Trends in Hospital Inpatient Stays

2/13/2018 Trends in Hospital Inpatient Stays by Age and Payer, 2000-2015 #235
Trends in Hospital Inpatient Stays by Age
and Payer, 20002015
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STATISTICAL BRIEF #235
January 2018 Highlights
Between 2000 and 2015, the
Trends in Hospital Inpatient Stays by Age and population rate of
nonneonatal, nonmaternal
Payer, 20002015 inpatient stays dropped for
all age groups; the largest
percentage decrease (25
Ruirui Sun, Ph.D., Zeynal Karaca, Ph.D., and Herbert S. Wong, Ph.D. percent) was among patients
aged 65 years and over.
Introduction
Between 2000 and 2015, for
The utilization of hospital care is related to and affected by changes in population all age groups under 65
characteristics, as well as market forces. In terms of population characteristics, years old the share of
growth in general and growth of the older adult population in particular may uninsured stays reached its
contribute to hospital visits.1 The U.S. population has grown in the past decades, and 16year low in 2015.
the population of older adults has grown disproportionately.2 Projections show that
one in five Americans will be 65 years or older by 2030.3
From 2007 to 2015, Medicaid
was the top primary payer
In terms of market forces, factors such as efforts to reduce unnecessary
for patients under age 18
hospitalization4 and adjustments in reimbursement incentives may decrease utilization years with nonneonatal,
of inpatient care.5 Market forces also may vary across age groups and eventually shift nonmaternal inpatient stays;
hospital utilization in terms of payer mix for those who seek care. Examples of such its share exceeded 50
factors include employment status6 and changes in health care policy that target age percent starting in 2012.
groups differently.
This Healthcare Cost and Utilization Project (HCUP) Statistical Brief presents data on From 2000 to 2015, the
hospital inpatient stays from 2000 through 2015 by age group and primary payer. share of Medicaid among
First, trends in the population rate of inpatient stays by age group are presented. nonneonatal, nonmaternal
Second, trends in expected primary payer among inpatient stays by age group are inpatient stays for those
examined. The National Inpatient Sample (NIS) from 2000 to 2015 was used to aged 1844 years and 4564
generate national estimates of inpatient stays. The total number of inpatient stays years increased by 74
related to maternal and neonatal diagnoses accounted for 2225 percent of all percent and 68 percent,
inpatient stays, and for 3446 percent of those stays, Medicaid was the primary respectively.
expected payer. Because of the relative size of this subpopulation and the high
concentration in the distribution of expected payer, maternal and neonatal stays were
excluded from the analysis. Among patients aged 1844
years, the share of
Findings nonneonatal, nonmaternal
inpatient stays covered by
National rate of inpatient stays by patient age, 20002015 Medicare increased by 21
Figure 1 presents the rate of nonneonatal, nonmaternal inpatient stays per 100,000 percent from 2000 to 2015.
population from 2000 to 2015. Results are shown by four age groups.
Among patients aged 4564
years, the share of
nonneonatal, nonmaternal
stays covered by Medicare
increased by 43 percent from
2000 to 2015.
https://hcup-us.ahrq.gov/reports/statbriefs/sb235-Inpatient-Stays-Age-Payer-Trends.jsp?utm_source=ahrq&utm_medium=en-1&utm_term=&utm_content=1&utm_c… 1/10
Among patients aged 65
years and over, Medicare and
private insurance together
accounted for about 97
percent of inpatient stays
each year.
Figure 1. Rate of nonneonatal, nonmaternal inpatient stays, per 100,000 population by age group, 20002015
Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets. Healthcare
Cost and Utilization Project (HCUP), National (Nationwide) Inpatient Sample (NIS), 20002015
Line graph that shows the rate of nonneonatal, nonmaternal inpatient stays per 100,000 by age from 2000 to 2015.
