Reducing Hospital Utilization and Related Expenses at the Community Level

Abstract

The reduction of health care expenses continues to be a major challenge for the economy and society of the United States and other nations. This study focused on a major source of health care expenses, inpatient hospitals, at the community level. It was based on the assumption that fewer inpatient hospital admissions per population contribute to lower health care costs. The study demonstrated that the hospitals of Syracuse, New York have generated fewer inpatient admissions and discharges than those of other New York State metropolitan areas per population. It suggested that the application of utilization rates for inpatient hospitalization in Syracuse to some other New York State areas could result in substantial savings. Between 2016 and 2017, the hospital discharge rates in Syracuse were 1.6 - 3.1 percentage points lower than those of Albany, 2.2 - 5.0 percentage points lower than those of Rochester, 4.1 - 4.9 lower than those of New York City, 5.4 - 8.2 percentage points lower than those of Buffalo, and 17.2 - 18.3 percentage points lower than those of Utica. The study suggested that the conservative hospitalization rates in Syracuse were developed and sustained over long periods of time through the use of ambulatory surgery, reduction of admissions through hospital emergency departments, and limitation of the inpatient bed supply. This was a lengthy process that resulted in a conservative hospital admission pattern. The study demonstrated, more recently, that specific programs such as the reduction of inpatient hospital readmissions and hospital lengths of stay have supported additional reductions of hospital and related utilization in Syracuse.