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  Chapter Eight:

  Health of Children
  Health of Adults
  STDs and AIDS
  Illegal Drugs
  Accidental Deaths
  Hospital Patients
  Health Care Costs
  Mental Patients
  Disabled Persons



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Hospital Patients

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The use of general hospitals increased steadily from the beginning of the century to about 1980, when usage began to decline.
The hospitals that are the subject of this discussion are known variously as general or community or short-term hospitals, under either public or private management. The category excludes institutions for the long-term treatment of mental disorders, special hospitals for tuberculosis and other chronic diseases, hospices that care for terminally ill patients, and the network of hospitals run by the Veterans Administration. 

In 1900, most Americans were born at home and died in their own beds. By 1930, nearly all births and a large proportion of deaths took place in hospitals, as was the case at the end of the century. During the fifty years that followed, the capacity of hospitals, measured by the number of beds, continued to grow a little faster than the population, while average occupancy rose from 63 percent of capacity in 1930 to 78 percent in 1980. Thereafter, the number of hospital patients began to decline, while community hospitals, stimulated by federal construction subsidies, continued to add new capacity. In the mid-1980s, declining occupancy forced many hospitals to close or consolidate, but not fast enough to match decreasing demand. By 1997, the occupancy rate had returned to the 1930 level and was still falling. 

Several interlocking factors account for the ongoing decline in general hospital usage. The ever-rising cost of hospital care encouraged health care managers to shorten hospital stays whenever possible and to rely increasingly on outpatient visits for various types of treatment, including surgery. From 1980 to 1995, the ratio of hospital admissions to population declined by a fourth, the average hospital stay shortened from 7.6 days to 6.5 days, the proportion of hospital surgical procedures performed on outpatients increased from 16 percent to 58 percent, and the ratio of outpatient visits to hospital admissions more than doubled.

Chapter 8 chart 9

Source Notes
Source Abbreviations

HS series B 361 and B 373, and SA 1999, table 204. For hospital use and outpatient surgery performed, see SA 1997, tables 187 and 194. For changes in hospital use, see American Hospital Association, Hospital Statistics (Health Forum, annual).


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