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Recommended Citation: Whalen D, Houchens R, Elixhauser A, 2005 HCUP Nationwide Inpatient Sample (NIS) Comparison Report. HCUP Method Series Report # 2008-01. Online February 22, 2008. U.S. Agency for Healthcare Research and Quality. Available: http://www.hcup-us.ahrq.gov/reports/methods/methods_topic.jsp |
This report provides a summary of analyses that compare estimates from the HCUP Nationwide Inpatient Sample (NIS) for 2005 to three related data sources: the American Hospital Association (AHA) Annual Survey, the National Hospital Discharge Survey (NHDS) from the National Center for Health Statistics, and the MedPAR inpatient data from the Centers for Medicare and Medicaid Services (CMS). For full information on these databases and complete details on prior years’ findings, refer to earlier versions of this report under the heading "NIS Comparison Reports" at http://www.hcup-us.ahrq.gov/db/nation/nis/nisrelatedreports.jsp
As shown in Figure 1 and Table 1, the NIS is drawn from a sampling frame comprising 37 states.
Figure 1. States Participating in the NIS, 2005 (text version)
The findings in this report are summarized in tables that highlight differences and similarities between the databases.
Based on the analyses presented in this report, the NIS appears to provide reliable national estimates when compared with other national data sources along the dimensions of hospital characteristics, numbers of discharges, length of stay, and in-hospital mortality.
Each of the data sources discussed has its strengths and weaknesses, and each may be the preferred choice for different research questions. The NIS offers a large sample that enables study of low incidence disorders and less common procedures; NIS estimates can be calculated for literally thousands of special sub-populations that may be of interest to researchers. In addition, NIS hospitals accurately reflect the universe of United States hospitals, particularly the relative mix of large and small hospitals. Therefore, the NIS may be more appropriate when hospital type and size are important considerations.
In contrast, the NHDS and MedPAR both offer data drawn from all 50 states, rather than the more limited sampling frame for the NIS. Where a comprehensive geographic representation is more important than a large sample size, and the question under study requires all age groups, the NHDS might be preferable. In the same situation, if only Medicare clients are of interest, the MedPAR data set might be preferable.
As for which of the data sources discussed is preferable or better, the answer depends on the needs of the researcher. The intended use of the data is the most critical factor in determining which data source will be most valuable. In general, the NIS estimates of variables essential to healthcare policy – including in-hospital mortality, inpatient population size, length of stay, and charges – are accurate and precise. Statistics can be calculated for large groups ranging from the inpatient population of the United States, as well as for small subsets featuring specific conditions. The characteristics documented in this report suggest that the NIS is a valuable tool for researchers and policy makers alike.
| NIS 2005 | Universe (U.S.) | |
|---|---|---|
| Number of States | 37 | 50 plus District of Columbia |
| Population | 255,210,568 | 295,895,897 |
| Sampling frame for the NIS includes: | 78% of U.S. Community Hospitals | 100% |
| 84% of community hospital discharges | 100% | |
| 86% of U.S. population | 100% | |
| Average population density (persons per square mile) | 116.5 | 30.22 |
| Population density for the least populated states (persons per square mile) | Nevada (21.9) South Dakota (10.3) |
Montana (6.4) Wyoming (5.2) Alaska (1.2) |
| Market penetration of Medicare managed care providers | 13.6% | 12.1% |
NIS hospitals resembled typical hospitals in the AHA universe in most characteristics, although NIS hospitals were more active, had higher and more intensive staffing rates, had larger expenditures compared to the AHA universe, and more Medicaid-covered patients. NIS facilities also admitted and discharged more patients and had higher expenditures and larger payrolls than hospitals in the AHA universe. NIS hospitals also tended to offer slightly more high-technology services, as compared with the universe. Nearly all NIS discharge estimates closely align with the discharge counts from the AHA Survey. This is not surprising, because NIS sampling strata and NIS discharge weights were based on AHA Annual Survey results. The AHA-derived sampling weights in the NIS yield discharge counts consistent with the AHA universe, overall, by region, and for most categories of hospital control and type. The 35 discharge comparisons shown in Table 6, exhibited no significant differences.
In contrast, the overall NIS estimated average length of stay was slightly longer than the AHA statistic. Rural hospitals was the one category where the weighted NIS hospital count differed from the actual AHA hospital count--the NIS includes relatively fewer small rural hospitals and relatively more large rural hospitals than found in the AHA universe.
| 2005 NIS Frame1 (Weighted) | 2005 NIS Frame1 (Unweighted) | 2005 AHA Universe | |
|---|---|---|---|
| U.S. | 5,146 | 1,054 | 5,203 |
| Region | |||
| Northeast | 669 | 138 | 669 |
| Midwest | 1,481 | 301 | 1,481 |
| South | 2,054 | 420 | 2,054 |
| West | 942 | 195 | 942 |
| Hospital Control | |||
| Public | 1,150 | 238 | 1,125 |
| Not for-profit | 3,006 | 614 | 2,953 |
| Proprietary | 989 | 202 | 1,068 |
| Location / Teaching Status | |||
| Rural | 2,056 | 421 | 2,056 |
| Small | 1,008 | 205 | 1,313 |
| Medium | 445 | 91 | 408 |
| Large | 603 | 125 | 335 |
| Urban, non-teaching | 2,339 | 476 | 2,339 |
| Small | 1,069 | 217 | 1,081 |
| Medium | 582 | 119 | 622 |
| Large | 688 | 140 | 636 |
| Urban, teaching | 751 | 157 | 751 |
| Small | 216 | 45 | 204 |
| Medium | 245 | 52 | 228 |
| Large | 290 | 60 | 319 |
Note: Significance tests were not performed because AHA numbers are not sample statistics.
1 The 2005 frame contains 37 states.
| NIS (Unweighted) | Universe | |
|---|---|---|
| High Tech Index1 (mean) | 2.57 | 2.41 |
| High Tech Index1 (median) | 2.00 | 2.00 |
| Neonatal ICUs2 (pct) | 16.79 | 18.20 |
| Cardiac Catheterization2 (pct) | 26.19 | 25.21 |
| CT Scanners2 (pct) | 78.75 | 70.96 |
| MRIs2 (pct) | 55.41 | 50.28 |
| Open Heart Surgeries2 (pct) | 20.49 | 20.63 |
| Transplant Services2 (pct) | 7.50 | 7.25 |
| Intensity Modulated Radiation Therapy2 (pct) | 15.84 | 16.17 |
| Extracorporeal Shock Wave Lithotripsy2 (pct) | 21.35 | 19.86 |
| PET Scanners2 (pct) | 14.99 | 12.44 |
| Pediatric Specialty Hospitals (pct) | 1.80 | 1.37 |
| Burn Units (pct) | 3.80 | 3.88 |
| Rehabilitation Units (pct) | 23.81 | 23.93 |
| Alc/Chem Dep Services (pct) | 7.59 | 7.50 |
| Trauma Centers (pct) | 27.89 | 27.50 |
| Emergency Departments (pct) | 80.36 | 73.97 |
Note: Significance tests were not performed because AHA numbers are not sample statistics.
1Prior to 2004, the index included Angioplasty services.
