Evaluating Hospital Inpatient Discharges at the Regional Level

摘要

Historically, the evaluation of hospital utilization in the United States has been addressed by providers and health planning agencies. This study evaluated resident inpatient hospital discharges for adult medicine and adult surgery in the Central New York Health Service Area, an eleven county region of upstate New York. It focused on small local hospitals and larger referral center hospitals in the region. The study demonstrated that numbers of adult medicine resident discharges from small local hospitals declined by 17.3 percent in most counties of the region between 2012 and 2017. This reduction resulted, in part, from the implementation of medical observation programs that shifted many patients with low severity of illness to outpatient status. The study also demonstrated that numbers of adult surgery resident inpatient discharges from small local hospitals declined by 15.8 percent. This resulted from the inmigration of many surgical patients from these providers to larger hospitals in the region. The study suggested that there may not be sufficient inpatient adult surgery and medicine volumes to support the current number of hospitals in the region.