2005 Inpatient Admission Trends Vary by Service Line:
Cardiology Declines; Nephrology, General Medicine Rise
Inpatient admissions related to cardiology were among those that declined in 2005
compared to 2004, while admissions related to general medicine and nephrology
were two of the categories that grew, according to a recent study by Solucient.
The study analyzed inpatient admissions in six major service lines—surgery,
women’s health, mental health, newborn, medicine and other—and 29
minor service lines. Minor service lines, which are defined by DRGs, are subdivisions
of major service lines.
The largest decrease in minor service lines by volume occurred in cardiology,
which dropped by almost 79,000 admissions in 2005. The contraction is attributed
primarily to fewer admissions in two categories: medical acute myocardial infarction
(AMI) which declined by 5 percent, and atherosclerosis and angina which dropped
by 11 percent.
The greatest increases by volume were seen in pulmonary and general medicine
patients. While pulmonary admissions vary from year to year, after falling in
2004, the number of admissions in this category returned to above their 2003
level. A major contributor to the increase in general medicine was a rise in
number of admissions related to cellulitis—up 8 percent from 2004. Rounding
out the top five minor service lines by growth in volume of admissions were
orthopedics (71,328), nephrology (62,575) and neurosurgery (60,914).
When analyzed by percentage increase, transplant and nephrology admissions accounted
for the greatest increase in minor service lines, going up by 18.1 percent and
15.1 percent, respectively, in 2005. The nephrology increase was largely due
to a 14.4 percent rise in patients admitted for renal failure.
Additional categories in the top five by growth rate included neurosurgery (8.1
percent), pulmonary (7.6 percent) and thoracic surgery (7.0 percent). Thoracic
surgery includes major chest procedures which range from thymectomy to lobectomy.
It does not include cardiovascular procedures, such as coronary artery bypass
graft. The greatest percentage decline was noted in rehabilitation, with 4.8
percent fewer admissions in 2005 compared to 2004.
At the major service-line level, five of the six categories experienced an
increase in inpatient admissions, with medicine recording the greatest gain
(2.5 percent). Medicine is composed of nine minor service lines, including cardiology,
general medicine, nephrology and pulmonary.
Surgery, mental health, newborn and women's health all experienced smaller
increases of 1.6 percent, and 0.9 percent, 0.7 percent and 0.2 percent, respectively.
The sixth category—other—registered a decrease of 3.3 percent.
Overall inpatient admissions increased by 1.6 percent from 2004 to 2005, reflecting
a similar rate of population growth.
Data for the study was provided by ACTracker®, an online tool that provides
national estimates of hospital and drug utilization approximately 45 days after
the end of each month, making the estimates the most timely and current of their
kind.
