STATISTICAL BRIEF #204 |
May 2016
Celeste M. Torio, Ph.D., M.P.H., and Brian J. Moore, Ph.D. Introduction Healthcare expenditures have maintained a relatively stable share of the Gross Domestic Product since 2009, reaching 17.5 percent in 2014.1 Hospital care expenditures in particular, which constitute the largest single component of healthcare spending, grew 4.1 percent in 2014.2 Although this is up from 3.5 percent in 2013, annual hospital care expenditure growth averaged 5.5 percent from 2008 through 2012.3 Policymakers are among those concerned with the burden of medical care expenses to governments, consumers, and insurers. Although only 7.2 percent of the U.S. population had a hospital inpatient stay in 2012, the mean expense per stay associated with those hospitalizations was over $18,000, making hospitalization one of the most expensive types of healthcare treatment.4,5 This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on costs of hospital inpatient stays in the United States in 2013. It describes the distribution of costs by expected primary payer and illustrates the conditions accounting for the largest percentage of each payer's hospital costs. The primary payers examined are Medicare, Medicaid, private insurance, and uninsured. The hospital costs represent the hospital's costs to produce the services—not the amount paid for services by payers—and they do not include the physician fees associated with the hospitalization. Findings Aggregate hospital inpatient costs and stays by payer, 2013 Figure 1 presents the distribution by expected primary payer for aggregate hospital costs and total hospital inpatient stays in 2013. |
|
Figure 1. Aggregate hospital costs and hospital stays by payer, 2013
Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 Figure 1. Aggregate hospital costs and hospital stays by payer, 2013. Figure 1 is a stacked bar chart that shows the percentage of aggregate hospital costs and hospital stays by payer in 2013. Aggregate costs for 2013 were $381.4 billion. Data show the percentage of aggregate hospital costs by payer: Medicare: 46%, Medicaid: 17%, Private insurance: 28%, Uninsured: 5%, Other/missing: 4%. Hospital stays totaled 35.6 million in 2013. Data show the percentage of hospital stays by payer: Medicare: 39%, Medicaid: 21%, Private insurance: 30%, Uninsured: 6%, Other/missing: 4%.
|
Table 1 presents the most expensive conditions treated in U.S. hospitals among all payers in 2013. |
Table 1. The 20 most expensive conditions treated in U.S. hospitals, all payers, 2013 | |||||
Rank | CCS principal diagnosis category | Aggregate hospital costs, $ millions | National costs, % | Number of hospital stays, thousands | Hospital stays, % |
---|---|---|---|---|---|
1 | Septicemia | 23,663 | 6.2 | 1,297 | 3.6 |
2 | Osteoarthritis | 16,520 | 4.3 | 1,023 | 2.9 |
3 | Liveborn | 13,287 | 3.5 | 3,765 | 10.6 |
4 | Complication of device, implant or graft | 12,431 | 3.3 | 632 | 1.8 |
5 | Acute myocardial infarction | 12,092 | 3.2 | 602 | 1.7 |
6 | Congestive heart failure | 10,218 | 2.7 | 882 | 2.5 |
7 | Spondylosis, intervertebral disc disorders, other back problems | 10,198 | 2.7 | 555 | 1.6 |
8 | Pneumonia | 9,501 | 2.5 | 961 | 2.7 |
9 | Coronary atherosclerosis | 9,003 | 2.4 | 458 | 1.3 |
10 | Acute cerebrovascular disease | 8,840 | 2.3 | 585 | 1.6 |
11 | Cardiac dysrhythmias | 7,178 | 1.9 | 710 | 2.0 |
12 | Respiratory failure, insufficiency, arrest (adult) | 7,077 | 1.9 | 387 | 1.1 |
13 | Complications of surgical procedures or medical care | 6,079 | 1.6 | 465 | 1.3 |
14 | Rehabilitation care, fitting of prostheses, and adjustment of devices | 5,373 | 1.4 | 390 | 1.1 |
15 | Mood disorders | 5,246 | 1.4 | 836 | 2.3 |
16 | Chronic obstructive pulmonary disease and bronchiectasis | 5,182 | 1.4 | 645 | 1.8 |
17 | Heart valve disorders | 5,151 | 1.4 | 123 | 0.3 |
18 | Diabetes mellitus with complications | 5,142 | 1.3 | 531 | 1.5 |
19 | Fracture of neck of femur (hip) | 4,861 | 1.3 | 303 | 0.9 |
20 | Biliary tract disease | 4,722 | 1.2 | 405 | 1.1 |
Total for top 20 conditions | 181,762 | 47.7 | 15,554 | 43.7 | |
Total for all stays | 381,439 | 100.0 | 35,598 | 100.0 | |
Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 |
Tables 2 through 5 list the 20 most expensive conditions for stays covered by Medicare, Medicaid, and private insurance and for uninsured stays in 2013.
