,416 $2,733,907,787 $5,497,907,056
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
24 | ALH Urban & Regional Economics
Impacts on Other Local Businesses.
Through hospital purchasing and employee
spending, the hospitals support a variety of
other local businesses. Some of these
businesses are within the healthcare sector
such as doctor’s offices and laboratories;
however, there are also significant impacts
in retail, restaurants, utilities, professional
services, higher education, and business
support services (see Table 7). While the
hospitals in Santa Clara County provide
critical healthcare services, they also play an
important role in supporting other types of
businesses and jobs outside of healthcare.
The sectors with the greatest local impacts,
highlighted in Table 7, include banking,
restaurants, medical and diagnostic labs,
doctors and other health practitioners,
telecommunications firms, and wholesalers.
TABLE 7
Significant Impacts to Select Industry Sectors (2011 dollars)
Industrial Sector Output Employment Income
Banking $284,467,008 664 $46,597,583
Restaurants $244,419,693 3,913 $94,370,864
Medical and Diagnostic Labs $232,270,468 1,219 $128,396,831
Offices of Physicians and Other Health Practitioners $227,890,655 1,832 $148,704,229
Telecommunications $187,666,838 334 $45,647,321
Wholesale Trade Businesses $184,344,560 828 $103,108,144
Employment Services $138,118,845 2,277 $116,203,041
Real Estate Establishments $116,539,045 627 $14,590,862
Private Junior Colleges, Colleges, Universities $104,449,406 758 $71,134,353
Legal Services $96,130,940 507 $56,669,523
Services to Buildings and Dwellings $82,307,140 1,270 $36,148,019
Retail Stores—Food and Beverage $74,021,899 1,074 $38,439,783
Insurance Carriers $73,349,751 248 $15,334,665
Other State and Local Government Enterprises $70,350,603 227 $28,085,728
Accounting, Tax Preparation, Bookkeeping, and Payroll Services
$69,869,102 591 $45,032,179
Management of Companies and Enterprises $69,809,921 296 $45,088,148
Electric Power Generation, Transmission, and Distribution
$65,690,239 62 $6,732,158
Internet Publishing and Broadcasting $60,837,958 158 $20,720,174
Management, Scientific, and Technical Consulting Services
$54,478,861 363 $38,570,780
Office Administrative Services $48,339,497 263 $38,527,798
Data Processing, Hosting, ISP, Web Search Portals and Related Services
$46,929,838 96 $9,776,333
Maintenance and Repair Construction of Nonresidential Structures
$45,999,535 298 $22,489,102
Insurance Agencies, Brokerages, and Related Activities $38,006,859 267 $19,011,680
Waste Management and Remediation Services $32,831,645 159 $10,158,006
TOTAL $2,649,120,305 18,331 $1,199,537,303
Note: Does not include all impacted industry sectors.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 25
Tax Revenue Impacts
Tax Revenue Impacts. Tax revenues are
also a source of impacts associated with
the hospitals. This includes property taxes
paid directly by the for profit hospitals as
well as tax revenues generated indirectly
by employees living in Santa Clara
County. Hospitals also pay sales taxes but
these expenditures are not available.
These tax revenues include payment by
both the direct employees of the hospitals
as well as the indirect employees of other
local businesses. Estimated annual tax
revenues total at least $609.7 million, to
the benefit of city, county, and state
government (see Table 8). This includes
property, sales, and personal income
taxes. The local share of these impacts
totals $130.2 million, flowing to city and
county governments.
Long-Term Construction Impacts
Santa Clara County’s hospitals are constantly
improving patient care through upgrading
their facilities. Construction efforts are driven
by multiple objectives, including meeting
stringent seismic requirements imposed by
the State of California. Most of the hospitals
provided information on estimated
construction costs for the next five years,
including 2012. These costs vary depending
upon the status of each hospital’s efforts to
meet California’s hospital seismic
requirements and other improvement or
expansion plans.
Planned Construction Activity. Eight of
the 11 Santa Clara County hospitals
provided capital construction funding
estimates over the next five years. The
most significant expansion will be at
Stanford Hospital and Clinics, Lucille
Packard Children’s Hospital, and Regional
Medical Center. All total, $4.0 billion in
current and future capital projects are
planned between 2012 and 2016 (see
Table 9). Expenditures will be even higher
since some VA projects do not yet have
cost estimates, the Regional Medical
Center figures do not include design fees,
OSHPD-related fees, and equipment
costs, and Kaiser Permanente was unable
to provide long-term construction data.
