Medicare patients: geographic differences in hospital discharge rates and multiple stays

Marked regional variations are found in patterns of use of short-stay hospitals by Medicare patients. Variations found in the rate of hospitalization, as measured by the number of discharges per 1,000 enrollees, and on the upward trend in that rate are the focus here. The data indicate that reductions in length of stay are offset by the rising number of admissions. An examination of multiple stays--a major factor in the number of discharges--shows that States with high rates of discharges have high percentages of patients with multiple stays. Furthermore, in these States the percentage of multiple stays is high, no matter what the diagnosis. In other States, the rate is low for all diagnoses. These findings suggest that options exist for the provision of care for the same or similar conditions and that geographic patterns appear in the use of those options. An urgent need exists for research to establish the variables affecting utilization and to explore ways of changing some of the patterns of delivering services.