|
Table 2. The 20 most expensive conditions billed to Medicare, 2013 | |||||
Rank | CCS principal diagnosis category | Aggregate hospital costs, $ millions | National costs, % | Number of hospital stays, thousands | Hospital stays, % |
---|---|---|---|---|---|
1 | Septicemia | 14,551 | 8.2 | 838 | 6.0 |
2 | Osteoarthritis | 9,090 | 5.1 | 568 | 4.1 |
3 | Congestive heart failure | 7,174 | 4.1 | 662 | 4.7 |
4 | Complication of device, implant or graft | 7,072 | 4.0 | 375 | 2.7 |
5 | Acute myocardial infarction | 6,660 | 3.8 | 346 | 2.5 |
6 | Pneumonia | 6,054 | 3.4 | 593 | 4.2 |
7 | Coronary atherosclerosis | 5,233 | 3.0 | 265 | 1.9 |
8 | Acute cerebrovascular disease | 4,900 | 2.8 | 376 | 2.7 |
9 | Cardiac dysrhythmias | 4,859 | 2.7 | 476 | 3.4 |
10 | Spondylosis, intervertebral disc disorders, other back problems | 4,315 | 2.4 | 237 | 1.7 |
11 | Respiratory failure, insufficiency, arrest (adult) | 4,162 | 2.4 | 248 | 1.8 |
12 | Fracture of neck of femur (hip) | 3,976 | 2.2 | 251 | 1.8 |
13 | Chronic obstructive pulmonary disease and bronchiectasis | 3,717 | 2.1 | 458 | 3.3 |
14 | Heart valve disorders | 3,617 | 2.0 | 85 | 0.6 |
15 | Rehabilitation care, fitting of prostheses, and adjustment of devices | 3,469 | 2.0 | 269 | 1.9 |
16 | Acute and unspecified renal failure | 3,215 | 1.8 | 348 | 2.5 |
17 | Complications of surgical procedures or medical care | 2,939 | 1.7 | 217 | 1.5 |
18 | Diabetes mellitus with complications | 2,441 | 1.4 | 219 | 1.6 |
19 | Urinary tract infections | 2,422 | 1.4 | 348 | 2.5 |
20 | Gastrointestinal hemorrhage | 2,306 | 1.3 | 234 | 1.7 |
Total for top 20 conditions | 102,169 | 57.8 | 7,411 | 53.0 | |
Total for all stays | 176,718 | 100.0 | 13,987 | 100.0 | |
Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 |
|
Table 3. The 20 most expensive conditions billed to Medicaid, 2013 | |||||
Rank | CCS principal diagnosis category | Aggregate hospital costs, $ millions | National costs, % | Number of hospital stays, thousands | Hospital stays, % |
---|---|---|---|---|---|
1 | Liveborn | 6,619 | 10.5 | 1,716 | 23.1 |
2 | Septicemia | 3,354 | 5.3 | 143 | 1.9 |
3 | Mood disorders | 1,582 | 2.5 | 238 | 3.2 |
4 | Complication of device, implant or graft | 1,453 | 2.3 | 68 | 0.9 |
5 | Pneumonia | 1,273 | 2.0 | 133 | 1.8 |
6 | Respiratory failure, insufficiency, arrest (adult) | 1,249 | 2.0 | 51 | 0.7 |
7 | Schizophrenia and other psychotic disorders | 1,220 | 1.9 | 132 | 1.8 |
8 | Previous C-section | 1,125 | 1.8 | 220 | 3.0 |
9 | Acute cerebrovascular disease | 1,061 | 1.7 | 44 | 0.6 |
10 | Cardiac and circulatory congenital anomalies | 1,001 | 1.6 | 15 | 0.2 |
11 | Congestive heart failure | 1,001 | 1.6 | 71 | 1.0 |
12 | Diabetes mellitus with complications | 978 | 1.5 | 110 | 1.5 |
13 | Acute myocardial infarction | 879 | 1.4 | 39 | 0.5 |
14 | Complications of surgical procedures or medical care | 824 | 1.3 | 59 | 0.8 |
15 | Trauma to perineum and vulva | 770 | 1.2 | 225 | 3.0 |
16 | Skin and subcutaneous tissue infections | 718 | 1.1 | 110 | 1.5 |
17 | Short gestation, low birth weight, and fetal growth retardation | 695 | 1.1 | 11 | 0.1 |
18 | Hypertension complicating pregnancy, childbirth and the puerperium | 675 | 1.1 | 109 | 1.5 |
19 | Biliary tract disease | 666 | 1.1 | 60 | 0.8 |
20 | Intracranial injury | 637 | 1.0 | 23 | 0.3 |
Total for top 20 conditions | 27,780 | 43.9 | 3,578 | 48.2 | |
Total for all stays | 63,297 | 100.0 | 7,417 | 100.0 | |
Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 |
|
Table 4. The 20 most expensive conditions billed to private insurance, 2013 | |||||
Rank | CCS principal diagnosis category | Aggregate hospital costs, $ millions | National costs, % | Number of hospital stays, thousands | Hospital stays, % |
---|---|---|---|---|---|
1 | Osteoarthritis | 6,280 | 5.8 | 386 | 3.6 |
2 | Liveborn | 5,797 | 5.4 | 1,758 | 16.2 |
3 | Spondylosis, intervertebral disc disorders, other back problems | 4,139 | 3.8 | 220 | 2.0 |
4 | Septicemia | 4,028 | 3.7 | 218 | 2.0 |
5 | Acute myocardial infarction | 3,230 | 3.0 | 153 | 1.4 |
6 | Complication of device, implant or graft | 3,121 | 2.9 | 150 | 1.4 |
7 | Coronary atherosclerosis | 2,478 | 2.3 | 121 | 1.1 |
8 | Acute cerebrovascular disease | 1,990 | 1.8 | 112 | 1.0 |
9 | Complications of surgical procedures or medical care | 1,872 | 1.7 | 153 | 1.4 |