TABLE 8
Annual Indirect Tax Revenue Impacts (2011 dollars)
Entity
Local
State
Sales Property Sales Income
Direct Taxes Paid by Hospitals $0 $3,977,364
NA NA
Hospital Employees $10,011,054 $35,361,214
$31,284,544 $182,821,986
Other Supported Employees $23,965,252 $60,855,516
$74,891,413 $190,459,284
TOTAL $33,976,306 $96,216,729 $106,175,957 $373,281,270
July 2012 | Santa Clara County Hospitals Economic Impact Analysis
26 | ALH Urban & Regional Economics
TABLE 9
Five-Year Construction Expenditures Estimates
Hospital
Annual Construction ($ millions)
2012 2013 2014 2015 2016 TOTAL
El Camino Los Gatos & Mountain View $33.0 $66.2 $55.8 $43.5 $5.7 $204
Good Samaritan1 $32.5 $32.5 $32.5 $32.5 $32.5 $163
Kaiser Permanente Santa Clara2 NA NA NA NA NA NA
Kaiser Permanente San Jose2 NA NA NA NA NA NA
Lucile Packard Children's Hospital $75.6 $106.5 $211.7 $246.2 $312.3 $952
O'Connor $39.3 $28.1 $12.7 $11.4 $9.8 $101
Regional Medical Center $77.8 $77.8 $0.0 $0.0 $0.0 $156
Santa Clara Valley Medical Center $183.8 $289.2 $228.9 $50.9 $86.9 $840
Saint Louise Regional Hospital $0.0 $0.0 $0.0 $0.0 $0.0 $0
Stanford Hospital and Clinics $75.8 $117.5 $254.2 $417.0 $412.7 $1,277
Veteran's Administration Palo Alto Health System3 $157.9 $116.9 NA NA NA $275
TOTAL $675.6 $834.7 $795.8 $801.5 $859.9 $3,967
Notes: 1Good Samaritan anticipates $10–$15 million per year for routine capital and $100 million in new Emergency Department,
parking garage, and replacement of all operating room suites, which is spread equally across each of the five years. 2
Kaiser Permanente construction data not available. 3
Additional VA projects are identified for 2014 but costs have not yet been assigned.
Comparative Value of Construction
Projects. These hospital projects are
among the costliest construction projects
in Santa Clara County, especially when
considered in the aggregate. The
combined hospital construction costs are
greater than the costs for any other major
construction project, including such high
visibility projects as the new San Francisco
49ers Stadium in Santa Clara at $1.2
billion3 and the BART Warm Springs
Extension in Fremont at $890 million.4
Thus, hospital construction impacts are
greater than any other construction
impacts in all of Santa Clara County.
3http://www.sfgate.com/49ers/article/Cost-of-49ers-
Santa-Clara-stadium-now-1-2-billion-3406744.php. 4 http://www.bart.gov/about/projects/wsx/.
Construction Impacts. The level of
planned construction activity over the
next five years translates into a total
construction impact of $6.2 billion on the
Santa Clara County economy, 39,530
temporary jobs in construction and
related supplier industries, and $2.8 billion
in payroll over the next five years (see
Table 10). Although these are non-
recurring impacts, they are significant
during the construction period and will
comprise a significant contribution to
Santa Clara County’s economy and
employment base. These impacts are in
addition to the on-going operations
impacts of the hospitals in this study.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 27
TABLE 10
Construction Impacts of Santa Clara County Hospitals, 2012–2016 (2012 dollars)
Type of Impact Employment Income Output
Direct Impacts 24,950 $1,868,128,256 $3,967,585,000
Indirect Impacts 5,133 $403,939,507 $864,220,502
Induced Impacts 9,447 $523,749,004 $1,396,985,791
TOTAL IMPACTS 39,530 $2,795,816,768 $6,228,791,293
Construction Industry Support. As the
largest source of construction in Santa
Clara County the hospitals are fueling
growth of the county’s construction
sector. This includes construction jobs
during the three years prior to 2012, when
hospital construction projects kept
numerous building trade sub-contractors
in operation. Because of the nature of
hospital construction it is dominated by
specialized building trades, resulting in
jobs supported by the hospitals that are
well paid with strong employee benefits.
