Key cardiovascular conditions decline

Surprisingly, however, cardiac disease and specifically heart attacks, have been the second-fastest declining hospitalization since 2003, according to one industry expert.

"This is occurring despite an aging population and more patients being diagnosed with heart diseases," says Kaveh Safavi, MD, JD, chief medical officer, Thomson Healthcare. "Other research suggests that long-term population treatment of risk factors for heart disease and treatment of newly diagnosed heart disease leads to stable heart disease that does not result in hospital stays-but does consume outpatient resources."

While the cardiac category is still an important condition in absolute terms relative to costs and hospital admissions, its relative position is declining. "Medical conditions such as infection are becoming increasingly important causes of hospitalization, as are joint replacements," he says. "We also have found that more patients in the hospital had heart disease in 2006 versus 2003, but that is not the reason for their hospitalizations."

The increasing rate of hospitalization for kidney disease, which has not been widely understood, might hold the biggest surprise. "In absolute terms, kidney disease is not yet a large part of the hospitalization picture, but some research has shown that it will be the fastest growing disease between now and 2025," Dr. Safavi says. "The United States has a real shortage of kidney specialists given the increasing demand.

"Population trends alone do not predict demand on future cost," Dr. Safavi adds. "We often think about technology as adding cost, but we may have evidence that in the long run, changing the natural history of diseases will change the cost and demand curves, also."