43
HOSPI TALS IN INTEGRATED SYSTEMS
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
HOSPITALS/SYSTEMS DIGEST 2013
Data source: IMS Health © 2013
UT I L I ZAT ION
Most U.S. Hospital Utilization Occurs in System Facilities
• Continuing a five-year trend, hospitals
affiliated with highly integrated health systems
recorded more admissions, patient-days,
outpatient visits and total surgical operations
than their nonsystem counterparts in 2011.
• Yet the system-affiliated portions of total
admissions, patient-days and outpatient
visits dipped between 2010 and 2011. This
pattern was most noticeable for outpatient
visits, to 53.6% from 54.2% the previous year.
Total hospital utilization, 2011
1
Utilization measure
Hospitals in Systems % of Total
Hospitals Not
in Systems
2
% of Total
All Hospitals
Total Facility Admissions
20,131,095
56.7%
15,345,183
43.3%
35,476,278
Total Facility Patient-Days
98,686,386
56.6
75,591,476
43.4
174,277,862
Total Outpatient Visits
233,584,086
53.6
202,566,806
46.4
436,150,892
Total Inpatient Surgeries
5,567,947
57.1
4,189,269
42.9
9,757,216
Total Outpatient Surgeries
9,382,098
54.8
7,727,932
45.2
17,110,030
Total Surgical Operations
14,950,045
55.6
11,917,201
44.4
26,867,246
Utilization per Short-Term Bed Ratios at System Hospitals Exceed Nonsystem Averages
• Even after a slight decline between 2010
(53.1) and 2011 (52.3), hospitals affiliated with
highly integrated systems recorded more
hospital admissions per short-term bed than
the nonsystem or overall hospital averages.
• Further, such facilities also reported a 12.0% gain
in the number of emergency department visits
per short-term bed between 2010 (274.4) and
2011 (307.4). This ratio for nonsystem-affiliated
hospitals was 251.5 (up just 1.7% from 247.4).
Hospital utilization per short-term staffed bed
1
Hospitals in Systems
Hospitals Not
in Systems
2
ALL HOSPITALS
Utilization MEASURE
2010
2011
2010
2011
2010
2011
Hospital Admissions/Short-Term Bed
53.1
52.3
44.5
43.7
48.2
47.4
Outpatient Visits/Short-Term Bed
1,020.7 1,072.1
979.7
1,012.2
997.4
1,038.0
Inpatient Surgeries/Short-Term Bed
15.0
14.8
13.3
13.5
14.1
14.1
Outpatient Surgeries/Short-Term Bed
38.5
39.1
39.1
40.8
38.8
40.0
Total Surgeries/Short-Term Bed
52.5
53.0
50.9
52.9
51.6
52.9
Emergency Dept. Visits/Short-Term Bed
274.4
307.4
247.4
251.5
259.3
276.2
1
Hospital data are based on all short-term, acute-care, nonfederal hospitals. Average occupancy and average length of stay represent only the
acute-care portion of the hospitals’ occupancy. All data are as of December 31, 2011.
2
Includes system hospitals that were not part of highly integrated systems and hospitals that were not part of any system.
Key Takeaway
Hospitals tied to highly integrated health systems may be using their affiliations with health plans to
reduce total admissions and patient-days: both of these figures declined faster at system hospitals
than at nonsystem facilities between 2010 and 2011. However, the opposite was true for total
emergency department (ED) visits, which grew by 0.9% for system-tied hospitals vs. 0.5% for nonsystem
(data not shown). This gap may narrow as preventive care measures of the Affordable Care Act
come into play and system hospitals further leverage HMO relationships to reduce ED utilization.
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