10 | Pneumonia | 1,605 | 1.5 | 170 | 1.6 |
11 | Cardiac dysrhythmias | 1,524 | 1.4 | 154 | 1.4 |
12 | Congestive heart failure | 1,451 | 1.3 | 97 | 0.9 |
13 | Biliary tract disease | 1,449 | 1.3 | 135 | 1.2 |
14 | Mood disorders | 1,431 | 1.3 | 255 | 2.3 |
15 | Fracture of lower limb | 1,300 | 1.2 | 78 | 0.7 |
16 | Previous C-section | 1,205 | 1.1 | 238 | 2.2 |
17 | Trauma to perineum and vulva | 1,202 | 1.1 | 346 | 3.2 |
18 | Secondary malignancies | 1,178 | 1.1 | 65 | 0.6 |
19 | Respiratory failure, insufficiency, arrest (adult) | 1,161 | 1.1 | 57 | 0.5 |
20 | Maintenance chemotherapy, radiotherapy | 1,129 | 1.0 | 72 | 0.7 |
Total for top 20 conditions | 47,569 | 44.1 | 4,939 | 45.5 | |
Total for all stays | 107,798 | 100.0 | 10,852 | 100.0 | |
Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 |
|
Table 5. The 20 most expensive conditions for uninsured individuals, 2013 | |||||
Rank | CCS principal diagnosis category | Aggregate hospital costs, $ millions | National costs, % | Number of hospital stays, thousands | Hospital stays, % |
---|---|---|---|---|---|
1 | Septicemia | 1,054 | 5.7 | 62 | 3.0 |
2 | Acute myocardial infarction | 913 | 4.9 | 45 | 2.2 |
3 | Acute cerebrovascular disease | 629 | 3.4 | 37 | 1.8 |
4 | Diabetes mellitus with complications | 493 | 2.7 | 66 | 3.2 |
5 | Biliary tract disease | 472 | 2.5 | 46 | 2.2 |
6 | Skin and subcutaneous tissue infections | 471 | 2.5 | 76 | 3.7 |
7 | Mood disorders | 407 | 2.2 | 98 | 4.7 |
8 | Coronary atherosclerosis | 390 | 2.1 | 23 | 1.1 |
9 | Pancreatic disorders (not diabetes) | 376 | 2.0 | 45 | 2.2 |
10 | Fracture of lower limb | 375 | 2.0 | 23 | 1.1 |
11 | Intracranial injury | 357 | 1.9 | 19 | 0.9 |
12 | Alcohol-related disorders | 350 | 1.9 | 61 | 3.0 |
13 | Pneumonia | 346 | 1.9 | 42 | 2.0 |
14 | Congestive heart failure | 342 | 1.8 | 32 | 1.6 |
15 | Crushing injury or internal injuryb | 340 | 1.8 | 17 | 0.8 |
16 | Liveborn | 323 | 1.7 | 167 | 8.0 |
17 | Respiratory failure, insufficiency, arrest (adult) | 281 | 1.5 | 18 | 0.9 |
18 | Complication of device, implant or graft | 270 | 1.5 | 14 | 0.7 |
19 | Appendicitis | 270 | 1.5 | 28 | 1.4 |
20 | Cardiac dysrhythmias | 227 | 1.2 | 26 | 1.3 |
Total for top 20 conditions | 8,685 | 46.8 | 945 | 45.7 | |
Total for all stays | 18,547 | 100.0 | 2,071 | 100.0 | |
Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013 |
Data Source The estimates in this Statistical Brief are based upon data from the Healthcare Cost and Utilization Project (HCUP) 2013 National Inpatient Sample (NIS). The statistics were generated from HCUPnet, a free, online query system that provides users with immediate access to the largest set of publicly available, all-payer national, regional, and State-level hospital care databases from HCUP.6 Definitions Diagnoses, ICD-9-CM, and Clinical Classifications Software (CCS) The principal diagnosis is that condition established after study to be chiefly responsible for the patient's admission to the hospital. ICD-9-CM is the International Classification of Diseases, Ninth Revision, Clinical Modification, which assigns numeric codes to diagnoses. There are approximately 14,000 ICD-9-CM diagnosis codes. CCS categorizes ICD-9-CM diagnosis codes into a manageable number of clinically meaningful categories.7 This clinical grouper makes it easier to quickly understand patterns of diagnoses. CCS categories identified as Other typically are not reported; these categories include miscellaneous, otherwise unclassifiable diagnoses. Types of hospitals included in the HCUP National Inpatient Sample The National Inpatient Sample (NIS) is based on data from community hospitals, which are defined as short-term, non-Federal, general, and other hospitals, excluding hospital units of other institutions (e.g., prisons). The NIS includes obstetrics and gynecology, otolaryngology, orthopedic, cancer, pediatric, public, and academic medical hospitals. Excluded are long-term care facilities such as rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals. Beginning in 2012, long-term acute care hospitals are also excluded. However, if a patient received long-term care, rehabilitation, or treatment for a psychiatric or chemical dependency condition in a community hospital, the discharge record for that stay will be included in the NIS. Unit of analysis The unit of analysis