Hospital Utilization and Turnover

The following information is from data obtained from the American Hospital Association (AHA), the Centers for Medicare and Medicaid Services (CMS) the Kaiser Family Foundation (KFF) and this study done by Health Affairs.

Hospital Inpatient Care

Overall, the number of admissions to U.S. hospitals and hospital inpatient censuses (hospital admissions times average length of stay) have been declining for decades. This is in spite of the fact that the U.S. population has both aged and increased substantially over the same period of time. In 1981 the U.S. population was just under 230 million and the median age for all U.S. citizens was about 30 years old. By 2014 the U.S. population had increased to over 318 million with a median age that’s over 37 years old. The following three graphs from AHA data show this declining hospital inpatient utilization:

Figure 1: Hospital censuses for all U.S. hospitals have been declining since 1981.

Figure 2: The total number of admissions to U.S. hospitals dropped significantly after the implementation of Diagnostic Related Groups (DRGs) as criteria for Medicare admissions in 1984. After rebounding slightly in the late nineties, they began to drop again in 2008.

Figure 3: Even during the years that hospital admissions were increasing (1995-2008) hospital censuses only increased slightly, if at all, because hospital stays have continued to decline. The average length of a hospitalization in the U.S. has dropped from 7.6 days in 1981 to 5.6 days in 2014.

Figure 4: The total number of admissions to hospitals in California has also been quite flat since 2001. In 2016 about 3 million patients were admitted to California hospitals which is slightly fewer than the 3.02 million patients admitted in 2001.

Figure 5: California hospital censuses followed national trends in that they were lower, on average, in 2016 than they were in 2001 since hospital stays have been decreasing.

Figure 6: The total number of Medicare recipients in California each year vs. Medicare admissions to California hospitals. Medicare recipients increased by 47% from 2001-2016.

Figure 7: The total number of Medi-Cal (California’s Medicaid) recipients in California each year vs. Medi-Cal admissions to California hospitals. Medi-Cal recipients increased by more than 100% from 2001-2016.

Figure 8: The Proportion of both Medicare and Medi-Cal patients admitted to California hospitals has been declining steadily each year since 2001.