Hospital stays grow shorter, heart disease leading cause of hospitalization

The latest data on national trends in hospitalization show that the number of hospital discharges stabilized during the 1990s — after peaking in the early 1980s — but that the average length of a hospital stay continued to decline over the past decade. According to a report released today by the Centers for Disease Control and Prevention, the average length of stay for hospital inpatients was 5.0 days in 1999, down from 7.3 days in 1980, as measured by the National Hospital Discharge Survey, conducted by CDC's National Center for Health Statistics.

"This annual survey is an important source of information to monitor the health care that our citizens receive," said Dr. Jeffrey Koplan, CDC Director. "Efforts to improve quality and access depend upon timely information," he said.

The drop in inpatient hospitalization is attributed primarily to an increase in ambulatory or same-day surgery, made possible over the past 20 years with new surgical techniques and less invasive procedures. Treatment advances including new drug therapies have also contributed to fewer and shorter hospital stays as have as cost-management controls and alternative forms of health care organization and payment.

In 1980, the rate of hospitalization was 168 per 1,000 population. That rate dropped nearly 30 percent to 122 per 1,000 population in 1990 and was 116 per 1,000 in 1999. Between 1990 and 1999, the discharge rate among the 15-44 year-olds decreased 17 percent and the rate among those 45 to 64 was down 14 percent, but this was more than offset by an 11 percent increase for those 65 and older, to keep the overall rate fairly constant during the 1990s.

Women were hospitalized at a rate 45 percent higher than for men in 1999 (due in part to hospitalization for deliveries and other obstetric and gynecological diagnoses), but men had slightly longer hospital stays. The hospitalization rate varied widely by region, from 93 per 1,000 in the West to 133 in the Northeast.

Six diagnostic categories–heart disease, delivery, pneumonia, cancer, psychoses and fractures accounted for more than 13 million of the 32 million hospitalizations in 1999. Heart disease was the most frequent cause of hospitalization with 4.5 million discharges. Coronary atherosclerosis–a type of heart disease–accounted for over 1 million discharges; the number and rate of coronary atherosclerosis diagnoses more than doubled during the 1990s. Among those over 65, the rate more than tripled.

During 1999, over 41 million procedures were performed on hospital inpatients. Almost three-fourths of the procedures were in four categories: diagnostic and therapeutic procedures, obstetrical procedures, operations on the cardiovascular system and operations on the digestive system. Men had more cardiovascular procedures (particularly arteriography and angiocardiography, cardiac catheterization, removal of coronary artery obstruction and insertion of stents) than women, while women had higher rates of digestive surgery. About one-fourth of the operations on women were obstetrical procedures.

The National Hospital Discharge Survey collects data from a sample of inpatient records acquired from a national sample of non-Federal, short-stay hospitals, to produce the only nationally representative data available on this important segment of health care. For more about the survey visit the website at http://www.cdc.gov/nchs.

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