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American Hospital Care Subject of New Federal Report

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Press Release Date: June 22, 2000

A new report by the U.S. Agency for Healthcare Research and Quality (AHRQ) shows that over a third of all hospital patients are initially seen in the emergency department before being admitted. This figure includes 40 percent of all hospitalized children and 55 percent of the very old (80 and older).

According to the report, which is based on 1997 data from AHRQ's Nationwide Inpatient Sample, the number one cause of hospital admission through the emergency room was pneumonia. Half of the other top 10 conditions for the admission of emergency room patients involved heart conditions. The other leading conditions for admission through the emergency department were stroke, chronic obstructive lung disease (emphysema or chronic bronchitis), asthma and blood infection (septicemia).

"This report, which is the first in a series by this agency on hospital care in the United States, provides a very broad, integrated view of that care. It addresses key questions in American health care—who uses hospitals? for what reasons? who pays for what? and what happens to hospital patients?" said AHRQ's director, John M. Eisenberg, M.D.

Among the study's other findings are that:

  • Over half of all hospital patients had at least one other illness, or comorbidity, in addition to the illnesses for which they were admitted. Comorbidities can make treatment more expensive and lengthen hospital stays.
  • High blood pressure was the most common comorbidity. The leading comorbidities among adolescents and adults up to age 44 included drug abuse, psychoses and depression. Alcohol abuse was a leading secondary condition in patients ages 18 to 64.
  • Medicare and Medicaid were billed for over half of all hospital stays, while private health insurance was charged for about 37 percent of stays. Roughly 5 percent of stays involved uninsured patients.
  • Roughly 23 percent of all hospital admissions for substance-related mental disorders and nearly 20 percent of those for alcohol-related mental disorders involved patients who had no health insurance.

The report also provides statistics on:

  • The age and gender of hospitalized patients.
  • Leading reasons for hospital admission overall and by age.
  • Hospital charges.
  • Lengths of stay.
  • In-hospital mortality.
  • Patients who leave against medical advice.
  • Types of locations to which patients are discharged.

Select to access chart on How Patients Are Admitted to the Hospital (PDF File, 23 KB; PDF Help).

The Nationwide Inpatient Sample—the AHRQ database used to develop the report—contains about 7 million records, making it one of the largest publicly available databases for research and policy analysis and the only one that provides information on total hospital charges for all patients, regardless of their type of insurance or other payment source.

Users can preview NIS data through HCUPnet, an interactive software tool on AHRQ's Web site ( for querying the database and selected state hospital databases that participate in AHRQ's Healthcare Cost and Utilization Project (HCUP).

Copies of Hospitalization in the United States, 1997: HCUP Fact Book No. 1 (AHRQ Publication No. 00-0031) are available without charge from the AHRQ Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907, (phone 800-358-9295).

Note to Editors: If you use this chart, or create your own from information in the attached chart, please include the following citation: Hospitalization in the United States, 1997: HCUP Fact Book No. 1. U.S. Agency for Healthcare Policy and Research. Rockville, MD. May 2000.

For more information, contact AHRQ Public Affairs (301) 427-1364: Bob Isquith, (301) 427-1539 (

The information on this page is archived and provided for reference purposes only.


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