2High technology service - used in the "High Tech Index."
| NIS Mean (Unweighted) | Universe Mean | NIS Median (Unweighted) | Universe Median | |
|---|---|---|---|---|
| Hospital Admissions | 7,004.68 | 6,790.64 | 3,386.50 | 3,178.00 |
| Hospital Discharges | 7,004.68 | 6,790.64 | 3,386.50 | 3,178.00 |
| Hospital Discharges1 | 7,828.76 | 7,558.52 | 3,759.00 | 3,483.00 |
| Average Length of Stay | 6.14 | 5.84 | 4.43 | 4.41 |
| Average Length of Stay1 | 5.62 | 5.45 | 4.05 | 4.04 |
| Births | 824.08 | 767.88 | 302.00 | 232.00 |
| Percent Medicare Days | 55.20 | 55.72 | 55.20 | 56.79 |
| Percent Medicare Discharges | 49.37 | 49.13 | 48.76 | 48.50 |
| Percent Medicare Discharges1 | 45.84 | 45.83 | 43.99 | 44.07 |
| Percent Medicaid Days | 14.73 | 14.39 | 12.69 | 12.42 |
| Percent Medicaid Discharges | 15.75 | 15.60 | 15.30 | 14.95 |
| Percent Medicaid Discharges1 | 14.12 | 14.16 | 13.75 | 13.55 |
| Hospital Beds | 146.20 | 144.50 | 83.50 | 81.00 |
| Occupancy Rate | 53.21 | 53.12 | 54.83 | 55.56 |
| Inpatient Surgeries | 1,987.14 | 1,991.45 | 898.00 | 825.00 |
| FTE2 | 846.75 | 829.46 | 395.00 | 381.50 |
| FTE2 per Bed | 5.60 | 5.56 | 5.18 | 5.11 |
| RN FTE2 per 1000 Patient Days | 3.17 | 3.29 | 2.96 | 2.94 |
| Intern-Resident FTE2 per 100 Beds | 5.45 | 5.92 | 0.00 | 0.00 |
| Intern-Resident FTE2 per 100 Beds (Teaching Hospitals) | 30.32 | 35.73 | 10.53 | 13.58 |
| Total Hospital Expenses [dollars] | 103,599,162 | 99,353,450 | 43,455,064 | 39,361,147 |
| Hosp. Expenses per Bed [dollars] | 628,002 | 616,550 | 561,940 | 560,385 |
| Total Hospital Payroll [dollars] | 42,397,469 | 40,086,698 | 17,610,999 | 16,080,243 |
| Hosp. Payroll per Bed [dollars] | 254,295 | 247,186 | 228,138 | 221,846 |
Note: Significance tests were not performed because AHA numbers are not sample statistics.
1Adjusted for well newborns.
2Full-time equivalents.
| Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | |||
|---|---|---|---|---|
| NIS | AHA | NIS | AHA | |
| Overall | 39,163 (765) | 39,611 | 4.65 (0.03) | 4.54** |
| Region | ||||
| Northeast | 7,753 (333) | 7,753 | 5.27 (0.09) | 5.15 |
| South | 9,020 (296) | 9,020 | 4.42 (0.06) | 4.34 |
| Midwest | 14,942 (537) | 14,942 | 4.60 (0.05) | 4.56 |
| West | 7,447 (311) | 7,447 | 4.35 (0.09) | 4.10** |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
| Hospital Ownership | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | ||
|---|---|---|---|---|
| NIS | AHA | NIS | AHA | |
| Total Public | 5,524 (604) | 5,284 | 4.83 (0.11) | 4.74 |
| 1-99 Beds | 1,130 (64) | 1,086 | 3.92 (0.18) | 4.02 |
| 100-199 Beds | 683 (90) | 874* | 3.96 (0.14) | 4.19 |
| 200-299 Beds | 573 (136) | 671 | 4.71 (0.15) | 4.31* |
| 300-499 Beds | 1,405 (223) | 1,252 | 5.29 (0.10) | 5.14 |
| 500+ Beds | 1,730 (368) | 1,399 | 5.44 (0.28) | 5.49 |
| Total Private Non-Profit | 28,231 (953) | 28,546 | 4.62 (0.04) | 4.49** |
| 1-99 Beds | 2,878 (162) | 2,708 | 3.78 (0.06) | 3.84 |
| 100-199 Beds | 4,989 (293) | 5,023 | 4.36 (0.06) | 4.17** |
| 200-299 Beds | 5,682 (490) | 5,766 | 4.66 (0.09) | 4.39** |
| 300-499 Beds | 8,829 (769) | 8,401 | 4.66 (0.07) | 4.47* |
| 500+ Beds | 5,851 (836) | 6,646 | 5.17 (0.12) | 5.12 |
| Total Proprietary | 5,408 (341) | 5,333 | 4.60 (0.09) | 4.58 |
| 1-99 Beds | 934 (91) | 1,019 | 4.95 (0.34) | 4.98 |
| 100-199 Beds | 1,667 (108) | 1,693 | 4.35 (0.16) | 4.25 |
| 200-299 Beds | 1,679 (202) | 1,323 | 4.47 (0.14) | 4.43 |
| 300-499 Beds | 635 (178) | 882 | 4.79 (0.13) | 4.90 |
| 500+ Beds | 491 (90) | 415 | 4.95 (0.23) | 4.78 |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
| Location / Teaching Status | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | ||
|---|---|---|---|---|
| NIS | AHA | NIS | AHA | |
| Rural | 5,176 (179) | 5,176 | 3.98 (0.06) | 4.18** |
| small | 1,291 (55) | 1,320 | 3.64 (0.15) | 3.68 |
| medium | 1,509 (128) | 1,337 | 3.69 (0.05) | 3.97** |
| large | 2,375 (220) | 2,518 | 4.34 (0.08) | 4.55* |
| Urban, Non-teaching | 17,899 (431) | 17,899 | 4.56 (0.04) | 4.34** |
| small | 2,016 (140) | 2,065 | 4.52 (0.17) | 4.49 |
| medium | 4,482 (200) | 4,867 | 4.33 (0.08) | 4.09** |
| large | 11,401 (395) | 10,965 | 4.65 (0.05) | 4.43** |
| Urban, Teaching | 16,088 (605) | 16,088 | 4.96 (0.06) | 4.87 |
| small | 2,447 (321) | 2,136 | 4.50 (0.14) | 4.54 |
| medium | 4,652 (530) | 4,403 | 4.86 (0.12) | 4.68 |
| large | 8,988 (846) | 9,547 | 5.15 (0.09) | 5.04 |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
All NIS and NHDS estimates agreed in the overall and regional comparisons. Agreements were also observed for most comparisons across hospital, patient, diagnoses, and procedure categories. Overall, agreement between the NIS and NHDS was observed for 70 percent of the discharge comparisons and 99 percent of the average length of stay (ALOS) comparisons. The degree of consistency for in-hospital mortality rates was also high: no significant differences were found among these region and patient categories, and estimates agreed for 65 percent of hospital category comparisons. Of the NIS-NHDS differences discovered, most occur in diagnosis and procedure groupings.
The NIS provides a large sample size that tends to yield estimates with much smaller standard errors than does a sample such as the NHDS. Without a sample of several million, as provided by the NIS, estimates for less common procedures and diagnoses are unreliable. While the NIS may over-represent urban areas, the prevalence of higher-density states in the NIS yields data on atypical conditions rarely included in a smaller sample.
When estimating ALOS and in-hospital mortality for the nation, or within any major categories, NIS rates were consistent with the NHDS data. Because NIS estimates have greater precision – the result of the large sample size – it may be preferred for certain analyses based on relatively uncommon conditions. Furthermore, the NIS contains total hospital charges, while the NHDS does not.
| Overall | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | |||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| Overall | 39,163 (765) | 38,666 (1,763) | 4.63 (0.03) | 4.62 (0.33) | 2.09 (0.04) | 1.98 (0.12) |
| Region | ||||||
| Northeast | 7,753 (333) | 7,931 (1,078) | 5.26 (0.09) | 5.191 (c) | 2.45 (0.17) | 2.131 (c) |
| South | 9,020 (296) | 8,753 (1,039) | 4.41 (0.06) | 4.091 (c) | 1.91 (0.05) | 2.011 (c) |
| Midwest | 14,942 (537) | 14,335 (795) | 4.58 (0.05) | 4.74 (0.41) | 2.08 (0.05) | 1.91 (0.15) |
| West | 7,447 (311) | 7,646 (570) | 4.33 (0.09) | 4.401 (c) | 1.94 (0.07) | 1.92 (0.20) |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
(c) A valid standard error could not be calculated.
