TRENDS: Outpatient utilization metrics have been going up

Health, United States, 2015 is available.  This is the latest in an annual compendium of statistics published by the federal government which is drawn from both government and nongovernment sources, including the American Hospital Association.  It’s a good place to start to look for historical trend statistics (usually at the national level) on topics related to health status and health care delivery.

Below are data from one table in this massive report.  The data below are authoritative national estimates, based on a sample survey, that were produced by the National Center for Health Statistics.

Why are utilization metrics expressed as “per 100 persons” or “per 1000 persons” interesting?  Because if you a health planner, you can take a geographical service area with a known population size and calculate the approximate number of physician office visits or hospital outpatient visits or emergency department visits that can be expected from that population in a twelve month period.  Doing a demand analysis would then go on to take into account the local competition and other factors, but national utilization estimates like this can be a helpful way to start.

PHYSICIAN OFFICE VISITS per 100 persons per year (age adjusted)

• 271  1995
• 304  2000
• 325  2010
• [not available] 2011

Note that this is consistently about 3 physician office visits per person per year.  Does that seem intuitively pleasing to you?  Did you go to see doctors three times last year?  Remember, too, that the above includes children and seniors.

HOSPITAL OUTPATIENT DEPARTMENT VISITS per 100 persons per year (age adjusted)

• 26  1995
• 31  2000
• 33  2010
• 40  2011

HOSPITAL EMERGENCY DEPARTMENT VISITS per 100 persons per year (age adjusted)

• 37  1995
• 40  2000
• 43  2010
• 45  2011

Source: Table 82, Visits to physician offices, hospital outpatient departments, and hospital emergency departments, by age, sex, and race: United States, selected years 1995-2011.  In U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2015). Health, United States, 2015. Retrieved from http://www.cdc.gov/nchs/hus.htm  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ADVANCED ENDOSCOPY SUITES: Poised for growth

There is a continued shift towards endoscopic instead of open surgical procedures.  Gastroenterologists are now able to access the entire length of the GI tract through the technique of double balloon endoscopy, which may mean a reduction in colorectal surgery cases.  This brief article discusses implications for anesthesiologists — opportunities to provide anesthesia care in the advanced endoscopy suite — and the role of different specialists in the care of endoscopy patients.  Issues involving which specialist is serving as the patient’s primary care physician are covered.

Source:  Tetzloff, J.E., and Maurer, W.G.  Anesthesia in the advanced endoscopy suite: what else can we do outside the O.R.?  Newsletter [American Society of Anesthesiologists];76(19):8-10, Sept. 2012.  Click here for the publisher’s website: http://viewer.zmags.com/publication/153a4063#/153a4063/1 Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Private Payer Health Care Cost and Utilization Report: 2010

The newly formed Health Care Cost Institute has released its first report on the nation’s health care costs and utilization. What’s unique about this report? For the first time, it provides a comprehensive look at the privately-insured, based on over 3 billion medical claims from 3 of the nation’s largest private insurers – Aetna, Humana, and UnitedHealthcare. The next report covering 2011 will also include claims data Kaiser Permanente when released later this year.

Here are some highlights from the report covering 2010:

• The annual expenditure for each under age-65 beneficiary of an employer-sponsored health plan — averaged across all plan members whether or not they filed a claim — was $4,255, with an annual growth of 3.3%. This overall mean expenditure included an average $893 for inpatient care, $1,126 for outpatient care, $1,472 for professional services, and $765 for prescription drugs.
• However, the average inpatient claim paid price was $14,662, an increase of 5.1% over 2009, while the average outpatient paid claim cost $2,224, up 10.1% from the previous year.
• The report documents a general overall decline or flat growth in the usage rate of health services since 2007. Economic factors may play a role. In 2010 the average out-of-pocket cost per beneficiary grew to $689, up over 7% from 2009. Out-of-pocket costs represented 16.2% of the total claim price, with the insurer covering nearly 84%.

Source: Health care cost and utilization report: 2010. Health Care Cost Institute, May 2012. http://www.healthcostinstitute.org/2010report

Posted by the AHA Resource Center, (312) 422-2050, rc@aha.org