Evaluating Hospital Inpatient Discharges at the Regional Level

Historically, the evaluation of hospital utilization in the United Stateshas been addressed by providers and health planning agencies. This studyevaluated resident inpatient hospital discharges for adult medicine and adultsurgery in the Central New York Health Service Area, an eleven county region ofupstate New York. It focused on small local hospitals and larger referralcenter hospitals in the region. The study demonstrated that numbers of adultmedicine resident discharges from small local hospitals declined by 17.3percent in most counties of the region between 2012 and 2017. This reductionresulted, in part, from the implementation of medical observation programs thatshifted many patients with low severity of illness to outpatient status. Thestudy also demonstrated that numbers of adult surgery resident inpatientdischarges from small local hospitals declined by 15.8 percent. This resultedfrom the inmigration of many surgical patients from these providers to largerhospitals in the region. The study suggested that there may not be sufficientinpatient adult surgery and medicine volumes to support the current number ofhospitals in the region.