Hospital Admissions, Price Before Covid-19

How the world has changed.

Before the COVID-19 outbreak, admissions for respiratory and infection diagnoses each accounted for less than 5% of hospital admissions among Americans under the 65 with employer-provided health insurance, according to a recent report from the Health Care Cost Institute (HCCI) a not-for-profit research institute that analyzes data from the private insurance market.

A current count isn’t available, but in COVID-19 hot spots like New York City and New Jersey, the percentage is certainly far higher.

In a report titled “Compared to What? Baseline Understanding of the Distribution of Hospital Care,” HCCI reported on hospital usage in 2018 based on its analysis of 2.8 billion claims. As the title suggests, the report is a window into what was previously normal for hospitals. It came out April 1, so before the COVID-19-related hospitalizations in New York City started to drop and when the prospect of hospitals being completely overwhelmed by the needs of COVID-19 patients seemed probable and frightening.

Related: Continued Uncertainty Regarding Hospital Pricing Transparency

Here are a few highlights: 

The most common reason for admission. Labor, delivery ,and newborn was No. 1, accounting for 18.23 admissions per 1,000 people. By contrast, respiratory disease was responsible for 2.13 admissions per 1,000 and infection just 1.56.

The longest average length of stay. Admissions for substance abuse were the longest, averaging 8.8 days, followed by mental health at 7.5 days, and HIV-AIDS at 7.4 days. Infections at 5.2 days and respiratory disease at 4.4 days were in the middle of the pack.

Average price day. Burns were the highest at $11,800 per day, followed by trauma at $8,800 per day. Infections came in at $5,100 per day. Respiratory disease was just a bit lower at $4,700 per day.

Average price per admissions. The average price per permission was $45,000. Trauma ($54,000) and burns ($52,000) were on the high end of distribution and pregnancy/childbirth on the low ($11,000). Infection ($27,000) and respiratory ($21,000) were in the middle.