28 | ALH Urban & Regional Economics
V. HOSPITAL COMMUNITY
BENEFITS
Definition of Community Benefits
Santa Clara County’s hospitals provide an
extensive array of community benefits,
including subsidized or free medical care
services. A community benefit is a service,
program, or project provided or funded by
the hospital that either directly or indirectly
fulfills an ongoing need or service delivery
gap that has been identified through the
hospital’s needs assessment processes. The
primary purpose of a community benefit
program is to improve the health status of
the community in general or improve the
health status of a group of community
members for whom disparities exist.
Many of the hospitals are required to
periodically prepare and submit a Community
Benefit Report and Community Benefit Plan
to the State of California. These explain in
detail the hospital’s commitment to providing
community benefits, the type or programs
and services provided, and the value of the
associated benefits. Community benefit
services and programs typically fall within the
following general categories: benefits for
economically disadvantaged; benefits for the
broader community; and health research,
education, and training programs.
Value of Community Benefits
The information in the hospital Community
Benefit Reports and supplemental
information provided by some of the
hospitals indicates that the value of
community benefits provided by the hospitals
in fiscal year 2011 was $600 million. These
benefits represent substantial additional
impacts generated by the hospitals that go
far beyond the economic impacts, affecting
the quality of life for Santa Clara County’s
residents and especially vulnerable
populations.
The value of these community benefits is
broken down as follows:
$90 million in charity care
$285 million in Medi-Cal shortfall
$251million in a range of other
community benefits
As noted, Medi-Cal shortfall comprised the
largest category of community benefits
provided by the hospitals. This reflects
undercompensated costs of medical services
to government-covered patients that qualify
for Medi-Cal services. The value of these
services provided by the hospitals totaled
$285 million in fiscal year 2011. Charity care,
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 29
provided to patients lacking insurance,
totaled $90 million, for a combined total of
$375 million in free or subsidized medical
care.
The remaining $251 million in community
benefits covered a broad spectrum of
programs and services, such as grants and
donations, physician and non-physician
provider education and training programs,
health research, community health
improvement services, and community
building activities. For some hospitals this
figure also includes unpaid costs of Medicare.
30 | ALH Urban & Regional Economics
VI. LONG TERM CARE
FACILITY IMPACTS
Operating Impacts
In addition to the 11 hospitals that provide
acute and tertiary patient services, Santa Clara
County also boasts 62 long term care facilities
to provide care for people who cannot be
cared for at home or in the community. The
operations of these long term care facilities
also provide significant economic benefits to
Santa Clara County. These positive impacts
include the following:
Long Term Care Facility Impacts. The 62
long term care facilities in Santa Clara
County create jobs for nearly 6,400 full-
time equivalent employees. These
facilities as a whole generate an annual
economic impact of $843.7 million (see
Table 11). This is in addition to the
economic impacts generated by the
hospitals. The long term care facilities
directly and indirectly support 8,600 jobs
and $350.9 million in payroll.
Revenue Impacts
Revenue Impacts of Long Term Care
Facilities. The employees of these long
term care facilities, as well as the
supported employees at other local
businesses, also generate state and local
revenue impacts. Annual revenues from
property, sales, and personal income
taxes are estimated at $9.3 million (see
Table 12). These revenues benefit local
and state government, helping to support
local and statewide services.
TABLE 11
Annual Operations Impacts Santa Clara County Long Term Care Facilities
Type of Impact Employment Income Output
Direct Impacts 6,386 $225,954,072 $517,824,119
Indirect Impacts 706 $41,239,170 $102,673,784
Induced Impacts 1,508 $83,689,263 $223,220,156
TOTAL IMPACTS 8,600 $350,882,505 $843,718,058
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 31
TABLE 12
Annual Indirect Revenue Impacts
Type of Employee
Local
State
Sales Property Sales Income
Long Term Care $854,558 $9,667,225
$2,670,495 $3,694,386
Other Supported Employees $929,717 $3,351,352
$2,905,367 $5,614,220
TOTAL $1,784,276 $13,018,577 $5,575,862 $9,308,606
32 | ALH Urban & Regional Economics
VII. CONCLUSION
This study has estimated the economic
impact of hospital and hospital-related
expenditures in Santa Clara County. Hospitals
and hospital-related spending generate $14.3
billion in spending annually, create almost
64,000 jobs, and support $5.9 billion in
income and wages. Hospitals and other
medical establishments in Santa Clara County
generate a wide variety of employment
opportunities, providing employment for a
range of skilled and unskilled workers.