is the hospital discharge (i.e., the hospital stay), not a person or patient. This means that a person who is admitted to the hospital multiple times in 1 year will be counted each time as a separate discharge from the hospital. Costs and charges Total hospital charges were converted to costs using HCUP Cost-to-Charge Ratios based on hospital accounting reports from the Centers for Medicare & Medicaid Services (CMS).8 Costs reflect the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility costs; charges represent the amount a hospital billed for the case. For each hospital, a hospital-wide cost-to-charge ratio is used. Hospital charges reflect the amount the hospital billed for the entire hospital stay and do not include professional (physician) fees. For the purposes of this Statistical Brief, aggregate costs are reported to the nearest million. How HCUP estimates of costs differ from National Health Expenditure Accounts There are a number of differences between the costs cited in this Statistical Brief and spending as measured in the National Health Expenditure Accounts (NHEA), which are produced annually by CMS.9 The largest source of difference comes from the HCUP coverage of inpatient treatment only in contrast to the NHEA inclusion of outpatient costs associated with emergency departments and other hospital-based outpatient clinics and departments as well. The outpatient portion of hospitals' activities has been growing steadily and may exceed half of all hospital revenue in recent years. On the basis of the American Hospital Association Annual Survey, 2012 outpatient gross revenues (or charges) were about 44 percent of total hospital gross revenues.10 Smaller sources of differences come from the inclusion in the NHEA of hospitals that are excluded from HCUP. These include Federal hospitals (Department of Defense, Veterans Administration, Indian Health Services, and Department of Justice [prison] hospitals) as well as psychiatric, substance abuse, and long-term care hospitals. A third source of difference lies in the HCUP reliance on billed charges from hospitals to payers, adjusted to provide estimates of costs using hospital-wide cost-to-charge ratios, in contrast to the NHEA measurement of spending or revenue. HCUP costs estimate the amount of money required to produce hospital services, including expenses for wages, salaries, and benefits paid to staff as well as utilities, maintenance, and other similar expenses required to run a hospital. NHEA spending or revenue measures the amount of income received by the hospital for treatment and other services provided, including payments by insurers, patients, or government programs. The difference between revenues and costs include profit for for-profit hospitals or surpluses for nonprofit hospitals. Payer Payer is the expected payer for the hospital stay. To make coding uniform across all HCUP data sources, payer combines detailed categories into general groups:
Hospital stays billed to the State Children's Health Insurance Program (SCHIP) may be classified as Medicaid, Private Insurance, or Other, depending on the structure of the State program. Because most State data do not identify patients in SCHIP specifically, it is not possible to present this information separately. For this Statistical Brief, when more than one payer is listed for a hospital discharge, the first-listed payer is used. About HCUP The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases bring together the data collection efforts of State data organizations, hospital associations, and private data organizations (HCUP Partners) and the Federal government to create a national information resource of encounter-level healthcare data. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on a broad range of health policy issues, including cost and quality of health services, medical practice patterns, access to healthcare programs, and outcomes of treatments at the national, State, and local market levels. HCUP would not be possible without the contributions of the following data collection Partners from across the United States: Alaska State Hospital and Nursing Home Association Arizona Department of Health Services Arkansas Department of Health California Office of Statewide Health Planning and Development Colorado Hospital Association Connecticut Hospital Association District of Columbia Hospital Association Florida Agency for Health Care Administration Georgia Hospital Association Hawaii Health Information Corporation Illinois Department of Public Health Indiana Hospital Association Iowa Hospital Association Kansas Hospital Association Kentucky Cabinet for Health and Family Services Louisiana Department of Health and Hospitals Maine Health Data Organization Maryland Health Services Cost Review Commission Massachusetts Center for Health Information and Analysis Michigan Health & Hospital Association Minnesota Hospital Association Mississippi Department of Health Missouri Hospital Industry Data Institute Montana MHA - An Association of Montana Health Care Providers Nebraska Hospital Association Nevada Department of Health and Human Services New Hampshire Department of Health & Human Services New Jersey Department of Health New Mexico Department of Health New York State Department of Health North Carolina Department of Health and Human Services North Dakota (data provided by the Minnesota Hospital Association) Ohio Hospital Association Oklahoma State Department of Health Oregon Association of Hospitals and Health Systems Oregon Office of Health Analytics Pennsylvania Health Care Cost Containment Council Rhode Island Department of Health South Carolina Revenue and Fiscal Affairs Office South Dakota Association of Healthcare Organizations Tennessee Hospital Association Texas Department of State Health Services Utah Department of Health Vermont Association of Hospitals and Health Systems Virginia Health Information Washington State Department of Health West Virginia Health Care Authority Wisconsin Department of Health Services Wyoming Hospital Association About Statistical Briefs HCUP Statistical Briefs are descriptive summary reports presenting statistics on hospital inpatient and emergency department use and costs, quality of care, access to care, medical conditions, procedures, patient populations, and other topics. The reports use HCUP administrative healthcare data. About the NIS The HCUP National Inpatient Sample (NIS) is a national database of hospital inpatient stays. The NIS is nationally representative of all community hospitals (i.e., short-term, non-Federal, nonrehabilitation hospitals). The NIS includes all payers. It is drawn from a sampling frame that contains hospitals comprising more than 95 percent of all discharges in the United States. The vast size of the NIS allows the study of topics at the national and regional levels for specific subgroups of patients. In addition, NIS data are standardized across years to facilitate ease of use. Over time, the sampling frame for the NIS has changed; thus, the number of States contributing to the NIS varies from year to year. The NIS is intended for national estimates only; no State-level estimates can be produced. The 2012 NIS was redesigned to optimize national estimates. The redesign incorporates two critical changes:
About the HCUPnet HCUPnet is an online query system that offers instant access to the largest set of all-payer healthcare databases that are publicly available. HCUPnet has an easy step-by-step query system that creates tables and graphs of national and regional statistics as well as data trends for community hospitals in the United States. HCUPnet generates statistics using data from HCUP's National (Nationwide) Inpatient Sample (NIS), the Kids' Inpatient Database (KID), the Nationwide Emergency Department Sample (NEDS), the Nationwide Readmissions Database (NRD), the State Inpatient Databases (SID), and the State Emergency Department Databases (SEDD). For More Information For more information about HCUP, visit http://www.hcup-us.ahrq.gov/. For additional HCUP statistics, visit HCUP Fast Stats at https://datatools.ahrq.gov/hcup-fast-stats for easy access to the latest HCUP-based statistics for health information topics, or visit HCUPnet, our interactive query system, at https://datatools.ahrq.gov/hcupnet. For information on other hospitalizations in the United States, refer to the following HCUP Statistical Briefs located at http://www.hcup-us.ahrq.gov/reports/statbriefs/statbriefs.jsp:
For a detailed description of HCUP and more information on the design of the National Inpatient Sample (NIS), please refer to the following database documentation: Agency for Healthcare Research and Quality. Overview of the National (Nationwide) Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality. Updated November 2015. http://www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed February 17, 2016. Suggested Citation Torio C (AHRQ), Moore B (Truven Health Analytics). National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. HCUP Statistical Brief #204. May 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.pdf. *** AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of healthcare in the United States. We also invite you to tell us how you are using this Statistical Brief and other HCUP data and tools, and to share suggestions on how HCUP products might be enhanced to further meet your needs. Please e-mail us at hcup@ahrq.gov or send a letter to the address below:David Knutson, Director Center for Delivery, Organization, and Markets Agency for Healthcare Research and Quality 5600 Fishers Lane Rockville, MD 20857 1 Centers for Medicare & Medicaid Services. Table 01 National Health Expenditures; Aggregate and per Capita Amounts, Annual Percent Change and Percent Distribution: Selected Calendar Years 1960-2014. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Tables.zip. Accessed March 9, 2016. 2 Martin AB, Hartman M, Benson J, Caitlin A. National health spending in 2014: faster growth driven by coverage expansion and prescription drug spending. Health Affairs. Epub ahead of print 2015; doi: 10.1377/hlthaff.2015.1194. 3 Ibid. 4 Carper K, Stagnitti MN. National Health Care Expenses in the U.S. Civilian Noninstitutionalized Population, 2012. Statistical Brief #457. November 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://meps.ahrq.gov/mepsweb/data_files/publications/st457/stat457.shtml. Accessed February 24, 2016. 5 Estimates of costs in this Statistical Brief differ from the healthcare expenses collected in the Medical Expenditure Panel Survey (MEPS) cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The Healthcare Cost and Utilization Project (HCUP) is based on billed charges, which are converted to estimates of the costs of producing hospital services using hospital-wide cost-to-charge ratios, whereas MEPS expenses represent payments to hospitals, physicians, and other healthcare providers and include amounts paid by individuals, private insurance, Medicare, Medicaid, and other payment sources. For more details, see Costs and charges in the Definitions section. 6 Agency for Healthcare Research and Quality. HCUPnet website. https://datatools.ahrq.gov/hcupnet. Accessed March 7, 2016. 7 Agency for Healthcare Research and Quality. HCUP Clinical Classifications Software (CCS). Healthcare Cost and Utilization Project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality. Updated June 2015. http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp. Accessed February 17, 2016. 8 Agency for Healthcare Research and Quality. HCUP Cost-to-Charge Ratio (CCR) Files. Healthcare Cost and Utilization Project (HCUP). 2001â2013. Rockville, MD: Agency for Healthcare Research and Quality. Updated November 2015. http://www.hcup-us.ahrq.gov/db/state/costtocharge.jsp. Accessed February 17, 2016. 9 For additional information about the NHEA, see Centers for Medicare & Medicaid Services (CMS). National Health Expenditure Data. CMS website May 2014. http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html?redirect=/NationalHealthExpendData/. Accessed February 17, 2016. 10 American Hospital Association. TrendWatch Chartbook, 2014. Table 4.2. Distribution of Inpatient vs. Outpatient Revenues, 1992-2012. Original source is no longer available on the Web; for related information refer to TrendWatch Chartbook, 2018. Table 4.2. Distribution of Inpatient vs. Outpatient Revenues, 1995-2016. www.aha.org/system/files/2018-05/2018-chartbook-table-4-2.pdf. Accessed October 14, 2019. |
Internet Citation: Statistical Brief #204. Healthcare Cost and Utilization Project (HCUP). April 2016. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.jsp?ref=assumaocontroledesuasaudecom. |
Are you having problems viewing or printing pages on this website? |
If you have comments, suggestions, and/or questions, please contact hcup@ahrq.gov. |
Privacy Notice, Viewers & Players |
Last modified 4/28/16 |