| Hospital Control | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | |||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| Total Public | 5,524 (604) | 4,559 (211) | 4.81 (0.11) | 4.82 (0.35) | 2.05 (0.07) | 1.76* (0.11) |
| 1-99 Beds | 1,130 (64) | 1,235 (59) | 3.90 (0.18) | 3.64 (0.27) | 2.37 (0.08) | 1.31** (0.09) |
| 100-199 Beds | 683 (90) | 850 (42) | 3.94 (0.14) | 4.15 (0.32) | 1.89 (0.14) | 1.68 (0.11) |
| 200-299 Beds | 573 (136) | 377 (20) | 4.69 (0.15) | 4.50 (0.36) | 1.95 (0.22) | 1.76 (0.13) |
| 300-499 Beds | 1,405 (223) | 1,408 (67) | 5.27 (0.10) | 5.45 (0.41) | 1.93 (0.11) | 2.27 (0.15) |
| 500+ Beds | 1,730 (368) | 686** (34) | 5.42 (0.28) | 6.61* (0.51) | 2.03 (0.17) | 1.63 (0.11) |
| Total Private Non-Profit | 28,231 (953) | 29,351 (1,339) | 4.60 (0.04) | 4.56 (0.33) | 2.09 (0.05) | 2.05 (0.13) |
| 1-99 Beds | 2,878 (162) | 6,626** (305) | 3.75 (0.06) | 4.02 (0.29) | 2.01 (0.06) | 1.72* (0.11) |
| 100-199 Beds | 4,989 (293) | 6,269** (289) | 4.34 (0.06) | 4.43 (0.32) | 2.10 (0.08) | 2.01 (0.13) |
| 200-299 Beds | 5,682 (490) | 6,172 (284) | 4.65 (0.09) | 4.62 (0.33) | 2.25 (0.22) | 2.04 (0.13) |
| 300-499 Beds | 8,829 (769) | 6,380** (294) | 4.64 (0.07) | 4.75 (0.34) | 2.04 (0.07) | 2.32 (0.15) |
| 500+ Beds | 5,851 (836) | 3,902* (181) | 5.15 (0.12) | 5.27 (0.38) | 2.03 (0.10) | 2.29 (0.15) |
| Total Proprietary | 5,408 (341) | 4,755 (220) | 4.58 (0.09) | 4.82 (0.35) | 2.11 (0.06) | 1.74** (0.11) |
| 1-99 Beds | 934 (91) | 1,014 (49) | 4.93 (0.34) | 5.24 (0.39) | 2.26 (0.20) | 1.60** (0.11) |
| 100-199 Beds | 1,667 (108) | 2,170** (102) | 4.33 (0.16) | 4.69 (0.34) | 2.00 (0.10) | 1.57** (0.10) |
| 200-299 Beds | 1,679 (202) | 945** (46) | 4.45 (0.14) | 4.68 (0.35) | 2.11 (0.09) | 2.25 (0.15) |
| 300-499 Beds | 635 (178) | 625 (32) | 4.77 (0.13) | 4.78 (0.37) | 2.27 (0.18) | 1.83 (0.13) |
| 500+ Beds | 491 (90) | 01 (a) | 4.93 (0.23) | 0.001 (a) | 2.00 (0.14) | 0.001 (a) |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
(a) Because of very small sample size, the NHDS estimate and standard error were unreliable and not reported.
| Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | ||||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| Age Group | ||||||
| 0-15 Years | 6,632 (261) | 6,594 (303) | 3.68 (0.08) | 3.88 (0.28) | 0.41 (0.02) | 0.43 (0.02) |
| 16-44 Years | 10,445 (259) | 10,494 (481) | 3.61 (0.04) | 3.69 (0.27) | 0.41 (0.01) | 0.36 (0.02) |
| 45-64 Years | 8,659 (201) | 8,349 (383) | 4.93 (0.04) | 4.96 (0.36) | 1.83 (0.05) | 1.77 (0.11) |
| 65+ Years | 13,374 (314) | 13,228 (605) | 5.70 (0.04) | 5.51 (0.40) | 4.40 (0.07) | 4.17 (0.27) |
| Gender | ||||||
| Female | 22,980 (472) | 22,720 (1,037) | 4.41 (0.03) | 4.39 (0.32) | 1.80 (0.04) | 1.65 (0.10) |
| Male | 16,052 (310) | 15,946 (729) | 4.95 (0.03) | 4.94 (0.36) | 2.51 (0.04) | 2.45 (0.15) |
| Race | ||||||
| White | 19,636 (776) | 23,031* (1,504) | 4.75 (0.04) | 4.63 (0.46) | 2.42 (0.05) | 2.09 (0.19) |
| Black | 3,395 (219) | 4,527** (316) | 5.26 (0.08) | 5.29 (0.58) | 1.93 (0.10) | 1.72 (0.17) |
| Other | 5,522 (348) | 1,706** (234) | 4.33 (0.08) | 4.681 (c) | 1.42 (0.06) | 2.051 (c) |
| Unknown | 10,609 (729) | 9,401 (1,224) | 4.36 (0.06) | 4.261 (c) | 1.88 (0.04) | 1.841 (c) |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
(c) A valid standard error could not be calculated.
| Principal Payer | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | |||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| Medicare | 14,556 (337) | 13,790 (704) | 5.75 (0.04) | 5.61 (0.43) | 3.89 (0.06) | 3.69 (0.26) |
| Medicaid | 7,642 (271) | 7,433 (591) | 4.33 (0.07) | 4.461 (c) | 0.85 (0.03) | 0.80 (0.09) |
| Private Insurance | 13,684 (421) | 13,204 (764) | 3.74 (0.03) | 3.79 (0.36) | 1.01 (0.04) | 1.05 (0.08) |
| Self Pay | 1,920 (110) | 1,668 (105) | 3.87 (0.08) | 3.84 (0.40) | 1.39 (0.05) | 1.18 (0.10) |
| No Charge | 175 (42) | 65* (12) | 4.35 (0.24) | 4.941 (c) | 1.21 (0.13) | 1.041 (c) |
| Other | 1,135 (59) | 2,504** (474) | 4.31 (0.08) | 4.491 (c) | 1.55 (0.12) | 1.551 (c) |
| Missing | 10 (3) | 01 (a) | 3.59 (0.70) | 0.001 (a) | 1.24 (0.76) | 0.001 (a) |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
(a) Because of very small sample size, the NHDS estimate and standard error were unreliable and not reported.
(c) A valid standard error could not be calculated.