<18 years: 2000, 2,603; 2001, 2,731; 2002, 2,661; 2003, 2,832; 2004, 2,778; 2005, 3,236; 2006, 2,623; 2007,
2,492; 2008, 2,354; 2009, 2,399; 2010, 2,632; 2011, 2,104; 2012, 2,338; 2013, 2,220; 2014, 2,133; 2015, 2,117;
net change 19%. 1844 years: increased steadily from 4,771 in 2000 to 4,971 in 2004; decreased to 4,773 in 2005;
increased to 4,837 in 2006; decreased steadily to 4,684 in 2009; increased to 4,702 in 2010; decreased steadily to
4,023 in 2014; increased to 4,024 in 2015; net change 16%. 4564 years: increased steadily from 11,459 in 2000 to
11,738 in 2003; decreased steadily to 11,437 in 2005; increased to 11,662 in 2006; decreased to 11,422 in 2007,
increased to 11,572 in 2008; decreased steadily to 10,416 in 2014; increased to 10,437 in 2015; net change 9%. 65+
years: increased from 35,214 in 2000 to 36,620 in 2001; decreased steadily to 34,938 in 2004; increased to 35,170 in
2005; decreased to 33,649 in 2007; increased to 34,380 in 2008; decreased steadily to 31,332 in 2010; increased to
31,861 in 2011; decreased steadily to 26,480 in 2015; net change 25%.
Older age groups have higher rates of nonneonatal and nonmaternal inpatient rates.
During the 16year time period, patients aged 65 years and over had the highest rate of inpatient stays (above
26,400 per 100,000 population every year), followed by those aged 4564 years (ranging from about 10,400 to
11,700 per 100,000 population). Patients aged 18 years and under were the most infrequent visitors for nonneonatal
and nonmaternal inpatient stays, with a rate below 3,300 per 100,000 population every year.
The rate of nonneonatal and nonmaternal inpatient stays reached the lowest levels in 2014 or 2015 for
all age groups.
Among patients aged 65 years and over, the rate of inpatient stays was 35,214 per 100,000 population in 2000. The
rate stayed at or above 35,000 until 2005 when it started to drop. By 2015, the rate had decreased to its lowest level
during this period—26,480 per 100,000 population—a 25 percent reduction compared with 2000.
Among patients aged 4564 years, the rate of nonneonatal, nonmaternal inpatient stays was 11,459 per 100,000
population in 2000 and remained above 11,400 through 2010 after which it began to drop. By 2015, the rate has
decreased to 10,437 per 100,000 population, a 9 percent decrease since 2000.
Among patients aged 1844 years, the rate was 4,771 per 100,000 population in 2000 and stayed at or above 4,700
per 100,000 through 2010. The rate began to drop below this level in 2011, and by 2015 the rate had decreased to
4,024, a 16 percent reduction since 2000.
Among patients aged 18 years and under, the rate stayed above 2,600 from 2000 to 2006, with the highest rate
reached in 2005 (3,236 per 100,000 population). In 2015, the rate reached its lowest level in 16 years at 2,117 per
100,000 population, a decrease of 19 percent since 2000.
Trends in primary payer among nonneonatal, nonmaternal inpatient stays by patient age, 20002015
Figures 2 to 5 present national trends in expected primary payer for nonneonatal, nonmaternal inpatient care for each age
group from 2000 to 2015.
Figure 2. National trends in primary payer among nonneonatal, nonmaternal inpatient stays for patients under
age 18 years, 20002015
Note: Shares of "Missing" and "Other" payers are not presented.
Line graph that shows the share of each payer among neonatal and nonmaternal inpatient stays for patients aged <18
years from 2000 to 2015. Medicaid: increased steadily from 38.9% in 2000 to 44.9% in 2004; decreased to 43.5% in
2005; increased steadily to 50.8% in 2010; decreased to 48.8% in 2011; increased steadily to 53.7% in 2015; net
change +38%. Private insurance: increased from 52.5% in 2000 to 52.8% in 2001; decreased steadily to 46.7% in
2004; increased to 47.8% in 2005; decreased steadily to 45.0% in 2007; increased to 46.0% in 2008; decreased
steadily to 41.7% in 2010; increased to 43.7% in 2011; decreased steadily to 39.5% in 2015; net change 25%.
