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Medical Letter on the CDC & FDA October 20, 2002

October 20, 2002

HEALTHCARE FINANCING: Hospital charges are rising while length of hospital stays is falling

BODY:
The average hospital charge for treating a patient admitted for a heart attack increased by roughly one-third from 1993 to 2000, according to trend data from the Agency for Healthcare Research and Quality (AHRQ) on all hospital patients in the United States, including those with private insurance, Medicare, Medicaid or no health insurance.

HCUPnet (www.ahrq.gov/data/hcup/hcupnet.htm), the agency's interactive, online hospital statistics tool, showed that the total average charge for treating a heart attack patient rose from $20,578 in 1993 to $28,663 in 2000, while during the same period the average number of days a patient spent in the hospital fell by 26% - from 7.4 days to 5.5 days. The total average charge is what hospitals charge for services, such as nursing care, laboratory analyses, diagnostic tests, medications, use of operating rooms and patient rooms, but not physicians' fees. Hospital charges are generally higher than the amounts that facilities are reimbursed by public and commercial insurers. Average total charges for many other high-cost conditions also increased between 1993 and 2000, according to the latest trend data available from AHRQ, while the time patients spent in the hospital decreased.

New technologies and rising medication costs explain much of the increase in average hospital charges, while economic pressures have contributed to shortening the average patient stay for most conditions.

Other conditions for which charges have increased and patient stays have decreased are:

*Blood poisoning (septicemia) - from $17,909 to $24,365. The average hospital stay declined from 10.0 days to 8.2 days.

*Heart rhythm disturbances (cardiac dysrhythmias) - from $10,152 to $14,213. Average hospital stays declined from 4.7 days to 3.6 days.

*Stroke (acute cerebral vascular disease) - from $15,365 to $19,956. Average hospital stays fell from 9.5 days to 6.7 days.

*Diabetes - from $11,021 to $14,779. Average hospital stays declined from 7.4 days to 5.6 days.

*Pneumonia - from $12,860 to $15,104. Average hospital stays decreased from 7.8 days to 6 days.

*Congestive heart failure - from $11,995 to $15,293. Average hospital stays declined from 7.4 days to 5.6 days.

*Nonspecific chest pain - from $5135 to $7543. Average hospital stays fell from 2.5 days to 1.8 days.

*Chronic obstructive lung diseases - from $11,263 to $12,491. Average hospital stays declined from 7.2 days to 5.3 days.
These statistics were obtained by going to HCUPnet, selecting "Start HCUPnet" and then selecting the "Trend" tab to search for various diagnoses. The 1993 average total charges have been adjusted to 2000 dollars, using the Consumer Price Index.

This article was prepared by Medical Letter on the CDC & FDA editors from staff and other reports.