There was a 30 percent increase (from 4 million to 5 million) in the rate of patients discharged to nursing homes or rehabilitation facilities during the same period.  The increase in discharges to home health care and nursing homes reflects the rising number of hospital patients who are acutely ill or cannot take care of themselves after being discharged from the hospital, according to AHRQ. 

AHRQ ™s analysis of hospital discharges between 1997 and 2006 showed:

Overall, hospitals discharges for all conditions rose from roughly 35 million to 40 million “ a 14 percent increase.

Discharges for patients who did not need any additional care increased only 9 percent, from about 27 million to 29 million.

The number of patients who died while in the hospital fell from 852,000 to 805,000 “ a 5 percent decrease.   This AHRQ News and Numbers summary is based on data in HCUP Facts and Figures, 2006, which provides highlights of the latest data from the 2006 Nationwide Inpatient Sample, a part of AHRQ's Healthcare Cost and Utilization Project.  The report provides data on leading reasons for hospitalization, such as arthritis, asthma, childbirth, cancer, diabetes, depression, and heart conditions, on procedures performed on hospital patients, and on related topics.

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Advanced age (defined in the NYCAS study as 80 years or older) increased the risk-adjusted odds of death or stroke by 30 percent; Non-white patients were 83 percent more likely to have a negative outcome within 30 days; Having coronary artery disease increased the odds of death or stroke by 51 percent; and Having diabetes treated with insulin increased the odds of death or stroke by 55 percent.

In addition, the more serious the neurological symptoms a patient had from the blockage of the carotid artery, the higher the risk of negative outcomes. Patients who suffered a stroke or temporary stroke in the year before carotid surgery also had increased risks.

"Having one risk factor would not necessarily be a reason not to have the surgery, but having multiple risk factors, like being over the age of 80 with heart disease and diabetes, might tip the balance for many patients in favor of medical management," Dr. Halm said.

The NYCAS study was supported by the Agency for Healthcare Research and Quality, Centers for Medicare & Medicaid Services, the Robert Wood Johnson Foundation and the National Institute of Neurological Disorders and Stroke.

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