| Principal Diagnosis | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | |||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| 218: Liveborn | 4,228 (157) | 4,008 (186) | 3.17 (0.05) | 3.39 (0.25) | 0.32 (0.01) | 0.40* (0.02) |
| 122: Pneumonia (except that caused by tuberculosis or sexually transmitted disease) | 1,355 (28) | 1,382 (66) | 5.52 (0.04) | 5.27 (0.39) | 3.98 (0.07) | 3.31** (0.22) |
| 101: Coronary atherosclerosis and other heart disease | 1,109 (49) | 1,110 (54) | 3.31 (0.05) | 3.30 (0.25) | 0.52 (0.01) | 0.59 (0.04) |
| 108: Congestive heart failure; nonhypertensive | 1,090 (25) | 1,113 (54) | 5.38 (0.04) | 5.09 (0.38) | 3.87 (0.07) | 3.11** (0.21) |
| 102: Nonspecific chest pain | 824 (32) | 40** (4) | 1.81 (0.01) | 1.421 (c) | 0.05 (0.00) | 0.001 (c) |
| 193: OB-related trauma to perineum and vulva | 784 (36) | --1 (a) | 2.05 (0.01) | --1 (a) | 0.00 (0.00) | --1 (a) |
| 195: Other complications of birth; puerperium affecting management of mother | 761 (29) | 71** (5) | 2.72 (0.02) | 3.12 (0.36) | 0.02 (0.00) | 0.00** (0.00) |
| 203: Osteoarthritis | 738 (29) | 760 (38) | 3.72 (0.03) | 3.74 (0.29) | 0.10 (0.00) | 0.09 (0.00) |
| 106: Cardiac dysrhythmias | 696 (19) | 758 (38) | 3.51 (0.03) | 3.30 (0.25) | 1.09 (0.03) | 0.50** (0.03) |
| 100: Acute myocardial infarction | 662 (23) | 682 (34) | 5.23 (0.06) | 5.50 (0.42) | 6.81 (0.13) | 7.91 (0.56) |
| 205: Spondylosis; intervertebral disc disorders; other back problems | 647 (28) | 610 (31) | 3.06 (0.04) | 3.08 (0.24) | 0.15 (0.01) | 0.11** (0.00) |
| 69: Affective disorders | 642 (39) | 963** (47) | 7.37 (0.17) | 7.21 (0.54) | 0.03 (0.00) | 0.05 (0.00) |
| 127: Chronic obstructive pulmonary disease and bronchiectasis | 630 (14) | 719* (36) | 4.89 (0.04) | 4.74 (0.36) | 2.04 (0.06) | 2.06 (0.14) |
| 237: Complication of device; implant or graft | 615 (22) | 539* (28) | 5.98 (0.07) | 5.97 (0.47) | 1.77 (0.05) | 1.34** (0.09) |
| 197: Skin and subcutaneous tissue infections | 582 (13) | 566 (29) | 4.55 (0.04) | 4.66 (0.36) | 0.34 (0.01) | 0.23** (0.01) |
| 55: Fluid and electrolyte disorders | 573 (13) | 740** (37) | 3.69 (0.03) | 3.45 (0.27) | 1.93 (0.06) | 1.73 (0.12) |
| 2: Septicemia (except in labor) | 537 (16) | 492 (25) | 8.84 (0.10) | 8.21 (0.64) | 18.28 (0.28) | 19.15 (1.42) |
| 159: Urinary tract infections | 528 (11) | 641** (32) | 4.44 (0.04) | 4.30 (0.33) | 1.22 (0.04) | 1.01* (0.07) |
| 109: Acute cerebrovascular disease | 526 (13) | 528 (27) | 6.18 (0.07) | 6.34 (0.49) | 10.12 (0.16) | 10.77 (0.79) |
| 254: Rehabilitation care; fitting of prostheses; and adjustment of devices | 516 (33) | 495 (26) | 12.26 (0.18) | 11.56 (0.90) | 0.71 (0.09) | 0.49* (0.03) |
| 181: Other complications of pregnancy | 513 (20) | 211** (12) | 2.42 (0.01) | 2.76 (0.25) | 0.03 (0.00) | 0.00** (0.00) |
| 50: Diabetes mellitus with complications | 491 (11) | 486 (25) | 5.34 (0.06) | 5.20 (0.41) | 1.00 (0.03) | 0.75** (0.05) |
| 189: Previous C-section | 481 (19) | --1 (a) | 2.85 (0.02) | --1 (a) | 0.00 (0.00) | --1 (a) |
| 238: Complications of surgical procedures or medical care | 463 (12) | 451 (24) | 6.28 (0.06) | 5.95 (0.47) | 1.39 (0.04) | 1.80** (0.13) |
| 149: Biliary tract disease | 455 (10) | 433 (23) | 4.23 (0.03) | 4.22 (0.34) | 0.73 (0.03) | 0.74 (0.05) |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
(a) Because of very small sample size, the NHDS estimate and standard error were unreliable and not reported.
(c) A valid standard error could not be calculated.
| Principal Procedure | Number of Discharges in Thousands (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | |||
|---|---|---|---|---|---|---|
| NIS | NHDS | NIS | NHDS | NIS | NHDS | |
| 137: Other procedures to assist delivery | 1,475 (64) | 1,020** (50) | 2.12 (0.01) | 2.17 (0.16) | 0.00 (0.00) | 0.00** (0.00) |
| 134: Cesarean section | 1,301 (49) | 1,255 (60) | 3.62 (0.03) | 3.49 (0.26) | 0.01 (0.00) | 0.02** (0.00) |
| 115: Circumcision | 1,195 (49) | 1,152 (56) | 2.99 (0.05) | 2.90 (0.22) | 0.00 (0.00) | 0.03** (0.00) |
| 45: Percutaneous transluminal coronary angioplasty (PTCA) | 749 (45) | 579** (29) | 2.70 (0.04) | 2.80 (0.22) | 0.75 (0.03) | 0.92* (0.06) |
| 70: Upper gastrointestinal endoscopy; biopsy | 706 (18) | 692 (35) | 5.40 (0.03) | 5.24 (0.40) | 1.40 (0.03) | 1.23 (0.08) |
| 140: Repair of current obstetric laceration | 694 (41) | 829* (41) | 2.15 (0.01) | 2.11 (0.16) | 0.00 (0.00) | 0.00 (0.00) |
| 216: Respiratory intubation and mechanical ventilation | 667 (15) | 634 (32) | 10.72 (0.19) | 10.34 (0.79) | 26.97 (0.41) | 24.38 (1.76) |
| 222: Blood transfusion | 614 (20) | 579 (29) | 5.77 (0.05) | 5.78 (0.45) | 5.04 (0.10) | 4.43 (0.32) |
| 47: Diagnostic cardiac catheterization; coronary arteriography | 603 (23) | 514* (26) | 3.60 (0.04) | 3.71 (0.29) | 0.83 (0.03) | 0.53** (0.03) |
| 228: Prophylactic vaccinations and inoculations | 570 (58) | 587 (30) | 2.57 (0.08) | 2.59 (0.20) | 0.02 (0.01) | 0.00 (0.00) |
| 124: Hysterectomy; abdominal and vaginal | 567 (18) | 552 (28) | 2.66 (0.02) | 2.74 (0.22) | 0.07 (0.00) | 0.10* (0.00) |
| 152: Arthroplasty knee | 549 (22) | 558 (28) | 3.81 (0.03) | 3.79 (0.30) | 0.11 (0.01) | 0.06** (0.00) |
| 231: Other therapeutic procedures | 512 (37) | 578 (29) | 5.25 (0.10) | 4.80 (0.37) | 2.89 (0.20) | 2.50 (0.18) |
| 54: Other vascular catheterization; not heart | 497 (14) | 480 (25) | 9.22 (0.11) | 9.42 (0.74) | 8.31 (0.22) | 7.73 (0.57) |
| 84: Cholecystectomy and common duct exploration | 388 (10) | 346 (19) | 4.71 (0.04) | 4.45 (0.36) | 0.75 (0.03) | 0.74 (0.05) |
| 153: Hip replacement; total and partial | 381 (14) | 369 (20) | 4.86 (0.05) | 5.03 (0.41) | 0.89 (0.04) | 1.22** (0.09) |
| 158: Spinal fusion | 332 (18) | 306 (17) | 3.94 (0.08) | 4.14 (0.34) | 0.24 (0.02) | 0.15** (0.01) |
| 48: Insertion; revision; replacement; removal of cardiac pacemaker or cardioverter/defibrillator | 325 (14) | 294 (16) | 4.76 (0.07) | 4.54 (0.38) | 0.97 (0.04) | 1.00 (0.08) |
| 133: Episiotomy | 308 (18) | 326 (18) | 2.17 (0.01) | 2.17 (0.18) | 0.00 (0.00) | 0.00 (0.00) |
| 80: Appendectomy | 308 (9) | 317 (17) | 2.88 (0.03) | 2.78 (0.23) | 0.12 (0.01) | 0.08* (0.00) |
| 58: Hemodialysis | 303 (10) | 258* (15) | 5.55 (0.07) | 5.49 (0.46) | 3.42 (0.10) | 3.40 (0.28) |
| 219: Alcohol and drug rehabilitation/detoxification | 294 (31) | 309 (17) | 5.59 (0.47) | 5.74 (0.47) | 0.11 (0.01) | 0.19** (0.01) |
| 78: Colorectal resection | 284 (8) | 269 (15) | 999 (0.07) | 10.07 (0.83) | 3.93 (0.10) | 3.90 (0.31) |
| 146: Treatment; fracture or dislocation of hip and femur | 276 (6) | 260 (15) | 6.03 (0.05) | 5.93 (0.50) | 1.86 (0.06) | 2.24 (0.18) |
| 61: Other OR procedures on vessels other than head and neck | 272 (9) | 238* (14) | 8.88 (0.23) | 9.09 (0.76) | 4.38 (0.13) | 3.34** (0.28) |
* Significant at a 5 percent level.
