Hospitals

1
Hospitals
2
Hospital Types
Source Centers for Medicare and Medicaid Services
3
The Nations Health Dollar, CY 2000
Hospital and physician spending accounts for more
than half of all health spending.
Total Health Spending 1.3 Trillion
Note Other spending includes dentist services,
other professional services, home health, durable
medical products, over-the-counter medicines and
sundries, public health, research and
construction. Source CMS, Office of the Actuar
y, National Health Statistics Group.
4
Distribution of Personal Health Care Expenditures

by Type of Service, 1960-2000
The share of health spending on home health and
nursing homes has grown. Physician share has
stayed about the same while the hospital share
grew and then declined.
47.3
41.7
39.3
36.5
25.9
25.3
22.9
21.9
22.5
Service
15.8
16.4
15.2
11.4
10.8
8.6
8.2
8.2
6.6
5.6
3.6
2.9
2.1
Percent
1.1
0.2
Source CMS, Office of the Actuary, National
Health Statistics Group.
5
Per Capita Health Spending by Type of Serviceby
OECD Country, 1980-1999
Health spending is moving to outpatient settings.
United States
Switzerland
Japan
Germany
France
Denmark
Canada
Australia
Source OECD Health Data 2002.
6
Community Hospital ExpendituresInpatient and
Outpatient Shares for All Payers
Over the last 20 years there has been a
significant shift in the composition of health
services as more treatments are performed in the
outpatient setting.
Percent
Note Community hospitals are all non-federal,
short-term general, and special hospitals whose
activities are available to the public.
Source CMS, Office of the Actuary, National Hea
lth Statistics Group.
7
Number of Hospital Discharges and Average Length
of Stay,1980-2000
Hospital discharges and length of stay have
declined over the last two decades.
Note Non-Federal short-stay hospitals.
Source Health, United States, 2002, National Ce
nter for Health Statistics. Table 91.
8
Growth in Inpatient and Outpatient Expenditures
in Community Hospitals for All Payers, 1980-2000
Managed care contributed to the slower pace in
inpatient expenditure growth and the continued
move of services to outpatient settings that
began with the introduction of Medicare PPS.
Introduction of Medicare PPS
Growth of Managed Care
Outpatient
Inpatient
Calendar Year
Note Community hospitals are all non-federal,
short-term general and special hospitals whose
facilities are available to the public.
Source CMS, Office of the Actuary, National Hea
lth Statistics Group.
9
Table 2.3 Number of Hospital Beds per 1,000 Perso
ns by State, 2000
WA
ME
NH
VT
MT
ND
MN
OR
WI
NY
MA
ID
SD
MI
RI
WY
CT
PA
NJ
IA
OH
NE
DE
NV
IN
IL
MD
WV
UT
VA
DC
CO
CA
KS
MO
KY
NC
TN
OK
AR
SC
NM
AZ
AL
GA
MS
TX
LA
FL
AK
Low (1.9 - 2.5)
HI
Medium (2.6 - 3.9)
High (4.0 - 6.6)
National average is 3
Note Per 1,000 population. Source 2000 AHA An
nual Survey. Kaiser Family Foundation State
Health Facts Online.
10
Table 2.4 Number of Physicians per 100,000 Person
s by State, 1999
Availability of Physicians varies substantially
by state.
WA
ME
NH
VT
MT
ND
MN
OR
WI
NY
MA
ID
SD
MI
RI
WY
CT
PA
NJ
IA
OH
NE
DE
NV
IN
IL
MD
WV
UT
VA
DC
CO
CA
KS
MO
KY
NC
TN
OK
AR
SC
NM
AZ
AL
GA
MS
TX
LA
FL
AK
Low (179 - 240)
HI
Medium (241 - 290)
High (291 - 811)
National average is 285
Note Includes non-federal physicians only.
Source Physician Characteristics and Distributi
on in the U.S. 2001-2002. American Medical
Association. Kaiser Family Foundation State
Health Facts Online.
11
Table 2.5 Active Physicians per 100,000 Persons b
y Location, 1950-1998
Since 1950, urban areas have seen much more rapid
growth in physicians than rural areas.

Projection for 2000. Note Includes all active
physicians. Source AMA data from the Bureau of H
ealth Professions and Health, United States, 1993.
12
Board of Directors of Different Types of Hospitals
Source Eldenburg et al, 2001
13
Source Eldenburg et al, 2001
14
Determinants of Board Turnover
Source Eldenburg et al, 2001
15
Determinants of CEO Turnover
Source Eldenburg et al, 2001
16
Hospitals that Exit 1980-1996
Source Eldenburg et al, 2001
17
Eldenburg, Leslie, Benjamin E. Hermalin, Michael
S. Weisbach, and Marta Wosinska, Hospital
Governance, Performance Objectives, and
Organizational Form, NBER Working paper 8201,
April 2001.