TABLE OF CONTENTS
HIGHLIGHTS
INTRODUCTION
HCUP PARTNERS
1. OVERVIEW
2. DIAGNOSES
3. PROCEDURES
4. COSTS
5. MHSA
SOURCES/METHODS
DEFINITIONS
FOR MORE INFO
ACKNOWLEDGMENTS
CITATION
FACTS & FIGURES 2008 PDF
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EXHIBIT 3.2 Most Frequent All-listed Procedures by Age (PDF)
Number of Discharges, Percent Distribution, and Growth for the Most Frequent All-listed Inpatient Hospital Procedures by Age Group, 1997 and 2008
| AGE GROUP AND ALL-LISTED CCS PROCEDURES |
NUMBER OF DISCHARGES IN THOUSANDS |
PERCENT OF AGE-SPECIFIC TOTAL DISCHARGES |
CUMULATIVE GROWTH |
| 1997 |
2008 |
1997 |
2008 |
1997-2008 |
| All ages, total discharges† |
34,679 |
39,885 |
|
|
15% |
| ‹ 1 year, total discharges |
4,426 |
4,775‡ |
100.0% |
100.0% |
8 |
| Prophylactic vaccinations and inoculations |
549 |
1,397 |
12.4 |
29.3 |
155 |
| Circumcision |
1,159 |
1,226‡ |
26.2 |
25.7 |
6 |
| Respiratory intubation and mechanical ventilation |
163 |
173‡ |
3.7 |
3.6 |
6 |
| Enteral and parenteral nutrition |
39 |
115 |
0.9 |
2.4 |
196 |
| Diagnostic spinal tap |
147 |
84 |
12.7 |
1.8 |
-43 |
| 1-17 years, total discharges |
1,821 |
1,574‡ |
100.0 |
100.0 |
-14 |
| Appendectomy |
74 |
78‡ |
4.1 |
4.9 |
5 |
| Repair of obstetric laceration |
58 |
53‡ |
3.2 |
3.4 |
-9 |
| Blood transfusion |
26 |
52 |
1.4 |
3.3 |
100 |
| Cancer chemotherapy |
43 |
41‡ |
2.4 |
2.6 |
-6 |
| Artificial rupture of membranes to assist delivery |
40 |
34‡ |
2.2 |
2.2 |
-15 |
| 18-44 years, total discharges |
9,444 |
10,354‡ |
100.0 |
100.0 |
6 |
| Cesarean section |
773 |
1,343 |
8.2 |
13.4 |
74 |
| Repair of obstetric laceration |
1,079 |
1,315 |
11.4 |
13.1 |
22 |
| Artificial rupture of membranes to assist delivery |
706 |
964 |
10.1 |
9.6 |
36 |
| Fetal monitoring |
952 |
925‡ |
7.5 |
9.2 |
-3 |
| Episiotomy |
813 |
329 |
8.6 |
3.3 |
-60 |
| 45-64 years, total discharges |
6,496 |
9,504 |
100.0 |
100.0 |
46 |
| Blood transfusion |
247 |
741 |
3.8 |
7.8 |
200 |
| Diagnostic cardiac catheterization, coronary arteriography |
578 |
655‡ |
8.9 |
6.9 |
13 |
| Respiratory intubation and mechanical ventilation |
186 |
415 |
2.9 |
4.4 |
123 |
| Upper gastrointestinal endoscopy |
275 |
392 |
4.2 |
4.1 |
42 |
| Percutaneous transluminal coronary angioplasty (PTCA) |
247 |
335 |
3.8 |
3.5 |
36 |
| 65-84 years, total discharges |
10,121 |
10,761‡ |
100.0 |
100.0 |
6 |
| Blood transfusion |
514 |
1,205 |
5.1 |
11.2 |
134 |
| Diagnostic cardiac catheterization, coronary arteriography |
738 |
686‡ |
7.3 |
6.4 |
-7 |
| Respiratory intubation and mechanical ventilation |
366 |
532 |
3.6 |
4.9 |
45 |
| Upper gastrointestinal endoscopy |
530 |
508‡ |
5.2 |
4.7 |
-4 |
| Echocardiogram |
306 |
371‡ |
2.8 |
3.4 |
21 |
| 85+ years, total discharges |
2,362 |
3,196 |
100.0 |
100.0 |
35 |
| Blood transfusion |
138 |
373 |
5.8 |
11.7 |
170 |
| Upper gastrointestinal endoscopy |
122 |
143 |
5.2 |
4.5 |
17 |
| Respiratory intubation and mechanical ventilation |
65 |
123 |
2.8 |
3.8 |
89 |
| Echocardiogram |
65 |
96 |
2.7 |
3.0 |
49 |
| Treatment, fracture or dislocation of hip and femur |
87 |
89‡ |
3.7 |
2.8 |
2 |
†Includes a small number of discharges (50,000 or 0.1 percent) with missing age.