** Significant at a 1 percent level.
1 A significance test was not performed because a valid standard error was not available.
(a) Because of very small sample size, the NHDS estimate and standard error were unreliable and not reported.
(c) A valid standard error could not be calculated.
With the exception of discharge counts, NIS estimates of Medicare measures were generally consistent with MedPAR statistics. NIS discharge estimates were uniformly higher than the MedPAR numbers by approximately 10 percent, consistent with the omission of most managed care enrollees from the MedPAR. While 13.3 percent of Medicare patients were enrolled in managed care programs, the MedPAR data contain virtually no managed care discharges (only 485 out of 13,544,670 total discharges, or 0.004 percent).
The NIS provides a large sample of Medicare discharges both in managed care and fee-for-service plans; it would therefore be the choice of researchers who wished to include all discharges regardless of payment type. Inclusion of Medicare managed care discharges leads to discrepancies in estimated discharge counts, but most other NIS Medicare estimates were similar to MedPAR statistics, particularly with respect to comparisons by hospital characteristics. For analyses involving charges on all payers, the NIS is the only choice.
The NIS also contains significant numbers of discharges for which race was missing (26 percent). While the NHDS also suffers from this problem (24 percent of discharges without race), race information is present for nearly all MedPAR discharges.
| Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| U.S. | 14,556 (336) | 13,178** | n/a | n/a | 5.77 (0.04) | 5.90** | 3.89 (0.06) | 3.74* | $28,174 (673) | $28,301 |
| Region | ||||||||||
| Northeast | 2,936 (154) | 2,565* | 20.17 (0.94) | 19.46 | 6.61 (0.12) | 6.58 | 4.67 (0.24) | 4.17* | $31,512 (2,069) | $32,844 |
| South | 3,534 (134) | 3,572 | 24.27 (0.86) | 27.10** | 5.30 (0.06) | 5.43* | 3.39 (0.07) | 3.34 | $21,784 (586) | $23,063* |
| Midwest | 5,688 (236) | 5,255 | 39.08 (1.18) | 39.88 | 5.75 (0.06) | 6.02** | 3.81 (0.07) | 3.79 | $25,309 (646) | $26,231 |
| West | 2,396 (125) | 1,784** | 16.46 (0.80) | 13.54** | 5.48 (0.12) | 5.55 | 3.88 (0.13) | 3.77 | $41,283 (2,461) | $38,351 |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
| Control | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| Total Public | 1,822 (178) | 1,563 | 12.52 (1.22) | 11.86 | 5.57 (0.11) | 5.55 | 3.91 (0.10) | 3.77 | $22,320 (1,252) | $22,408 |
| 1-99 Beds | 568 (30) | 441** | 31.19 (2.61) | 28.25 | 4.51 (0.09) | 4.29* | 3.82 (0.11) | 3.44** | $10,006 (355) | $10,120 |
| 100-199 Beds | 245 (39) | 294 | 13.46 (2.35) | 18.85* | 5.04 (0.13) | 5.39** | 3.74 (0.17) | 3.69 | $18,878 (1,322) | $18,841 |
| 200-299 Beds | 164 (48) | 213 | 9.01 (2.63) | 13.63 | 6.30 (0.21) | 5.79* | 4.40 (0.39) | 3.86 | $23,996 (2,024) | $25,132 |
| 300-499 Beds | 376 (80) | 312 | 20.66 (4.44) | 20.00 | 6.22 (0.18) | 6.34 | 3.74 (0.28) | 4.03 | $32,719 (1,888) | $31,047 |
| 500+ Beds | 467 (133) | 300 | 25.64 (5.99) | 19.24 | 6.38 (0.21) | 6.57 | 4.05 (0.19) | 4.00 | $30,126 (4,520) | $33,029 |
| Total Private Non-Profit | 10,653 (367) | 9,683** | 73.18 (1.46) | 73.48 | 5.74 (0.05) | 5.75 | 3.91 (0.08) | 3.75 | $27,693 (876) | $27,703 |
| 1-99 Beds | 1,271 (69) | 1,073** | 11.93 (0.71) | 11.08 | 4.74 (0.08) | 4.85 | 3.69 (0.09) | 3.45* | $15,476 (636) | $14,924 |
| 100-199 Beds | 2,041 (126) | 1,798 | 19.16 (1.18) | 18.57 | 5.46 (0.08) | 5.52 | 3.92 (0.11) | 3.72 | $22,925 (1,382) | $22,347 |
| 200-299 Beds | 2,070 (196) | 1,941 | 19.43 (1.92) | 20.04 | 5.87 (0.11) | 5.72 | 4.21 (0.32) | 3.77 | $29,935 (1,900) | $27,334 |
| 300-499 Beds | 3,244 (304) | 2,794 | 30.45 (2.73) | 28.86 | 5.79 (0.08) | 5.83 | 3.84 (0.11) | 3.73 | $28,269 (1,204) | $29,950 |
| 500+ Beds | 2,024 (301) | 2,075 | 19.00 (2.56) | 21.43 | 6.44 (0.18) | 6.34 | 3.83 (0.19) | 3.93 | $37,078 (3,273) | $36,272 |
| Total Proprietary | 2,080 (120) | 1,931 | 14.29 (0.85) | 14.65 | 6.10 (0.14) | 6.96** | 3.81 (0.11) | 3.68 | $35,750 (1,471) | $36,070 |
| 1-99 Beds | 385 (32) | 486** | 18.50 (1.56) | 25.20** | 7.35 (0.60) | 8.98** | 4.19 (0.36) | 3.52 | $28,324 (2,249) | $29,673 |
| 100-199 Beds | 676 (49) | 598 | 32.50 (2.09) | 30.97 | 5.68 (0.20) | 6.18* | 3.54 (0.17) | 3.64 | $31,606 (1,891) | $33,108 |
| 200-299 Beds | 627 (85) | 456* | 30.14 (3.84) | 23.64 | 5.79 (0.20) | 6.21* | 3.86 (0.22) | 3.88 | $43,115 (3,543) | $38,915 |
| 300-499 Beds | 257 (68) | 271 | 12.39 (3.28) | 14.03 | 5.97 (0.18) | 6.53** | 3.79 (0.22) | 3.65 | $40,200 (2,192) | $46,975** |
| 500+ Beds | 134 (40) | 118 | 6.45 (1.91) | 6.13 | 6.26 (0.35) | 6.46 | 3.84 (0.25) | 3.87 | $34,759 (3,230) | $41,393* |
*Significant at a 5 percent level.
**Significant at a 1 percent level.
1A significance test was not performed because a valid standard error was not available.
| Hospital Type | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| Rural | 2,433 (84) | 2,208** | 16.71 (0.61) | 16.75 | 4.88 (0.06) | 4.81 | 3.90 (0.07) | 3.59** | $14,619 (494) | $14,865 |
| small | 669 (26) | 555** | 27.49 (1.33) | 25.13 | 4.18 (0.07) | 3.99* | 3.70 (0.10) | 3.27** | $9,584 (327) | $9,371 |
| medium | 680 (59) | 565 | 27.95 (2.65) | 25.61 | 4.63 (0.07) | 4.61 | 3.81 (0.10) | 3.53** | $13,854 (468) | $13,922 |
| large | 1,084 (101) | 1,087 | 44.55 (3.07) | 49.25 | 5.46 (0.10) | 5.33 | 4.07 (0.12) | 3.78* | $18,204 (955) | $18,159 |
| Urban, Non-teaching | 7,130 (200) | 6,297** | 48.98 (1.15) | 47.78 | 5.85 (0.06) | 6.10** | 3.96 (0.10) | 3.75 | $29,763 (809) | $29,376 |
| small | 832 (52) | 854 | 11.67 (0.75) | 13.56* | 6.33 (0.29) | 7.59** | 3.98 (0.19) | 3.61 | $23,598 (1,271) | $24,911 |
| medium | 1,791 (87) | 1,672 | 25.12 (1.22) | 26.55 | 5.56 (0.09) | 5.83** | 3.89 (0.11) | 3.74 | $27,148 (1,459) | $26,926 |
| large | 4,506 (187) | 3,770** | 63.20 (1.31) | 59.87* | 5.88 (0.07) | 5.88 | 3.98 (0.16) | 3.79 | $31,960 (1,143) | $31,474 |
| Urban, Teaching | 4,992 (257) | 4,673 | 34.29 (1.26) | 35.46 | 6.08 (0.08) | 6.16 | 3.80 (0.10) | 3.80 | $32,661 (1,562) | $33,201 |
| small | 746 (116) | 567 | 14.94 (2.31) | 12.14 | 5.57 (0.18) | 6.00* | 3.49 (0.25) | 3.55 | $28,781 (3,689) | $29,985 |
| medium | 1,430 (191) | 1,248 | 28.64 (3.98) | 26.71 | 5.89 (0.14) | 6.02 | 4.07 (0.18) | 3.78 | $27,304 (1,574) | $30,391* |
| large | 2,816 (295) | 2,857 | 56.40 (4.26) | 61.14 | 6.32 (0.13) | 6.25 | 3.73 (0.13) | 3.86 | $36,143 (2,377) | $35,068 |
*Significant at a
5 percent level.