Uninsured: decreased steadily from 4.9% in 2000 to 3.8% in 2003; increased to 4.5% in 2004; decreased steadily to
3.9% in 2006; increased to 4.3% in 2007; decreased to 3.5% in 2008; increased to 4.2% in 2009; decreased steadily
to 2.6% in 2011; increased steadily to 2.8% in 2013; decreased steadily to 2.5% in 2015; net change 49%. Medicare:
fluctuated between 0.2 and 0.5 between 2000 and 2015; began and ended at 0.3%; net change 26%.
Starting in 2007, Medicaid replaced private insurance as the most common primary payer for
nonneonatal and nonmaternal inpatient stays among those under age 18 years.
In 2000, the most common payer for nonneonatal and nonmaternal inpatient stays among patients under age 18
years was private insurance (52.5 percent), followed by Medicaid (38.9 percent). By 2015, the share of Medicaid had
reached 53.7 percent, which is an increase of 38 percent since 2000. By 2015, the share of private insurance had
dropped to 39.5 percent, its lowest level in 16 years—a decrease of 25 percent since 2000.
The share of uninsured patients within this age group fluctuated between 3.2 and 4.9 percent from 2000 to 2010 and
dropped to 2.8 percent or below thereafter. The share of Medicare within this age group stayed below 0.5 percent in
all years.
Figure 3. National trends in primary payer among nonneonatal, nonmaternal inpatient stays for patients aged
1844 years, 20002015
Line graph that shows the share of each payer among neonatal and nonmaternal inpatient stays for patients aged 1844
years from 2000 to 2015. Medicaid: increased steadily from 19.9% in 2000 to 22.9% in 2005; decreased steadily to
21.6% in 2007; increased steadily to 26.3% in 2010; decreased to 25.7% in 2011; increased steadily to 34.6% in
2015; net change +74%. Private insurance: increased from 50.5% in 2000 to 50.7% in 2001; decreased steadily to
45.4% in 2004; increased to 45.5% in 2005; decreased steadily to 43.7% in 2007; increased to 45.6% in 2008;
decreased steadily to 38.3% in 2010; increased to 39.6% in 2011; decreased steadily to 37.1% in 2014 and 2015; net
change 27%. Uninsured: increased from 12.7 in 2000 and 2001 to 13.3% in 2002; decreased to 12.9% in 2003;
increased steadily to 16.6% in 2007; decreased to 15.0% in 2008; increased steadily to 17.4% in 2010; decreased to
16.5% in 2011; increased steadily to 17.6% in 2013; decreased steadily to 11.9% in 2015; net change 6%. Medicare:
decreased steadily from 9.5% in 2000 to 9.3% in 2002; increased steadily to 11.9% in 2013; decreased steadily to
11.5% in 2015; net change +21%.
Among nonneonatal, nonmaternal inpatient stays for 18to44yearolds, private insurance was the most
common primary payer, followed by Medicaid.
The most common primary payer for nonneonatal and nonmaternal inpatient stays among patients aged 1844 years
was private insurance, which accounted for 50.5 percent of stays in 2000 and dropped to 37.5 percent in 2013.
During the same period, the share of Medicaid increased from 19.9 percent to 26.5 percent, the share of uninsured
increased from 12.7 percent to 17.6 percent, and the share of Medicare increased from 9.5 percent to 11.9 percent.
From 2013 to 2015, the share of Medicaid within this age group increased and the share of uninsured
decreased.
The share of Medicaid in 2015 was 34.6 percent, which is an increase of 74 percent since 2000. The share of
uninsured in 2015 dropped to 11.9 percent, its lowest level during these 16 years.
The share of private insurance dropped to 37.1 percent in 2015 and remained as the most common payer within this
age group. The share of Medicare in 2015 was 11.5, an increase of 21 percent since 2000.
