Evaluating Hospital Inpatient Discharges at the Regional Level

Ronald Lagoe,Shelly Littau

doi:10.4236/crcm.2019.84007

Abstract

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.

Highlights

In recent years, interest in improving efficiency and outcomes in the health care system of the United States has increased
This study focused on hospital utilization in the Central New York Health Service Area of New York State
The initial component of the study focused on resident hospital discharges by county in the Central New York Health Service Area for adult medicine

Summary

Introduction

Interest in improving efficiency and outcomes in the health care system of the United States has increased. A major driver of health care at the community level is the utilization of inpatient hospitals These providers focus on the delivery of inpatient acute care, they deliver emergency, outpatient, and other services. This care can include inpatient adult medicine, adult surgery, pediatrics, obstetrics, and mental health. Health planning initiatives have focused on hospital discharges at regional and community levels. These include the Health Systems Agencies developed through federal legislation during the twentieth century as well as State government efforts to evaluate and regulate health care providers [8]. Because of the relationship between hospital discharges and reimbursement, efforts to maintain financial viability are frequently linked to inpatient discharge volumes [9]

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Method

Results

Discussion