A new report from the Maryland Hospital Association says that income is down and expenses have risen for many of the state's 58 hospitals. The report says 34 hospitals in the state lost a combined $466 million during the last quarter of 2008. Virginia hospitals are also reporting shortfalls. Washington, DC, hospitals have yet to report results for the final quarter of 2008, but Robert A. Malson, chief executive officer of the District of Columbia Hospital Association, said they, too, are affected by the downturn. Hospital officials in the three jurisdictions said they are looking closely at expenses and developing plans for cutting costs.