The wages and salaries for Santa Clara
County’s healthcare workers are 45% higher
than the average county job. Santa Clara
County’s healthcare worker average wages
and salaries are also 11% to 22% higher than
wages and salaries earned by healthcare
workers throughout California. Because of
these higher wages, hospitals in Santa Clara
County have the potential to create a greater
local economic impact than hospitals in many
other California locations. The healthcare
sector in Santa Clara County is the third
largest sector, and was one of the few sectors
that grew from 2000 to 2010.
Growth in the healthcare sector indicates that
the Santa Clara County hospital impacts are
only likely to grow over time. This is especially
the case given the high volumes of
construction planned by the hospitals, much
of which is targeted to meet California
seismic requirements for hospitals. The $3.8
billion in planned construction activities over
the next five years will result in a construction
impact of $6.0 billion on the Santa Clara
County economy, 38,329 temporary jobs in
construction and related supplier industries,
and $2.7 billion in payroll over the next five
years. Although these are non-recurring
impacts, they are significant during the
construction period and will comprise a
significant contribution to Santa Clara
County’s economy and employment base.
The hospitals’ impacts go far beyond
monetary and labor impacts. The county’s
hospitals provide an extensive array of
community benefits to economically
disadvantaged populations and the broader
community. In a given year these benefits are
valued at over $543 million, with $311 million
including free or subsidized medical care
through charity care or under-compensated
costs of government-funded programs, such
as Medi-Cal. These benefits represent
substantial additional impacts generated by
the hospitals, affecting the quality of life for
Santa Clara county’s residents and especially
vulnerable populations. Hence the hospitals
are a great source of economic and quality-
of-life enrichment for all of Santa Clara
County.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | 33
ASSUMPTIONS AND GENERAL LIMITING CONDITIONS
ALH Urban & Regional Economics has made
extensive efforts to confirm the accuracy and
timeliness of the information contained in this
study. Such information was compiled from a
variety of sources, including interviews with
government officials, review of City and
County documents, and other third parties
deemed to be reliable. Although ALH Urban
& Regional Economics believes all
information in this study is correct, it does not
warrant the accuracy of such information and
assumes no responsibility for inaccuracies in
the information by third parties. We have no
responsibility to update this report for events
and circumstances occurring after the date of
this report. Further, no guarantee is made as
to the possible effect on development of
present or future federal, state or local
legislation, including any regarding
environmental or ecological matters.
The accompanying projections and analyses
are based on estimates and assumptions
developed in connection with the study. In
turn, these assumptions, and their relation to
the projections, were developed using
currently available economic data and other
relevant information. It is the nature of
forecasting, however, that some assumptions
may not materialize, and unanticipated events
and circumstances may occur. Therefore,
actual results achieved during the projection
period will likely vary from the projections,
and some of the variations may be material to
the conclusions of the analysis.
Contractual obligations do not include access
to or ownership transfer of any electronic
data processing files, programs or models
completed directly for or as by-products of
this research effort, unless explicitly so agreed
as part of the contract.
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | A-1
APPENDIX A: TECHNICAL APPENDIX
The economic impacts shown in this report
are based on the economic theory of input-
output analysis. Input-output analysis relies
on large matrices of industry data showing
what is purchased and what is produced by
various segments of the economy. These
transaction matrices describe the
interconnectedness of the industries,
households, and government entities in a
specific geographic area. The output of one
industry will appear as the input of other
industries. Certain simplifying assumptions
are made, such as that productive resources
will always be combined in the same
proportions to produce any amount of a final
product. This makes it possible to determine
the total quantities of various goods that
must be produced to obtain a given amount
for final consumption.
Input-output models describe both the
transactions between a particular region and
the rest of the world (imports and exports), as
well as economic activities within a region. In
the case of hospitals, they purchase goods
and services from industries in the local
economy (and elsewhere in the world)
creating additional demand for production at
these industries. They also provide services
that are purchased by local households and
government.
