Section 5: Women's Health (PDF)

EXHIBIT 5.1 Overview of Female and Male Hospital Stays (PDF)
EXHIBIT 5.2 Common Conditions During Hospital Stays for Females (PDF)
EXHIBIT 5.3 Mood Disorders (PDF)
EXHIBIT 5.4 Procedures (PDF)
EXHIBIT 5.5 Children (PDF)
EXHIBIT 5.6 Childbirth (PDF)

• In 2009, almost 6 out of every 10 hospital stays were for females. Specifically, 42 percent of all stays were for males, 12 percent were for females hospitalized for pregnancy and childbirth (maternal stays), and 46 percent were for females hospitalized for non-maternal conditions.
• Females were more likely than males to be hospitalized across all communities and all regions. For example, the rate of hospitalization for females in the lowest income communities was 34 percent higher than males and the female hospitalization rate in the highest income communities was 38 percent higher. Similarly, females were 20-41 percent more likely than males to be hospitalized across all regions in the U.S.
• Medicare was the primary payer for the largest percentage of male stays (39 percent) and non-maternal female stays (45 percent).
• Forty-five percent of maternal stays had Medicaid as the primary payer.
• The number of uninsured hospital stays was similar for males (1.2 million) and females (1.1 million).
• The average length of hospital stay declined for males and non-maternal females from 5.2 to 4.8-4.9 days from 1997 to 2009; however, the average length of hospital stay increased slightly for maternal females from 2.5 to 2.7 days.
• On average, hospital stays for non-maternal females cost less than stays for males ($9,400 versus $10,400).
• Stays for maternal females cost an average of $3,900, less than half of the cost of a non-maternal stay.
• The total cost for hospital care in the U.S. was $361.5 billion in 2009—47 percent for males, 48 percent for non-maternal females, and 5 percent for maternal females.

• Pregnancy and childbirth was the most common reason for hospitalizations of females — 295 hospital stays per 10,000 population.
• Circulatory conditions were less common reasons for hospital stays for females (176 per 10,000 population) than for males (202 per 10,000 population). On the other hand, respiratory system conditions were more common for females (135 per 10,000 population) than for males (123 per 10,000 population).
• Hospitalization for urinary tract infections in females was 2.5 times higher than in males.
• Biliary tract hospital stays were 67 percent higher in females than males.
• Osteoarthritis occurred at a 47-percent higher rate in females than males.
• Compared with females, males had higher rates of hospitalization for coronary atherosclerosis (77 percent higher) and acute myocardial infarction, or heart attack (62 percent higher).
• Average hospital costs were lower for females than males for congestive heart failure, acute cerebrovascular disease, coronary atherosclerosis, and acute myocardial infarction.
• Hospital costs were similar for females and males for stays involving complication of device, implant or graft; osteoarthritis; spondylosis; and complication of surgical procedures or medical care.

• Females accounted for a higher rate of hospital stays for mood disorders in 2009 than males (41 stays per 10,000 population for females and 34 stays per 10,000 population for males).
• The rate of mood disorders has been greater for females compared with males over the 12-year period from 1997 to 2009. Females had a 42-percent higher rate of hospitalization for mood disorders than males in 1997, a difference that narrowed to 21 percent in 2009.
• The rate of stays for mood disorders was consistently higher among females than males across all age groups in 2009, with the exception of adults age 85 and older, where the rates were similar for males and females.
• The highest rate of hospitalization among females for mood disorders was in the Midwest (50 stays per 10,000 population)—2.5 times higher than the lowest rate in the West (20 stays per 10,000).
• The largest male-to-female difference in hospitalizations for mood disorders was in the South, where the hospitalization rate for females (34 per 10,000 population) was 36 percent higher than for males (25 per 10,000 population).

• The rate of cholecystectomy was 71 percent higher for females than for males.
• The rate of knee arthroplasty for females was 57 percent higher than for males.
• The rate of knee arthroplasty increased by 69 percent for females 65 to 84 years old (from 72 stays per 10,000 population in 1997 to 122 stays per 10,000 population in 2009), while it increased by only 55 percent for males (from 58 stays per 10,000 population in 1997 to 90 stays per 10,000 population in 2009).
• The rate of hip replacement for females was 38 percent higher than for males.
• Hip replacements for females age 45 to 64 years old increased by 81 percent from 10 per 10,000 population in 1997 to 17 per 10,000 population in 2009. The rate for males in this period nearly doubled, from 10 per 10,000 population in 1997 to 19 per 10,000 population in 2009.

• Asthma was a common condition among children 1 to 2, 3 to 5, 6 to 9, and 10 to 14 years old. Among 1 to 9 year olds, males had 64- to 75-percent higher rates of stays for asthma compared to females.
• Mood disorders were common among 10 to 14 and 15 to 17 year olds. Females 15 to 17 years old had a 70-percent higher rate of hospitalization for mood disorders in 2009 than males (46 female stays per 10,000 population versus 27 male stays per 10,000 population).
• Diagnostic spinal tap was a top five procedure among children less than 1, 1 to 2, 6 to 9, and 10 to 14 years old. Among 6 to 9 year olds, males had a higher rate of diagnostic spinal tap in the hospital than females (3 male stays versus 2 female stays per 10,000 children). For all other age groups, the rate of diagnostic spinal tap was similar between males and females.
• Appendectomy was frequently performed in children 3 to 5, 6 to 9, 10 to 14, and 15 to 17 years old. With the exception of children 3 to 5 years, males had 36- to 50-percent higher rates of appendectomy than females.

• There were 4.6 million maternal stays in 2009, up from 4.3 million in 1997.
• The rate of stays for childbirth among 20 to 24 year olds remained stable from 1997 to 2007 and then declined 14 percent from 2007 to 2009 (from 1,082 to 951 stays per 10,000 population).
• The rate of stays for childbirth among 25-34 year olds increased 20 percent between 1997 to 2007 (from 950 to 1,141 stays per 10,000 population) and then declined 13 percent to 1,012 stays per 10,000 population.
• The rate of vaginal deliveries decreased 16 percent, from 79 percent of all deliveries in 1997 to 66 percent in 2009. The rate of Cesarean sections increased by 60 percent between 1997 and 2009, from 21 percent of all deliveries to 34 percent of all deliveries.
• The highest rate of C-sections was for females 35-44 years old—44 percent of all deliveries in this age group were via C-section in 2009, a 52-percent increase since 1997 (when the C-section rate was 29 percent in this age group).
• For teenage births (15-19 years old), 24 percent of all deliveries were via C-section in 2009, up 71 percent from 14 percent in 1997.
• The rate of vaginal delivery with episiotomy decreased 66 percent — from 23 percent of all deliveries in 1997 to 8 percent in 2009.
• The rate of vaginal birth following induction increased 24 percent (from 124 to 154 stays per 1,000 deliveries). However, the increase for C-section following induction was even higher—a 73-percent increase from 1997 to 2009 (from 22 to 38 stays per 1,000 deliveries).
• The rate of vaginal birth after C-section declined 67 percent from 1997 to 2009 (from 42 to 14 stays per 1,000 deliveries).
• During this same time period, the rate of repeat C-sections nearly doubled from 77 to 149 repeat C-sections per 1,000 deliveries.

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