4564 years, 20002015
Line graph that shows the share of each payer among neonatal and nonmaternal inpatient stays for patients aged 4564
years from 2000 to 2015. Medicaid: fluctuated between 13.2% and 13.3% from 2000 to 2002; increased steadily 14.9%
in 2006; decreased to 14.4% in 2007 and 2008; increased steadily to 17.1% in 2010; decreased to 16.8% in 2011;
increased steadily to 22.1% in 2015; net change +68%. Private insurance: increased from 57.0% in 2000 to 57.1% in
2001; decreased steadily to 50.3% in 2007; increased to 51.3% in 2008; decreased steadily to 41.9% in 2014;
increased to 42.0% in 2015; net change 26%. Uninsured: increased from 6.4% in 2000 and 2001 to 6.8% in 2002;
decreased to 6.4% in 2003; increased steadily to 8.2% in 2007; decreased to 7.7% in 2008; increased steadily to 9.3%
in 2010; decreased to 8.6% in 2011; increased steadily to 9.6% in 2013; decreased steadily to 6.1% in 2015; net
change 4%. Medicare: increased steadily from 17.9% in 2000 to 25.5% in 2015; net change +43%.
Among nonneonatal, nonmaternal inpatient stays for patients aged 4564 years, private insurance was
the most common primary payer, followed by Medicare.
The share of private insurance among inpatient stays for patients aged 4564 years dropped from 57.0 percent in
2000 to 42.1 percent in 2013. During the same period, the share of Medicare increased from 17.9 percent to 25.1
percent, the share of Medicaid increased from 13.2 percent to 17.6 percent, and the share of uninsured increased
from 6.4 percent to 9.6 percent, which remained the lowest among all payers for this age group.
From 2013 to 2015, the share of inpatient stays covered by Medicaid increased and the share that were
uninsured decreased.
By 2015, the share of inpatient stays covered by Medicaid in this age group had increased to 22.1 percent, an
increase of 68 percent since 2000. The share of stays that were uninsured had dropped to 6.1 percent, its lowest
level during this period.
The share of inpatient stays covered by private insurance in 2014 and 2015 was at about the same level as it had
been in 2013. From 2000 to 2015, the share of stays covered by private insurance decreased by 26 percent, but
private insurance remained the most common primary payer. The share of stays covered by Medicare reached 25.5
percent in 2015, an increase of 43 percent since 2000.
65 years and over, 20002015
Line graph that shows the share of each payer among stays for patients aged 65 years and over from 2000 to 2015.
Medicaid: fluctuated between 1.3% and 1.8% between 2000 and 2015, starting at 1.5% in 2000 and ending at 1.4% in
2015; net change 7%. Private insurance: decreased from 8.2% in 2000 and 2001 to 6.2% in 2003; increased to 7.3%
in 2004; decreased to 6.5% in 2005; increased steadily to 8.9% in 2008; decreased steadily to 7.1% in 2012; increased
steadily to 7.6% in 2014; decreased to 7.5% in 2015; net change 9%. Uninsured: fluctuated between 0.4% and 0.7%
between 2000 and 2015, starting and ending at 0.6%; net change 3%. Medicare: decreased from 88.6% in 2000 to
88.5% in 2001; increased steadily to 90.9% in 2003; decreased to 89.7% in 2004; increased to 90.9% in 2005;
decreased steadily to 87.7% in 2008; increased to 88.1 in 2009; decreased to 88.0% in 2010; increased steadily to
89.8% in 2012; decreased steadily to 89.1% in 2014 and 2015; net change +1%.
Medicare and private insurance accounted for about 97 percent of nonneonatal and nonmaternal
inpatient stays among patients aged 65 years and over.
Among patients aged 65 years and over, the share of inpatient stays covered by Medicare fluctuated between 88 and
91 percent during the 20002015 period; at the same time, the share of stays covered by private insurance
fluctuated between 6 and 9 percent. These two payers together consistently covered about 97 percent of the
inpatient stays within this age group during the 16year period.