**Significant at
a 1 percent level.
1A
significance test was not performed because a valid standard error was not
available.
| Hospital Type | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| Age Group | ||||||||||
| 0-64 Years | 2,397 (63) | 2,329 | 16.47 (0.30) | 17.67** | 6.08 (0.06) | 6.21* | 1.98 (0.04) | 1.94 | $27,228 (664) | $28,174 |
| 65-74 Years | 4,243 (103) | 3,885** | 29.15 (0.17) | 29.48 | 5.47 (0.04) | 5.66** | 2.96 (0.06) | 2.93 | $30,396 (698) | $30,802 |
| 75-84 Years | 5,145 (129) | 4,429** | 35.35 (0.19) | 33.61** | 5.81 (0.04) | 5.93* | 4.21 (0.07) | 4.01** | $28,897 (720) | $28,678 |
| 85+ Years | 2,765 (70) | 2,533** | 18.99 (0.21) | 19.22 | 5.88 (0.05) | 5.95 | 6.41 (0.10) | 6.16* | $24,259 (711) | $23,930 |
| Gender | ||||||||||
| Female | 8,266 (188) | 7,422** | 56.79 (0.15) | 56.32** | 5.74 (0.04) | 5.88** | 3.62 (0.06) | 3.49* | $26,492 (628) | $26,574 |
| Male | 6,279 (150) | 5,756** | 43.14 (0.15) | 43.67** | 5.81 (0.04) | 5.93** | 4.26 (0.06) | 4.06** | $30,389 (748) | $30,532 |
| Race | ||||||||||
| White | 8,681 (347) | 10,902** | 59.64 (1.67) | 82.72** | 5.79 (0.05) | 5.75 | 4.06 (0.07) | 3.76** | $29,337 (830) | $27,606* |
| Black | 1,007 (66) | 1,616** | 6.92 (0.43) | 12.26** | 6.67 (0.12) | 6.79 | 3.74 (0.14) | 3.68 | $30,997 (1,357) | $30,085 |
| Other | 1,056 (78) | 610** | 7.25 (0.52) | 4.63** | 6.41 (0.13) | 6.34 | 3.98 (0.14) | 3.67* | $38,341 (1,607) | $36,028 |
| Unknown | 3,810 (273) | 48** | 26.17 (1.87) | 0.37** | 5.32 (0.06) | 5.79** | 3.53 (0.07) | 2.79** | $22,109 (711) | $28,136** |
*Significant at a
5 percent level.
**Significant at
a 1 percent level.
1A
significance test was not performed because a valid standard error was not
available.
| DRG | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| 127: Heart failure & shock | 769 (18) | 679** | 5.28 (0.05) | 5.15* | 5.05 (0.03) | 5.09 | 3.92 (0.07) | 3.81 | $19,563 (518) | $19,276 |
| 89: Simple pneumonia & pleurisy age >17 w/CC | 664 (15) | 577** | 4.56 (0.05) | 4.38** | 5.47 (0.04) | 5.50 | 4.24 (0.09) | 4.15 | $19,059 (449) | $18,874 |
| 88: Chronic obstructive pulmonary disease | 498 (11) | 444** | 3.42 (0.05) | 3.37 | 4.84 (0.04) | 4.91 | 1.46 (0.05) | 1.41 | $16,692 (409) | $16,638 |
| 209: Major joint & limb reattachment procedures of lower extremity | 415 (16) | 368** | 2.85 (0.08) | 2.79 | 4.43 (0.04) | 4.43 | 0.58 (0.02) | 0.59 | $37,165 (799) | $37,022 |
| 462: Rehabilitation | 373 (25) | 309* | 2.56 (0.17) | 2.34 | 11.79 (0.15) | 12.38** | 0.86 (0.11) | 0.28** | $24,806 (860) | $26,771* |
| 182: Esophagitis | 350 (8) | 310** | 2.40 (0.02) | 2.35 | 4.49 (0.03) | 4.49 | 1.47 (0.05) | 1.34* | $16,513 (428) | $16,158 |
| 416: Septicemia age >17 | 337 (11) | 300** | 2.31 (0.05) | 2.28 | 7.57 (0.08) | 7.55 | 20.47 (0.32) | 19.59** | $35,507 (1,133) | $33,879 |
| 430: Psychoses | 332 (21) | 339 | 2.28 (0.14) | 2.57* | 10.48 (0.26) | 10.54 | 0.08 (0.01) | 0.08 | $18,275 (769) | $18,108 |
| 14: Specific cerebrovascular disorders except TIA | 319 (8) | 298* | 2.19 (0.02) | 2.26** | 5.32 (0.05) | 6.13** | 10.18 (0.19) | 9.63** | $22,872 (584) | $23,188 |
| 174: G.I. hemorrhage w/CC | 299 (7) | 262** | 2.05 (0.02) | 1.98** | 4.62 (0.03) | 4.64 | 2.84 (0.07) | 2.80 | $19,872 (478) | $19,348 |
| 296: Nutritional & misc metabolic disorders age >17 w/CC | 279 (6) | 249** | 1.92 (0.02) | 1.89 | 4.64 (0.04) | 4.63 | 3.22 (0.10) | 3.25 | $15,507 (392) | $15,273 |
| 143: Chest pain | 277 (9) | 238** | 1.90 (0.04) | 1.81* | 2.03 (0.02) | 2.08* | 0.10 (0.01) | 0.11 | $11,001 (267) | $10,905 |
| 320: Kidney & urinary tract infections age >17 w/CC | 270 (6) | 235** | 1.85 (0.02) | 1.78* | 4.99 (0.05) | 5.00 | 1.90 (0.07) | 1.85 | $16,409 (427) | $16,143 |
| 138: Cardiac arrhythmia & conduction disorders w/CC | 242 (6) | 212** | 1.66 (0.01) | 1.61** | 3.85 (0.03) | 3.88 | 2.41 (0.08) | 2.44 | $15,804 (406) | $15,547 |
| 316: Renal failure | 238 (8) | 215** | 1.64 (0.03) | 1.63 | 6.24 (0.05) | 6.23 | 7.03 (0.17) | 6.87 | $24,078 (632) | $23,728 |
| 79: Respiratory infections & inflammations age >17 w/CC | 193 (6) | 166** | 1.33 (0.02) | 1.26** | 8.24 (0.09) | 8.29 | 11.14 (0.24) | 10.93 | $30,713 (929) | $30,096 |
| 527 | 192 (13) | 179 | 1.32 (0.07) | 1.36 | 2.23 (0.04) | 2.17 | 0.27 (0.02) | 0.25 | $44,942 (1,525) | $43,506 |
| 121: Circulatory disorders w/ ami & major comp | 172 (5) | 147** | 1.18 (0.02) | 1.11** | 6.08 (0.06) | 6.07 | 0.00 (0.00) | 0.001 | $29,246 (844) | $28,746 |
| 148: Major small & large bowel procedures w/CC | 148 (4) | 132** | 1.02 (0.01) | 1.00 | 11.87 (0.08) | 11.82 | 6.96 (0.17) | 7.03 | $64,851 (1,647) | $63,968 |
| 210: Hip & femur procedures except major joint age >17 w/CC | 148 (4) | 127** | 1.02 (0.01) | 0.96** | 6.59 (0.05) | 6.58 | 2.68 (0.09) | 2.63 | $35,532 (836) | $34,758 |
| 475: Respiratory system diagnosis with ventilator support | 145 (4) | 134* | 1.00 (0.01) | 1.02 | 11.54 (0.24) | 12.26** | 33.03 (0.44) | 32.79 | $70,242 (1,905) | $72,598 |
| 141: Syncope & collapse w/CC | 143 (4) | 126** | 0.98 (0.01) | 0.95 | 3.39 (0.04) | 3.40 | 0.38 (0.03) | 0.42 | $14,780 (401) | $14,508 |
| 277: Cellulitis age >17 w/CC | 140 (3) | 124** | 0.96 (0.01) | 0.94 | 5.53 (0.05) | 5.53 | 0.80 (0.05) | 0.80 | $17,345 (490) | $16,841 |
| 395: Red blood cell disorders age >17 | 136 (3) | 118** | 0.93 (0.01) | 0.90* | 4.14 (0.05) | 4.23 | 1.35 (0.07) | 1.36 | $16,144 (447) | $16,478 |
| 524 | 124 (3) | 109** | 0.85 (0.01) | 0.83 | 3.09 (0.03) | 3.10 | 0.20 (0.03) | 0.19 | $14,277 (363) | $13,961 |
*Significant at a
5 percent level.
