Healthcare Cost and Utilization Project
HCUP Research Note

Hospital Inpatient Statistics, 1996

Summary

This Research Note provides descriptive statistics for U.S. hospital inpatient stays in 1996 using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. National estimates are provided for all discharges by principal diagnosis and by principal procedure. Statistics are presented on the number of discharges, mean length of stay, mean charges, charges in quartiles, percent who died in the hospital, percent male, and mean age. Diagnoses and procedures are categorized using the Clinical Classifications Software (CCS), formerly called Clinical Classifications for Health Policy Research (CCHPR). CCS is a system for collapsing diagnosis and procedure codes into clinically meaningful categories.

Key information from the Research Note is summarized here. Select to access the full text of Hospital Inpatient Statistics, 1996. Print versions of the HCUP Research Note (AHCPR Publication No. 99-0034) are available from the AHCPR Publications Clearinghouse (P.O. Box 8547, Silver Spring, MD 20907, Telephone 800-358-9295).

By Anne Elixhauser, Ph.D., and Claudia A. Steiner, M.D., M.P.H., Agency for Health Care Policy and Research

The unprecedented volume, pace, and variation of change in the U.S. health care system requires a new information paradigm in which State, Federal, and private-sector policymakers have timely and direct access to standardized databases and the tools for using them.

Through the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership to build a standardized, multi-State health data system, the Agency for Health Care Policy and Research (AHCPR) has taken the lead in developing databases, Web-based products, software tools, and statistical reports and in making them publicly available to policymakers, health system leaders, and researchers.

This report, Hospital Inpatient Statistics, 1996, is based on data from the latest year of the HCUP Nationwide Inpatient Sample (NIS). Hospital Inpatient Statistics, 1996 updates previously published statistical reports that presented data for 1992 and 1995. This report and its predecessors provide answers to the most common questions about hospital care, such as:

• What are the most frequent conditions requiring hospitalization? Coronary atherosclerosis with over 1.4 million admissions, followed by pneumonia with over 1.2 million admissions.
• What hospital stays are the most expensive? Organ transplantations have the highest mean total charges ($191,000), followed by tracheostomy ($148,000).
• How do the average mean charges for alternative treatments of benign uterine cancer compare? Abdominal hysterectomy ($9,660) is nearly 20 percent more expensive than vaginal hysterectomy ($8,120).
• What conditions have the highest rate of inhospital mortality? Cardiac arrest and ventricular fibrillation with mortality rates of 50 percent, followed by shock (49.8 percent) and malignant neoplasm without specification of site (29.6 percent).
• How are hospitalization patterns changing? The rates of many inpatient procedures are declining, often because these procedures are more cost-effectively performed on an outpatient basis. For example, from 1992 to 1996, the rate of inguinal and femoral hernia repairs performed on an inpatient bases declined nearly 50 percent.

The data presented in Hospital Inpatient Statistics, 1996, are organized using the Clinical Classifications Software (CCS), formerly called the Clinical Classifications for Health Policy Research (CCHPR). CCS collapses about 12,000 diagnosis codes and 3,500 procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) into a smaller number of clinically meaningful, relatively homogenous clusters. Without the CCS tool, researchers have two relatively unsatisfactory alternatives: They may work directly with the ICD-9-CM coded data, but 12,000 diagnosis codes and 3,500 procedure codes are cumbersome and often too detailed to be useful. Or they may use software that was designed to bundle or aggregate procedures for purposes of payment, such as diagnosis-related groups (DRGs). However, these "reimbursement groupers" mask clinically important details about procedures that were performed. CCS, a "clinical grouper," makes ICD-9-CM data more amenable to clinically focused statistical analyses.

Select NIS data are now available through HCUPnet, an interactive data repository which can accommodate specific queries on number of discharges, length of stay, charges, and inhospital mortality for diagnoses and procedures. NIS database releases can be purchased in CD-ROM form from the National Technical Information Service by calling 800-553-6847, or online at https://classic.ntis.gov/search/. Select to access more information on NIS and other HCUP databases, tools, and publications.

We invite you to tell us how you are using HCUP data and tools and to share suggestions of how these products might be improved to better meet your needs. Please E-mail us at hcup@ahrq.gov or send a letter to the address below:

Irene Fraser, Ph.D.
Director
Center for Organization and Delivery Studies
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 605
Rockville, MD 20852

Current as of September 1999

Send Questions & Comments to: hcup@ahrq.gov