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Number 359 + July 8, 2005

2003 National Hospital Discharge Survey

by Carol J. DeFrances, Ph.D.; Margaret J. Hall, Ph.D.; and Michelle N. Podgornik, M.P.H., Division of Health Care Statistics

This report presents the most current nationally representative data on inpatient care in the United States. Data are from the National Hospital Discharge Survey (NHDS), the longest continuously running nationally representative survey of hospital utilization.

As seen in the figure on this page, the length of stay for inpatients has changed dramatically from 1970 through 2003. In 1970, the average length of stay was 7.8 days, with one-third of patients hospitalized for 8 days or more. In 2003, the average length of stay decreased to 4.8 days, with only 16 percent of inpatients staying 8 days or more. During the same period, the percent of patients hospitalized for 3 days or less increased from 36 percent to 57 percent. Length of stay declined despite a significant increase in the average age of hospital inpatients (1).

A number of forces have exerted pressure on the length of hospital stays, including the shift from a Medicare cost-based to a prospective payment system for hospitals in the early 1980s, greater development and coverage of postacute care alternatives to hospitalization, the growth in utilization review programs, and the increased enrollment in managed care programs. Also important were advances in technology and drug therapy (including anesthesia and pain relief) that assisted in

Percent distribution of hospital inpatients by length of stay: United States, selected years 1970-2003

earlier diagnosis and treatment of acute conditions, safer and less invasive surgical interventions, and shorter postoperative recovery times.

This report presents information about inpatient hospital utilization during 2003 as well as trend data for selected variables. Additional information about hospital utilization and other health topics is available from the National Center for Health Statistics (NCHS) Web site: http://www.cdc.gov/nchs/.

Individual-year public-use data files are available for download from the Web site, and a multiyear public-use data file for trend analysis is available on CD-ROM. These and other products can also be obtained from the NCHS Data Dissemination Branch at 301-458-INFO or 1–866-441-NCHS (6247) or by e-mail at NCHSquery@cdc.gov.


This report was prepared in the Division of Health Care Statistics. Rong Cai, under contract with Lockheed Martin Information Technology, produced estimated parameters for relative standard error equations; she also performed the computer programming for the report. This report was edited by Klaudia M. Cox and typeset by Annette F. Holman of the Office of Information Services, Information Design and Publishing Staff.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics

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