Within this age group, the share of stays covered by Medicaid remained under 2 percent, and the share of stays that
were uninsured remained under 0.8 percent.
To summarize across age groups, from 2000 to 2015, for patients aged 64 years or younger, the share of inpatient stays
with an expected primary payer of private insurance decreased and the share of stays with Medicaid increased. The share of
uninsured stays reached its 16year low in 2015. For patients aged 1864 years, the share of stays with Medicare increased
during the 16year period.
About Statistical Briefs
HCUP Statistical Briefs provide basic descriptive statistics on a variety of topics using HCUP administrative health care data.
Topics include hospital inpatient, ambulatory surgery, and emergency department use and costs, quality of care, access to
care, medical conditions, procedures, and patient populations, among other topics. The reports are intended to generate
hypotheses that can be further explored in other research; the reports are not designed to answer indepth research
questions using multivariate methods.
Data Source
The estimates in this Statistical Brief are based upon data from the Healthcare Cost and Utilization Project (HCUP) 2000
2015 National (Nationwide) Inpatient Sample (NIS). Supplemental sources included population denominator data for use
with HCUP databases, derived from information available from the Bureau of the Census.7
Definitions
Unit of analysis
The unit of analysis is the hospital discharge (i.e., the hospital stay), not a person or patient. This means that a person who
is admitted to the hospital multiple times in 1 year will be counted each time as a separate discharge from the hospital.
Payer
Payer is the expected primary payer for the hospital stay. To make coding uniform across all HCUP data sources, payer
combines detailed categories into general groups:
Medicare: includes patients covered by feeforservice and managed care Medicare
Medicaid: includes patients covered by feeforservice and managed care Medicaid
Private Insurance: includes Blue Cross, commercial carriers, and private health maintenance organizations (HMOs)
and preferred provider organizations (PPOs)
Uninsured: includes an insurance status of selfpay and no charge
Other: includes Workers' Compensation, TRICARE/CHAMPUS, CHAMPVA, Title V, and other government programs
Hospital stays billed to the State Children's Health Insurance Program (SCHIP) may be classified as Medicaid, Private
Insurance, or Other, depending on the structure of the State program. Because most State data do not identify patients in
SCHIP specifically, it is not possible to present this information separately.
Diagnosisrelated groups (DRGs) and major diagnostic categories (MDCs)
DRGs comprise a patient classification system that categorizes patients into groups that are clinically coherent and
homogeneous with respect to resource use. DRGs group patients according to diagnosis, type of treatment (procedures),
age, and other relevant criteria. Each hospital stay has one assigned DRG.
Coding criteria for the types of hospitalization are based on MDCs. MDCs are broad groups of DRGs that relate to an organ
or a body system (e.g., digestive system) and not to an etiology. For example, MDC 01 — Diseases and Disorders of the
Nervous System and MDC 02 — Diseases and Disorders of the Eye. Each hospital stay has one DRG and one MDC assigned
to it. In this Statistical Brief, nonneonatal and nonmaternal hospitalizations are identified using the MDCs that are not equal
to 14 (Pregnancy, Childbirth and the Puerperium) or 15 (Newborns and Other Neonates with Conditions Originating in the
Perinatal Period).
Types of hospitals included in the HCUP National (Nationwide) Inpatient Sample
The National (Nationwide) Inpatient Sample (NIS) is based on data from community hospitals, which are defined as short
term, nonFederal, general, and other hospitals, excluding hospital units of other institutions (e.g., prisons). The NIS
includes obstetrics and gynecology, otolaryngology, orthopedic, cancer, pediatric, public, and academic medical hospitals.
Excluded are longterm care facilities such as rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals.
Beginning in 2012, longterm acute care hospitals are also excluded. However, if a patient received longterm care,
rehabilitation, or treatment for a psychiatric or chemical dependency condition in a community hospital, the discharge
record for that stay will be included in the NIS.