In this case, the IMPLAN (IMpact analysis for
PLANning) input-output model was used to
derive multipliers used in the economic
impact analysis of hospitals in Santa Clara
County. The IMPLAN model was originally
developed by the U.S. Forest Service but is
now widely used by numerous state and
federal government agencies, academic
institutions, and private companies in the
United States. The IMPLAN software performs
calculations and provides an interface for
users to model final demand changes.
IMPLAN then estimates the ripple effects of
these changes in expenditures on the
county’s economic sectors through the use of
economic multipliers.
The IMPLAN model incorporates economic
base data for a specific geography, in this
case Santa Clara County, to describe
commodity flows from producers to
intermediate and final consumers. Industries
producing goods and services for final use
create final demand that drives the model.
Industries like hospitals purchase specific
types of goods and services from
intermediate and final producers who in turn
purchase goods from other industries. This
trickle down cycle can be described using
multipliers to show how a $1 change in final
demand (created in this case by hospitals)
translates into a given amount of additional
output, income and employment for other
local industries.
Multipliers are a numeric way of describing
the secondary impacts stemming from a
change in final demand. Using local economic
base data allows the model to control for the
types of buyers and suppliers that exist (or do
not exist) in the local area, and what must be
purchased outside the local area. This limits
the volume of transactions that can occur
locally and hence the size of the multipliers.
In addition to accounting for purchases
between industries or businesses, the IMPLAN
model also accounts for additional spending
by households. The households in this case
are the families of the hospital employees, as
A-2 | ALH Urban & Regional Economics
well as the families of employees at
supported local supplier industries.
Transactions between industries or businesses
are called indirect impacts, whereas
transactions between households and
businesses are called induced impacts. The
value of services produced by the hospitals in
this study represents the direct impacts.
Direct, indirect, and induced impacts can all
be quantified in terms of three variables:
output, income, and employment. The
application of these three types of impacts to
the hospitals in Santa Clara County is
described below.
Direct Impacts
Output—Value of services produced by
the hospitals, represented in this case by
total net revenues
Jobs—Total number of hospital FTEs
Income—Salaries and wages of hospital
employees
Indirect Impacts
Output—Amount of actual local
operating expenditures made by the
hospitals, which in turn translates into
increased demand for goods and services
from other local businesses
Jobs—Employees at local businesses
where hospitals make purchases
(estimated using IMPLAN multiplier data
based on increases in output by industry
type)
Income—Salaries and wages of
employees at local businesses where
hospitals make purchases (estimated
using IMPLAN multiplier data based on
increases in output by industry type)
Induced Impacts
Output—Amount of local consumer
spending by hospital employees and by
employees at local businesses where
hospitals make purchases (supplier
employees)
Jobs—Employees at local businesses
where hospital employees shop and
where supplier employees shop
(estimated using IMPLAN multiplier data
based on increases in output by industry
type)
Income—Salaries and wages of
employees at local businesses where
hospital and supplier employees shop
(estimated using IMPLAN multiplier data
based on increases in output by industry
type)
Santa Clara County Hospitals Economic Impact Analysis | July 2012
ALH Urban & Regional Economics | B-1
APPENDIX B: STUDY RESOURCES
Implan, Data set and software for Santa Clara County, 2010 data file, www.implan.com
Select Santa Clara County Hospital Annual Reports
Select Santa Clara County Hospital Community Benefits Reports for FY 2011
State of California Employment Development Department, “California Regional
Economies Employment Series for Santa Clara County”
http://www.labormarketinfo.edd.ca.gov/Content.asp?pageid=173
State of California Office of Statewide Health and Planning Development, System for Integrated
Electronic Reporting and Auditing, Annual Financial Disclosure Reports, Hospitals and Long
Term Care, http://siera.oshpd.ca.gov/annualfinancial.aspx
United States Bureau of Labor Statistics, Table 4: Consumer Price Index for all Urban Consumers
(CIP-U) U.S. Average, Hospital Services CPI Index, http://www.bls.gov/cpi/#publications
United States Bureau of Labor Statistics, “May 2011 Metropolitan and Non metropolitan Area
Occupational Employment and Wage Estimates San Jose-Sunnyvale-Santa Clara and the
State of California;” http://www.bls.gov/oes/current/oes_41940.htm; and
http://www.bls.gov/oes/current/oes_ca.htm