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TABLE OF CONTENTS
CHAPTER 3.0: Utilization and Volume
Chart 3.1: Inpatient Admissions in Community Hospitals, 1987 – 2007
Chart 3.2: Total Inpatient Days in Community Hospitals, 1987 – 2007
Chart 3.3: Inpatient Admissions per 1,000 Persons, 1987 – 2007
Chart 3.4: Inpatient Days per 1,000 Persons, 1987 – 2007
Chart 3.5: Average Length of Stay in Community Hospitals, 1987 – 2007
Chart 3.6: Average Length of Stay in Community Hospitals by State, 2007
Chart 3.7: Emergency Department Visits and Emergency Departments in Community Hospitals, 1991 – 2007
Chart 3.8: Hospital Emergency Department Visits per 1,000 Persons, 1991 – 2007
Chart 3.9: Percent of Hospitals Reporting Emergency Department Capacity Issues by Type of Hospital, 2007
Chart 3.10: Percent of Hospitals Reporting Time on Ambulance Diversion in Last 12 Months
Chart 3.11: Conditions Hospitals Reported as Number One Factor Contributing toAmbulance Diversions, January 2007
Chart 3.12: Total Hospital Outpatient Visits in Community Hospitals, 1987 – 2007
Chart 3.13: Hospital Outpatient Visits per 1,000 Persons, 1987 – 2007
Chart 3.14: Percentage Share of Inpatient vs. Outpatient Surgeries, 1987 – 2007
Chart 3.1: Inpatient Admissions in Community Hospitals, 1987 – 2007
27
28
29
30
31
32
33
34
35
36
37
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Mill
ions
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Chart 3.2: Total Inpatient Days in Community Hospitals, 1987 – 2007
100
140
180
220
260
300
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Mill
ions
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Chart 3.3: Inpatient Admissions per 1,000 Persons, 1987 – 2007
0
20
40
60
80
100
120
140
160
180
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Inpa
tient
Adm
issi
ons
per
Tho
usan
d
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2007. Link: http://www.census.gov/popest/states/tables/NST-EST2007-01.xls.
Chart 3.4: Inpatient Days per 1,000 Persons, 1987 – 2007
0
200
400
600
800
1,000
1,200
1,400
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Inpa
tient
Day
s pe
r T
hous
and
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2007. Link: http://www.census.gov/popest/states/tables/NST-EST2007-01.xls.
Chart 3.5: Average Length of Stay in Community Hospitals, 1987 – 2007
7.2
7.2
7.2
7.2
7.2
7.1
7.0
6.7
6.5
6.2
6.1
6.0
5.9
5.8
5.7
5.7
5.7
5.6
5.6
5.6
5.5
0
1
2
3
4
5
6
7
8
9
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Day
s
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Chart 3.6: Average Length of Stay in Community Hospitals by State,2007
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
5.0 to 5.9 Days
4.0 to 4.9 Days
6.0 to 7.9 Days
> 8 Days
RI 5.2 DaysDE 6.3 DaysDC 6.7 Days
Chart 3.7: Emergency Department Visits and Emergency Departments(1) in Community Hospitals, 1991 – 2007
80
85
90
95
100
105
110
115
120
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Num
ber
of E
D V
isits
(M
illio
ns)
3,500
3,700
3,900
4,100
4,300
4,500
4,700
4,900
5,100
5,300
Em
erge
ncy
Dep
artm
ents
ED Visits Emergency Departments
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. (1) Defined as hospitals reporting ED visits in 2005 AHA Annual Survey.
Chart 3.8: Hospital Emergency Department Visits per 1,000 Persons,1991 – 2007
250
270
290
310
330
350
370
390
410
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Vis
its p
er T
hous
and
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2007. Link: http://www.census.gov/popest/states/tables/NST-EST2007-01.xls.
Chart 3.9: Percent of Hospitals Reporting Emergency Department Capacity Issues by Type of Hospital, 2007
Source: American Hospital Association 2007 Survey of Hospital Leaders.
25%
24%
27%
20%
30%
22%
18%
46%
11%
35%
47%
42%
73%
31%
65%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
All Hospitals
Non-teaching Hospitals
Teaching Hospitals
Rural Hospitals
Urban Hospitals
ED is "At" Capacity ED is "Over" Capacity
Chart 3.10: Percent of Hospitals Reporting Time on Ambulance Diversion in Last 12 Months
Source: American Hospital Association 2007 Survey of Hospital Leaders.
36%
30%
64%
17%
56%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
All Hospitals
Non-teaching
Teaching
Rural
Urban
Percentage of Hospitals
Chart 3.11: Conditions Hospitals Reported as Number One Factor Contributing to Ambulance Diversions, January 2007
Source: American Hospital Association 2007 Survey of Hospital Leaders.
4%
7%
12%
17%
29%
30%
0% 10% 20% 30% 40%
Lack of Psychiatric Beds
Lack of Specialty Physician Coverage
Staff Shortages
Lack of General Acute Care Beds
ED Overcrowded
Lack of Staffed Critical Care Beds
Percentage of Hospitals
Chart 3.12: Total Hospital Outpatient Visits in Community Hospitals,1987 – 2007
0
100
200
300
400
500
600
700
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Mill
ions
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Chart 3.13: Hospital Outpatient Visits per 1,000 Persons, 1987 – 2007
0
500
1,000
1,500
2,000
2,500
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Vis
its p
er T
hous
and
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2007. Link: http://www.census.gov/popest/states/tables/NST-EST2007-01.xls.
Chart 3.14: Percentage Share of Inpatient vs. Outpatient Surgeries,1987 – 2007
0%
20%
40%
60%
80%
100%
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Per
cent
age
of S
urge
ries
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
Inpatient Surgeries
Outpatient Surgeries