About HCUP
The Healthcare Cost and Utilization Project (HCUP, pronounced "HCup") is a family of health care databases and related
software tools and products developed through a FederalStateIndustry partnership and sponsored by the Agency for
Healthcare Research and Quality (AHRQ). HCUP databases bring together the data collection efforts of State data
organizations, hospital associations, and private data organizations (HCUP Partners) and the Federal government to create
a national information resource of encounterlevel health care data. HCUP includes the largest collection of longitudinal
hospital care data in the United States, with allpayer, encounterlevel information beginning in 1988. These databases
enable research on a broad range of health policy issues, including cost and quality of health services, medical practice
patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels.
HCUP would not be possible without the contributions of the following data collection Partners from across the United
States:
Alaska Department of Health and Social Services
Alaska State Hospital and Nursing Home Association
Arizona Department of Health Services
Arkansas Department of Health
California Office of Statewide Health Planning and Development
Colorado Hospital Association
Connecticut Hospital Association
District of Columbia Hospital Association
Florida Agency for Health Care Administration
Georgia Hospital Association
Hawaii Health Information Corporation
Illinois Department of Public Health
Indiana Hospital Association
Iowa Hospital Association
Kansas Hospital Association
Kentucky Cabinet for Health and Family Services
Louisiana Department of Health
Maine Health Data Organization
Maryland Health Services Cost Review Commission
Massachusetts Center for Health Information and Analysis
Michigan Health & Hospital Association
Minnesota Hospital Association
Mississippi State Department of Health
Missouri Hospital Industry Data Institute
Montana Hospital Association
Nebraska Hospital Association
Nevada Department of Health and Human Services
New Hampshire Department of Health & Human Services
New Jersey Department of Health
New Mexico Department of Health
New York State Department of Health
North Carolina Department of Health and Human Services
North Dakota (data provided by the Minnesota Hospital Association)
Ohio Hospital Association
Oklahoma State Department of Health
Oregon Association of Hospitals and Health Systems
Oregon Office of Health Analytics
Pennsylvania Health Care Cost Containment Council
Rhode Island Department of Health
South Carolina Revenue and Fiscal Affairs Office
South Dakota Association of Healthcare Organizations
Tennessee Hospital Association
Texas Department of State Health Services
Utah Department of Health
Vermont Association of Hospitals and Health Systems
Virginia Health Information
Washington State Department of Health
West Virginia Department of Health and Human Resources, West Virginia Health Care Authority
Wisconsin Department of Health Services
Wyoming Hospital Association
About the NIS
The HCUP National (Nationwide) Inpatient Sample (NIS) is a nationwide database of hospital inpatient stays. The NIS is
nationally representative of all community hospitals (i.e., shortterm, nonFederal, nonrehabilitation hospitals). The NIS
includes all payers. It is drawn from a sampling frame that contains hospitals comprising more than 95 percent of all
discharges in the United States. The vast size of the NIS allows the study of topics at the national and regional levels for
specific subgroups of patients. In addition, NIS data are standardized across years to facilitate ease of use. Over time, the
sampling frame for the NIS has changed; thus, the number of States contributing to the NIS varies from year to year. The
NIS is intended for national estimates only; no Statelevel estimates can be produced.
The 2012 NIS was redesigned to optimize national estimates. The redesign incorporates two critical changes:
Revisions to the sample design—starting with 2012, the NIS is now a sample of discharge records from all HCUP
participating hospitals, rather than a sample of hospitals from which all discharges were retained (as is the case for
NIS years before 2012).
Revisions to how hospitals are defined—the NIS now uses the definition of hospitals and discharges supplied by the
statewide data organizations that contribute to HCUP, rather than the definitions used by the American Hospital
Association (AHA) Annual Survey of Hospitals.
The new sampling strategy is expected to result in more precise estimates than those that resulted from the previous NIS
design by reducing sampling error: for many estimates, confidence intervals under the new design are about half the length
of confidence intervals under the previous design. The change in sample design for 2012 necessitates recomputation of
prior years' NIS data to enable analyses of trends that use the same definitions of discharges and hospitals.
