National hospital discharge survey: 2006 annual summary.

Objectives-This report presents 2006 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Methods-The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2006, data were collected for approximately 376,000 discharges. Of the 478 eligible nonfederal short-stay hospitals in the sample, 438 (92 percent) responded to the survey. Results-An estimated 34.9 million inpatients were discharged from nonfederal short-stay hospitals in 2006. These discharges used 166.3 million days of care and had an average length of stay of 4.8 days. In 2006, hospitals with under 100 beds accounted for 77 percent of inpatient discharges in nonmetropolitan areas, but only 13 percent of inpatient discharges in metropolitan areas. Forty-three percent of the total days of care were accounted for by persons age 65 and over, although this age group represented only 12 percent of the population. The rate of discharges with a first-listed diagnosis of stroke among persons age 65-74, 75-84, and 85 and over dropped significantly from 1996 to 2006. The leading diagnostic category was diseases of the circulatory system. Among the 8.7 million inpatient discharges age 45-64, 4.2 million (48 percent) had at least one surgical procedure.

2006 National Hospital Discharge Survey.

OBJECTIVES: This report presents national estimates of hospital inpatient care in the United States during 2006 and selected trend data. Numbers and rates of discharges, diagnoses, and procedures are shown by age and sex. Average lengths of stay are presented for all discharges and for selected diagnostic categories by age and by sex. METHODS: The estimates are based on data collected through the 2006 National Hospital Discharge Survey, an annual national probability sample survey of discharges from nonfederal, general, and short-stay hospitals. In this report, sample data are weighted to produce annual estimates of inpatient care, excluding newborns. Diagnoses and procedures presented are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification. RESULTS: Trends in the utilization of nonfederal short-stay hospitals show that the age distribution of inpatients has changed dramatically from 1970 through 2006. In 1970, 20 percent of inpatients were aged 65 years and over, with those aged 75 years and over comprising 9 percent of all inpatients. By 2006, 38 percent of inpatients were aged 65 years and over, with those aged 75 years and over comprising 24 percent of all inpatients. During this same time period, the percentage of inpatients under age 15 years declined from 13 to 7 percent, and inpatients aged 15-44 years declined 43 to 31 percent. In 2006, there were an estimated 34.9 million hospital discharges, excluding newborn infants. Fifty-eight percent of all discharges were hospitalized 3 days or fewer. The rate of hospitalizations for coronary atherosclerosis for all age groups, particularly those aged 65 years and over, has declined since 2002. There were 46 million procedures performed on inpatients during 2006. The rate of knee replacement for those aged 65 years old increased 46 percent between 2000-2006, whereas the rate doubled among those aged 45-64 years old during the same time period.

Distribution of African Americans in residential care/assisted living and nursing homes: more evidence of racial disparity?

OBJECTIVES: In this study, we examined racial separation in long-term care. METHODS: We used a survey of a stratified sample of 181 residential care/assisted living (RC/AL) facilities and 39 nursing homes in 4 states. RESULTS: Most African Americans resided in nursing homes and smaller RC/AL facilities and tended to be concentrated in a few predominantly African American facilities, whereas the vast majority of Whites resided in predominantly White facilities. Facilities housing African Americans tended to be located in rural, nonpoor, African American communities, to admit individuals with mental retardation and difficulty in ambulating, and to have lower ratings of cleanliness/maintenance and lighting. CONCLUSIONS: These racial disparities may result from economic factors, exclusionary practices, or resident choice. Whether separation relates to inequities in care is undetermined.