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Abstract

Objectives—This report presents national estimates of the use of non-Federal short-stay hospitals in the United States during 2003 and trend data for selected variables. Numbers and rates of discharges, diagnoses, and procedures are shown by age and sex. Average lengths of stay are presented for all discharges and for selected diagnostic categories by age and sex.

Methods—The estimates are based on medical abstract data collected through the 2003 National Hospital Discharge Survey. The survey has been conducted annually by the National Center for Health Statistics since 1965. Diagnoses and procedures presented are coded using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9–CM).

Results—Trends in the utilization of non-Federal short-stay hospitals show that the length of stay for inpatients has changed significantly from 1970 through 2003. In 1970, the average length of stay was 7.8 days compared with 4.8 days in 2003. The percentage of discharges hospitalized for 8 days or more was 33 percent in 1970 compared with 16 percent in 2003. Inpatients staying in the hospital for 3 days or less increased significantly during this period, from 36 percent in 1970 to 57 percent in 2003.

In 2003, there were an estimated 34.7 million hospital discharges, excluding newborn infants. The discharge rate was 1,199.7 per 10,000 population. The rate of hospitalization for malignant neoplasms for people under 45 years of age, for those aged 45–64 years, and for persons 65 years and over has decreased significantly from 1990 to 2003. Of those discharges hospitalized for respiratory diseases, two-thirds had first-listed diagnoses of pneumonia (37 percent), asthma (15 percent), or chronic bronchitis (14 percent). There were 43.9 million procedures performed on inpatients during 2003. One-quarter of all procedures performed on females were obstetrical. Almost one-quarter of all procedures performed on males were cardiovascular.

Keywords: inpatients c diagnoses c procedures c ICD–9–CM

Advance Data No. 359 + July 8, 2005

Introduction

This report presents data from the 2003 National Hospital Discharge Survey (NHDS). The survey has been conducted continuously by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) since 1965. The NHDS is the principal source for national data on the characteristics of patients discharged from non-Federal short-stay hospitals. National estimates of hospital use derived from the NHDS are published for each calendar year by NCHS. This report provides an overview of the 2003 data, including the number and rate of discharges and average lengths of stay by age and sex of patients for selected diagnoses (tables 1–7). Average lengths of stay are also presented for selected diagnostic categories. Estimates of the number and rate of selected procedures performed on hospital inpatients are shown by age and sex (tables 8–11).

Detailed data from the NHDS are published in Series 13 of Vital and Health Statistics, which includes two reports on trends in hospital use (2,3). Trend data from the NHDS also have been used in a NCHS special report on health care utilization (4). NHDS data have been used in articles examining important topics of interest in public health and health services research (5–21), and for a variety of activities by governmental, scientific, academic, and commercial institutions. A list of NCHS and selected other publications using NHDS data is available at http:// www.cdc.gov/nchs/about/major/hdasd/ nhds.htm.

Estimates of the number of procedures shown in this report are for inpatients only. Data on ambulatory surgery are available from the National Survey of Ambulatory Surgery (NSAS), which was conducted by NCHS from 1994 through 1996 and covers hospital- based and free-standing ambulatory surgery centers. Data from the 3 years of this survey have been published (22–27). Plans for a 2006 NSAS are currently underway.

Information on ambulatory procedures is collected annually in two other NCHS surveys. The National

Ambulatory Medical Care Survey obtains information on visits to physicians’ offices (28). The National Hospital Ambulatory Medical Care Survey collects data on visits to hospital outpatient and emergency departments (29,30).

Highlights

Patient and hospital characteristics

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    Trends in hospital utilization show that from 1970 through 2003, the percentage of inpatients hospitalized for 8 days or more decreased significantly while those staying 3 days or less significantly increased. In 1970, 33 percent of all inpatients were hospitalized for 8 days or more compared with 16 percent in 2003. The percentage of inpatients staying 3 days or less increased from 36 percent in 1970 to 57 percent in

2003.

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    In 2003, there were an estimated 34.7 million inpatients discharged, excluding newborn infants, from non-Federal short-stay hospitals in the United States (table 1).

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      The discharge rate was 1,199.7 per 10,000 population—977.3 for males and 1,413.7 for females (table 6). Males had an average length of stay of 5.2 days compared with 4.6 days for females (table 7).

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      The discharge rate per 10,000 population ranged from 1,003.3 in the West to 1,337.1 in the Northeast region. The average length of stay ranged from 4.4 days in the Midwest to 5.5 days in the Northeast region (table 1).

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      The average length of stay for children under 15 years old was 4.5 days; for people 15–44 years old, it was 3.8 days; for people 45–64 years old, it was 4.9 days; and for those 65 years and over, it was 5.7 days (table 4).

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      In 2003, patients under 15 years comprised 7 percent of hospital discharges, 15–44-year-olds made up 31 percent, 45–64-year-olds were 23 percent, and those 65 years and over were 38 percent (table 1).

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