For More Information
For other information on hospitalizations in the United States, refer to the HCUP Statistical Briefs located at www.hcup
us.ahrq.gov/reports/statbriefs/sb_hospoverview.jsp.
For additional HCUP statistics, visit:
HCUP Fast Stats at www.hcupus.ahrq.gov/faststats/landing.jsp for easy access to the latest HCUPbased statistics
for health information topics
HCUPnet, HCUP's interactive query system, at www.hcupnet.ahrq.gov/
For more information about HCUP, visit www.hcupus.ahrq.gov/.
For a detailed description of HCUP and more information on the design of the National (Nationwide) Inpatient Sample (NIS),
please refer to the following database documentation:
Agency for Healthcare Research and Quality. Overview of the National (Nationwide) Inpatient Sample (NIS). Healthcare
Cost and Utilization Project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality. Updated December 2016.
www.hcupus.ahrq.gov/nisoverview.jsp. Accessed January 31, 2017.
Suggested Citation
Sun R (AHRQ), Karaca Z (AHRQ), Wong HS (AHRQ). Trends in Hospital Inpatients Stays by Age and Payer, 20002015.
HCUP Statistical Brief #235. January 2018. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup
us.ahrq.gov/reports/statbriefs/sb235InpatientStaysAgePayerTrends.pdf.
***
AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information
about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are
using this Statistical Brief and other HCUP data and tools, and to share suggestions on how HCUP products might be
enhanced to further meet your needs. Please email us at hcup@ahrq.gov or send a letter to the address below:
Sharon B. Arnold, Ph.D., Acting Director
Center for Delivery, Organization, and Markets
Agency for Healthcare Research and Quality
5600 Fishers Lane
Rockville, MD 20857
This Statistical Brief was posted online on January 23, 2018.
1 Bernstein AB, Hing E, Moss AJ, Allen KF, Siller AB, Tiggle RB. Health Care in America: Trends in Utilization. 2003. National
Center for Health Statistics. www.cdc.gov/nchs/data/misc/healthcare.pdf. Accessed December 19, 2017.
2 Howden LM, Meyer JA. Age and Sex Composition: 2010. 2010 Census Briefs, May 2011. U.S. Census Bureau.
www.census.gov/content/dam/Census/library/publications/2011/dec/c2010br03.pdf. Accessed December 19, 2017.
3 Colby SL, Ortman JM. Projections of the Size and Composition of the U.S. population: 2014 to 2060. Current Population
Reports. March 2015. U.S. Census Bureau. www.census.gov/content/dam/Census/library/publications/2015/demo/p25
1143.pdf. Accessed December 19, 2017.
4 Leslie DL, Rosenheck R. Shifting to outpatient care? mental health care use and cost under private insurance. American
Journal of Psychiatry. 1999;156(8):12507.
5 Bernstein et al., 2003. Op. cit.
6 Maeda JL, Henke RM, Marder WD, Karaca Z, Friedman BS, Wong HS. Association between the unemployment rate and
inpatient cost per discharge by payer in the United States, 20052010. BMC Health Services Research. 2014;14:378.
7 Barrett M, Coffey R, Levit K. Population Denominator Data for Use With the HCUP Databases (Updated With 2016
Population Data). HCUP Methods Series Report # 201704 ONLINE. October 17, 2017. U.S. Agency for Healthcare Research
and Quality. www.hcupus.ahrq.gov/reports/methods/methods.jsp. Accessed November 22, 2017.
Internet Citation: Statistical Brief #235. Healthcare Cost and Utilization Project (HCUP). January 2018. Agency for Healthcare Research and Quality, Rockville,
MD. www.hcupus.ahrq.gov/reports/statbriefs/sb235InpatientStaysAgePayerTrends.jsp?
utm_source=ahrq&utm_medium=en1&utm_term=&utm_content=1&utm_campaign=ahrq_en2_13_2018.
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