**Significant at
a 1 percent level.
1A
significance test was not performed because a valid standard error was not
available.
| Principal Diagnosis | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| 108: Congestive heart failure; nonhypertensive | 840 (21) | 745** | 5.77 (0.05) | 5.65* | 5.44 (0.04) | 5.48 | 4.18 (0.08) | 4.06 | $26,918 (779) | $27,444 |
| 122: Pneumonia (except that caused by tuberculosis or sexually transmitted disease) | 815 (18) | 708** | 5.60 (0.06) | 5.37** | 6.10 (0.05) | 6.14 | 5.41 (0.09) | 5.31 | $23,141 (575) | $23,098 |
| 101: Coronary atherosclerosis and other heart disease | 617 (28) | 580 | 4.24 (0.14) | 4.40 | 3.61 (0.05) | 3.63 | 0.72 (0.03) | 0.77 | $42,519 (1,304) | $41,265 |
| 106: Cardiac dysrhythmias | 460 (13) | 411** | 3.16 (0.04) | 3.12 | 3.85 (0.03) | 3.85 | 1.36 (0.04) | 1.34 | $25,423 (681) | $25,502 |
| 127: Chronic obstructive pulmonary disease and bronchiectasis | 452 (10) | 404** | 3.10 (0.05) | 3.06 | 5.07 (0.04) | 5.15 | 2.24 (0.06) | 2.19 | $18,545 (466) | $18,554 |
| 203: Osteoarthritis | 438 (17) | 415 | 3.01 (0.09) | 3.15 | 3.84 (0.03) | 4.20** | 0.15 (0.01) | 0.14 | $34,993 (737) | $39,380** |
| 100: Acute myocardial infarction | 391 (13) | 346** | 2.68 (0.06) | 2.63 | 5.89 (0.06) | 5.89 | 9.27 (0.16) | 9.21 | $46,896 (1,338) | $46,877 |
| 254: Rehabilitation care; fitting of prostheses; and adjustment of devices | 377 (25) | 313* | 2.59 (0.17) | 2.37 | 11.86 (0.15) | 12.46** | 0.86 (0.11) | 0.28** | $25,117 (873) | $27,125* |
| 2: Septicemia (except in labor) | 375 (12) | 335** | 2.57 (0.06) | 2.54 | 8.77 (0.12) | 8.77 | 20.25 (0.32) | 19.39** | $44,216 (1,439) | $42,983 |
| 109: Acute cerebrovascular disease | 354 (9) | 332* | 2.43 (0.03) | 2.52** | 5.93 (0.06) | 6.69** | 10.41 (0.19) | 9.90** | $28,206 (810) | $28,259 |
| 237: Complication of device; implant or graft | 351 (12) | 336 | 2.41 (0.05) | 2.54* | 6.14 (0.07) | 6.20 | 2.21 (0.07) | 2.15 | $41,238 (1,192) | $42,565 |
| 159: Urinary tract infections | 323 (7) | 281** | 2.22 (0.03) | 2.13** | 4.99 (0.05) | 5.02 | 1.75 (0.06) | 1.72 | $16,813 (448) | $16,679 |
| 102: Nonspecific chest pain | 322 (10) | 283** | 2.21 (0.04) | 2.15 | 2.16 (0.02) | 2.19 | 0.12 (0.01) | 0.11 | $12,613 (297) | $12,583 |
| 55: Fluid and electrolyte disorders | 307 (6) | 273** | 2.11 (0.02) | 2.07 | 4.43 (0.03) | 4.41 | 2.80 (0.09) | 2.81 | $15,191 (378) | $15,022 |
| 226: Fracture of neck of femur (hip) | 268 (7) | 238** | 1.84 (0.02) | 1.80 | 6.30 (0.05) | 6.81** | 3.00 (0.08) | 2.92 | $33,962 (730) | $35,866** |
| 205: Spondylosis; intervertebral disc disorders; other back problems | 231 (8) | 225 | 1.58 (0.04) | 1.70** | 3.90 (0.05) | 4.11** | 0.34 (0.02) | 0.32 | $30,371 (1,142) | $29,821 |
| 131: Respiratory failure; insufficiency; arrest (adult) | 221 (8) | 212 | 1.52 (0.04) | 1.61* | 10.31 (0.26) | 10.98* | 21.87 (0.40) | 21.09 | $56,286 (1,680) | $58,673 |
| 50: Diabetes mellitus with complications | 213 (5) | 195** | 1.46 (0.02) | 1.48 | 6.32 (0.08) | 6.36 | 1.67 (0.07) | 1.54 | $26,784 (823) | $26,826 |
| 153: Gastrointestinal hemorrhage | 212 (5) | 186** | 1.45 (0.01) | 1.41** | 4.84 (0.03) | 4.87 | 3.88 (0.10) | 3.88 | $22,295 (529) | $21,892 |
| 157: Acute and unspecified renal failure | 205 (7) | 182** | 1.40 (0.03) | 1.38 | 7.01 (0.07) | 6.99 | 7.79 (0.20) | 7.56 | $28,408 (850) | $27,968 |
| 238: Complications of surgical procedures or medical care | 201 (5) | 189* | 1.38 (0.02) | 1.43* | 7.13 (0.10) | 7.31 | 2.27 (0.08) | 2.36 | $31,750 (867) | $32,005 |
| 197: Skin and subcutaneous tissue infections | 200 (4) | 178** | 1.37 (0.01) | 1.35 | 5.56 (0.05) | 5.61 | 0.71 (0.04) | 0.73 | $18,009 (503) | $17,721 |
| 69: Affective disorders | 176 (11) | 179 | 1.21 (0.07) | 1.36* | 9.62 (0.23) | 9.59 | 0.09 (0.01) | 0.09 | $17,554 (855) | $16,902 |
| 145: Intestinal obstruction without hernia | 175 (4) | 155** | 1.20 (0.01) | 1.18 | 6.71 (0.05) | 6.77 | 3.82 (0.11) | 4.01 | $28,552 (719) | $28,639 |
| 149: Biliary tract disease | 171 (4) | 151** | 1.17 (0.01) | 1.14* | 5.45 (0.04) | 5.43 | 1.56 (0.07) | 1.55 | $30,373 (700) | $29,641 |
*Significant at a
5 percent level.
**Significant at
a 1 percent level.
