Washington State Hospital Association Health Information Program

1. Hospital Services Are Changing • Washington state is one of the leaders in efficient use of services. • Year-to-year differences in inpatient use patterns are small. • Larger shifts are seen over time, as patient populations and medical technology change. • Questions about data in this presentation? Contact Jane Feldman janef@wsha.org • Updated October 2006 Washington State Hospital Association Health Information Program

2. Over one-quarter of inpatient cases are deliveries and newborns Inpatient Stays by Service Lines Moms and babies are each counted as an inpatient stay. Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

3. Including newborns, about 1 in 5 inpatients are children under age 18 All Stays by Patient Age Non-Maternity Stays by Age Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

4. Ten non-maternity diagnoses (DRGs) account for 17% of all inpatient stays • DRG% of All Stays • 209 Hip joint replacement 2.3 • 430 Psychoses 2.3 • 89 Simple pneumonia, pleurisy 2.2 • 127 Heart failure & shock 2.0 • 359 Selected uterine procedures 1.6 • Rehabilitation 1.4 • 88 Chronic lung disease 1.3 • 182 Selected gastroenterological 1.3 • disorders • 14 Intracranial hemorrhage or 1.2 • cerebral infarction • 416 Septicemia age >17 1.2 • See slide notes. • Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

5. Over half of all hospital stays are insured by government programs Medicare, for the elderly, and Medicaid, for low-income patients, are major sources of hospital coverage. Inpatient Stays by Payer Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

6. Medicaid is a major insurer of children and young adults Hospital Insurer by Patient Age Patients are classified based on their primary insurer. Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

7. Two out of five inpatients are admitted from the emergency room Admission Source by Payer Inpatient Admits Most admits from the emergency room are covered by Medicare or private insurers. 52% 39% 9% Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

8. Four out of five patients are discharged to their homes Discharge Outcomes 18% of discharged patients receive long-term care, home health services, or care at another hospital. Data Source: Health Information Program Enhanced CHARS Inpatient file, CY2005 Washington State Hospital Association Health Information Program

9. Inpatient volume has increased 6 percent since 2001, 15 percent since 1997 Inpatient Discharges, including Births In 2005, admissions grew by 3% over the prior year. Data Source: Health Information Program Enhanced CHARS Inpatient files Washington State Hospital Association Health Information Program

10. Growth in hospital-based outpatient visits has stabilized in recent years Outpatient Visits Outpatient Visits include: ER visits, ambulatory surgeries, routine treatments. Data Source: DATABANK Quarterly Hospital Financial Reporting system Washington State Hospital Association Health Information Program

11. Inpatient use rates have grown very slowly, and outpatient rates have flattened More outpatient care may be occurring in facilities that are not hospital-based. Outpatient visits per 1000 population Inpatient visits per 1000 population See slide notes. Data Sources: DATABANK Quarterly Hospital Financial Reporting system, Health Information Program Enhanced CHARS Inpatient files, Washington State Office of Financial Management Washington State Hospital Association Health Information Program

12. Hospital-based primary care visits are increasing after several years of decline Outpatient visits per 1000 population Per capita emergency room visits increased by 15 percent since 2000. Primary Care Visits ER Visits Outpatient Surgeries Data Sources: DATABANK Quarterly Hospital Financial Reporting system, Washington State Office of Financial Management Washington State Hospital Association Health Information Program