Dying In a Hospital Costs More than Surviving an Inpatient Stay

Cheryl Clark, for HealthLeaders Media , November 5, 2009

If anyone needs more evidence that healthcare spending is concentrated at the end of life, here's another raft of confirming statistics from the federal government for 2007.

The statistics were released by the federal Agency or Healthcare Research and Quality, which analyzed 765,651 hospital patient deaths in 2007. The statistical brief issued yesterday is the first analysis of the cost of death for payers other than Medicare.

  • One of every three people, who died in the U.S. in 2007, died in a hospital, or 765,651 of 2,423,995 deaths. Although 1.9% of hospital admissions resulted in death, their care cost 5.2% of all spending for hospital inpatient care by all payers, or $20 billion.
  • The average hospital cost for a stay ending in death was nearly three times higher, about $26,000, than the cost of a patient who was discharged alive, which was $9,447. The cost for patients who died was higher because their stays were 8.8 days vs. 4.5 days for those who lived.
  • Adding fuel to hospital concerns about preventing hospital-acquired infections, the leading principal diagnosis for patients who died while receiving inpatient care was septicemia, or infection of the bloodstream.

Those infections were responsible for 15% of all deaths, the leading principal diagnosis in hospital mortality. Of all patients diagnosed with septicemia in the hospital, 17% died in the hospital.

Other causes of death in the hospital included respiratory failure, aspiration pneumonitis, cancer of the bronchus, acute cerebrovascular disease or stroke, pneumonia, heart attack, congestive heart failure, secondary cancers, and acute and unspecified renal failure.

  • Of the patients who died in a hospital, 73% had one or more procedures while 27% had no procedures. Those with procedures were more likely to die than those who did not. One in four patients who died had a respiratory intubation and mechanical ventilation. Other procedures in people who died included vascular catheterizations other than the heart.
  • Twelve percent of patients, or one in eight patients who died in a hospital, was admitted for an elective procedure or other non-urgent reason while 72% came through the emergency room. Only 7% of patients who died in a hospital were admitted to hospitals because of unintentional or intentional injuries, and 2% were newborn infants.
  • Medicare was the coverage source for 67% of all inpatients who died in a hospital, at a cost of more than $12 billion. That accounted for 7% of all Medicare inpatient costs.
  • If you are in a hospital, you are more likely to die in the Northeast than in the Midwest, which had the lowest inpatient death rate, 1.8%, compared to 2.13% in the Northeast, 1.96% in the South, and 1.89% in the West.

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