1A
significance test was not performed because a valid standard error was not
available.
| Principal Procedure | Number of Discharges in Thousands (Standard Error) | Percentage of Discharges (Standard Error) | Average Length of Stay in Days (Standard Error) | In-Hospital Mortality Rate Percent (Standard Error) | Average Total Hospital charge (Standard Error) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | NIS | MedPAR | |
| 70: Upper gastrointestinal endoscopy; biopsy | 403 (11) | 359** | 2.77 (0.04) | 2.72 | 5.89 (0.04) | 5.97 | 1.81 (0.05) | 1.84 | $25,076 (684) | $24,495 |
| 222: Blood transfusion | 396 (13) | 322** | 2.72 (0.08) | 2.44** | 5.99 (0.06) | 6.05 | 5.72 (0.12) | 5.67 | $23,109 (646) | $23,384 |
| 45: Percutaneous transluminal coronary angioplasty (PTCA) | 388 (24) | 364 | 2.66 (0.13) | 2.76 | 3.00 (0.04) | 2.96 | 1.07 (0.05) | 1.09 | $49,533 (1,599) | $46,535 |
| 152: Arthroplasty knee | 321 (13) | 292* | 2.20 (0.07) | 2.22 | 3.94 (0.03) | 3.95 | 0.17 (0.01) | 0.16 | $36,581 (803) | $40,840** |
| 216: Respiratory intubation and mechanical ventilation | 315 (8) | 287** | 2.16 (0.03) | 2.17 | 9.51 (0.16) | 9.90* | 37.20 (0.40) | 36.69 | $58,491 (1,670) | $59,717 |
| 47: Diagnostic cardiac catheterization; coronary arteriography | 300 (12) | 283 | 2.06 (0.05) | 2.15 | 4.12 (0.05) | 4.12 | 1.21 (0.05) | 1.28 | $28,151 (734) | $27,760 |
| 54: Other vascular catheterization; not heart | 255 (8) | 240 | 1.75 (0.03) | 1.82 | 9.38 (0.11) | 9.25 | 11.75 (0.29) | 11.36 | $38,695 (914) | $38,369 |
| 153: Hip replacement; total and partial | 250 (8) | 219** | 1.72 (0.04) | 1.66 | 5.26 (0.05) | 5.26 | 1.24 (0.05) | 1.27 | $40,638 (911) | $50,218** |
| 48: Insertion; revision; replacement; removal of cardiac pacemaker or cardioverter/defibrillator | 247 (11) | 232 | 1.69 (0.05) | 1.76 | 4.83 (0.08) | 4.75 | 1.09 (0.05) | 1.14 | $64,078 (1,725) | $66,065 |
| 58: Hemodialysis | 232 (7) | 218 | 1.59 (0.04) | 1.65 | 5.64 (0.07) | 5.73 | 3.73 (0.12) | 3.50 | $24,563 (774) | $24,356 |
| 146: Treatment; fracture or dislocation of hip and femur | 192 (5) | 163** | 1.31 (0.02) | 1.24** | 6.21 (0.05) | 6.24 | 2.37 (0.07) | 2.34 | $33,483 (783) | $33,013 |
| 231: Other therapeutic procedures | 188 (19) | 158 | 1.29 (0.13) | 1.20 | 5.85 (0.14) | 5.69 | 6.21 (0.37) | 5.63 | $23,738 (1,705) | $22,484 |
| 61: Other OR procedures on vessels other than head and neck | 170 (6) | 166 | 1.17 (0.03) | 1.26** | 7.63 (0.14) | 7.36 | 4.52 (0.17) | 4.26 | $54,556 (1,640) | $53,398 |
| 76: Colonoscopy and biopsy | 157 (4) | 138** | 1.07 (0.01) | 1.04 | 5.94 (0.05) | 6.01 | 1.32 (0.06) | 1.29 | $23,486 (613) | $23,117 |
| 78: Colorectal resection | 145 (4) | 128** | 0.99 (0.01) | 0.97 | 10.97 (0.08) | 10.98 | 6.06 (0.16) | 6.22 | $61,693 (1,566) | $61,351 |
| 84: Cholecystectomy and common duct exploration | 134 (3) | 119** | 0.92 (0.01) | 0.90 | 6.38 (0.06) | 6.37 | 1.75 (0.08) | 1.76 | $37,772 (859) | $36,877 |
| 193: Diagnostic ultrasound of heart (echocardiogram) | 124 (12) | 115 | 0.85 (0.08) | 0.87 | 5.45 (0.15) | 5.37 | 2.39 (0.15) | 2.26 | $23,476 (1,569) | $22,222 |
| 213: Physical therapy exercises; manipulation; and other procedures | 122 (16) | 101 | 0.84 (0.11) | 0.77 | 11.24 (0.44) | 11.70 | 0.96 (0.14) | 0.63* | $24,961 (1,418) | $28,377* |
| 44: Coronary artery bypass graft (CABG) | 120 (8) | 115 | 0.82 (0.04) | 0.87 | 10.33 (0.13) | 9.99* | 3.00 (0.14) | 3.11 | 104,295 (3,723) | $98,670 |
| 39: Incision of pleura; thoracentesis; chest drainage | 107 (3) | 95** | 0.74 (0.01) | 0.72 | 8.07 (0.07) | 8.12 | 7.09 (0.20) | 7.44 | $33,113 (977) | $32,546 |
| 169: Debridement of wound; infection or burn | 107 (2) | 100* | 0.73 (0.01) | 0.76 | 12.14 (0.31) | 12.44 | 4.37 (0.18) | 4.40 | $47,356 (1,448) | $48,716 |
| 37: Diagnostic bronchoscopy and biopsy of bronchus | 88 (3) | 82 | 0.60 (0.01) | 0.62 | 9.31 (0.10) | 9.22 | 6.24 (0.23) | 5.95 | $43,465 (1,501) | $41,532 |
| 158: Spinal fusion | 88 (5) | 88 | 0.60 (0.03) | 0.67* | 4.80 (0.10) | 4.77 | 0.58 (0.06) | 0.57 | $65,063 (2,591) | $63,077 |
| 3: Laminectomy; excision intervertebral disc | 87 (4) | 84 | 0.59 (0.02) | 0.64 | 3.41 (0.07) | 3.37 | 0.27 (0.04) | 0.34 | $24,621 (1,120) | $23,875 |
| 51: Endarterectomy; vessel of head and neck | 85 (3) | 78 | 0.59 (0.01) | 0.59 | 2.79 (0.06) | 2.78 | 0.37 (0.05) | 0.40 | $24,234 (697) | $24,327 |
*Significant at a
5 percent level.
**Significant at
a 1 percent level.
1A
significance test was not performed because a valid standard error was not
available.
Centers for Medicare & Medicaid Services (2006). CMS State County File, 2002-2005. Washington, DC: CMS. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/HealthPlanRepFileData/Downloads/SC-2005-.zip (Accessed August 22, 2007.)
National Center for Health Statistics (2007). National Hospital Discharge Survey Public Use Data File Documentation: 2005. Washington, DC: U.S. Department of Health and Human Services, National Center for Health Statistics.
U.S. Agency for Healthcare Research and Quality (2007). Design of the Nationwide Inpatient Sample (NIS), 2005. Rockville, MD. http://hcup-us.ahrq.gov/db/nation/nis/reports/NIS_2003_Design_Report_Edited_012506.pdf (Accessed August 21, 2007.)
U.S. Census Bureau (2007). Table 3: Annual Estimates of the Population by Sex, Race and Hispanic or Latino Origin for the United States: April 1, 2000 to July 1, 2005 (NC-EST2005-03). Washington, DC: Population Division, U.S. Census Bureau (2007).
U.S. Census Bureau (2007). Table 1: Annual Estimates of the Population for the United States, Regions, and States and for Puerto Rico: April 1, 2000 to July 1, 2006 (NST-EST2006-01). Washington, DC: Population Division, U.S. Census Bureau (2007).
U.S. Census Bureau (2007). State and Metropolitan Area Data Book – 5th Edition. Washington, DC: U.S. Bureau of the Census.
| Internet Citation: HCUP NIS 2005 NIS Comparison Report. Healthcare Cost and Utilization Project (HCUP). November 2015. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/db/nation/nis/reports/2005niscomparisonrpt.jsp. |
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