‡ 2008 discharges are not statistically different from 1997 discharges at p‹0.05.
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 1997 and 2008. |
While some of the most frequent procedures varied by age group, some were common across several age groups.
- Blood transfusion was a top five procedure in all age groups except infants less than 1 year and individuals 18-44 years old. It was the third most common procedure for 1-17 year olds and the first for adults 45-64, 65-84, and 85 years and older. Blood transfusion was one of the fastest growing procedures from 1997 to 2008.
- Respiratory intubation and mechanical ventilation was common among four age groups (infants, adults 45-64, 65-84 years old, and 85 years and older) and represented 4 to 5 percent of discharges in each age group.
- Respiratory intubation and mechanical ventilation grew rapidly from 1997 to 2008 among 45-64 year olds (123 percent), 65-84 year olds (45 percent), and seniors 85 years and older (89 percent).
- Upper gastrointestinal endoscopy was common among 45-64 year olds and both senior age groups (65-84 and 85 years and older). From 1997 to 2008, the number of discharges grew for 45-64 year olds (42 percent) and patients 85 years and older (17 percent). For 65-84 year olds, however, the number of discharges remained fairly stable (4-percent decline).
- Diagnostic cardiac catheterization and coronary arteriography was common for 45-64 year olds (655,000 procedures) and 65-84 year olds (686,000 procedures), but the number of procedures grew negligibly.
- Echocardiogram was the fifth most frequent procedure for patients 65-84 years (371,000 stays) and the fourth most frequent procedure for patients 85 years and older (96,000 stays)
For infants:
- The most common procedures performed on infants were routine procedures, such as vaccinations (performed in 29.3 percent of infant stays) and circumcision (performed in 25.7 percent of infant stays).
- In 2008, 1.2 million circumcisions were completed in the hospital (56 percent of male liveborn infants).
- Procedures on infants also included those done for complex conditions affecting severely ill babies, such as respiratory intubation and mechanical ventilation (performed during 173,000 infant stays in 2008), enteral/parenteral nutrition (performed during 115,000 infant stays in 2008), and diagnostic spinal tap (performed during 84,000 infant stays in 2008).
- Enteral and parenteral nutrition, or tube feeding, during infant hospitalizations increased 196 percent whereas spinal tap procedures decreased 43 percent, compared with an 8-percent growth in all infant discharges from 1997 to 2008.
For children 1-17:
- Appendectomy was the most common procedure for 1-17 year olds, accounting for 4.9 percent of hospitalizations in this age group.
- Other top procedures common in stays for children included repair of obstetric laceration in teen deliveries, cancer chemotherapy, and artificial rupture of membranes to assist in teen delivery.
For adults 18-44:
- All five of the most common procedures were related to pregnancy and childbirth for adults 18-44 years old.
- C-sections and repair of obstetric laceration were the most frequently performed procedures each occurring in over 13 percent of all discharges in 2008.
- C-sections increased by 74 percent from 1997 to 2008.
- Episiotomy was the fifth most frequently occurring procedure in this age group, but decreased by 60 percent between 1997 and 2008.
- Artificial rupture of membranes to assist delivery also experienced rapid growth from 1997 to 2008 (up 36 percent), while fetal monitoring procedures declined slightly (down 3 percent).
For adults 45-64 and 65-84:
- In 2008, the top four most frequently performed procedures were the same for individuals 45-64 and 65-84 years old: blood transfusion, diagnostic cardiac catheterization and coronary arteriography, respiratory intubation and mechanical ventilation, and upper gastrointestinal endoscopy.
- Blood transfusion was the leading procedure for 45-64 year olds and 65-84 year olds.
- Diagnostic cardiac catheterization and coronary arteriography was the second most common procedure performed in each of these age groups.
For adults 85 years and older:
- For patients 85 years and older, treatment of a fracture or dislocation of the hip and femur was a top procedure performed during a hospital stay and appeared only in this age group.
- Discharges for treatment of a hip fracture or dislocation changed very little (2 percent) from 1997 to 2008, accounting for 89,000 stays in 2008.
- Twelve percent of all hospital stays for this age group involved a blood transfusion.
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