About Hospital Utilization
About Avoidable Hospital Stays
About County Rates of Hospital Use
About Hospital Utilization
What is hospital utilization?
Hospital utilization means use of hospital services. It includes information on:
- Number of hospital stays. A hospital stay means that you are admitted into the hospital and stay for at least one night. One person may have multiple hospital stays in a year, and each stay will be counted separately in the rate you see.
- Length of hospital stays. This is the number of days a person spends in the hospital during one hospital stay.
- Charges for hospital stays. Charges are what a hospital bills or asks to be paid for services.
- Costs for hospital stays. Costs shown are the estimated costs to a hospital for services performed since the actual values are not available. Costs are calculated using available charge data and information—specifically, cost-to-charge ratios—from hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS).
- Cost savings. Cost savings are an estimate of dollars saved if avoidable hospital stays were reduced by 10, 20, 30, 40, or 50%. Cost savings are based on charges that have been adjusted to costs using hospital-specific cost-to-charge ratios.
Why should I look at information about hospital utilization and how can it help me?
You may be interested in a specific medical condition or procedure and would like to get details. For example, you or a loved one may need hip replacement surgery. You may want to look at:
- Numbers of hip replacement surgeries done at hospitals in your area. You may want to choose a hospital that performs many hip replacements, because hospitals that do these procedures more often may do them better.
- Length of stay information for hip replacement surgeries. This will give you an idea of how long you might stay in the hospital.
- Charges and costs for hip replacement surgeries. This will give you an idea of how much you and your health plan might be charged for the stay (although your out-of-pocket cost depends on your health plan).
About Avoidable Hospital Stays
What are avoidable hospital stays?
An avoidable hospital stay is one that might have been avoided with better medical care outside of the hospital. For example, a diabetes patient who receives good care from her primary care physician might not need a hospital stay for diabetes complications. Hospital stays like these are not always avoidable, but they are potentially avoidable with good quality health care.
Information about avoidable hospital stays is about communities, not hospitals. It is based on where patients live, not on where hospitals are located. High rates of avoidable hospital stays can point to possible breakdowns in health care in the community.
Why should I look at information about avoidable hospital stays and how can it help me?
This information can be used by policy makers and public health workers. It can help them identify areas that might have problems with outpatient care and what types of problems these are. The information includes estimates of cost savings if you reduce avoidable hospital stays by 10%, 20%, 30% or more. This can help motivate efforts to improve community health care and reduce avoidable hospital stays.
About County Rates of Hospital Use
What are county rates of hospital use?
The county rates show use of hospital services by county, based on where patients live. County rates include information on:
- Number of hospital stays. A hospital stay means that you are admitted into the hospital and stay for at least one night. One person may have multiple hospital stays in a year, and each stay will be counted separately in the rate you see. County rates show the number of stays for each 100,000 people who live in the county.
- Charges for hospital stays. Charges are what a hospital bills or asks to be paid for services.
- Costs for hospital stays. Costs shown are the estimated costs to a hospital for services performed since the actual values are not available. Costs are calculated using available charge data and information—specifically, cost-to-charge ratios—from hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS).
Why should I look at information about county rates of hospital use and how can it help me?
This information can be used by policy makers and public health workers. It can help them identify areas whose residents have high rates of hospital use for particular conditions and procedures. The information is reported by county based on the patient’s residence, not the hospital location. It tells you, for example, the county of origin for patients with lung cancer or for patients receiving back surgery. This information can help motivate efforts to address the causes of particular medical problems such as cancer, injury, or infections.