Characteristics of Hospital Stays

HCUP Statistical Brief #184

With more than 67 million beneficiaries, Medicaid has emerged as the largest health insurance program in the United States. The Medicaid population includes infants, children, young mothers, homeless adults, individuals with disabilities, and individuals who are dually eligible for Medicare and Medicaid. The considerable diversity among patients covered by Medicaid in age, race/ethnicity, and type of health conditions poses great challenges for managing the use of health services by this population. Specifically, among patients with physical or behavioral chronic conditions, Medicaid patients have been shown to experience higher hospital readmission rates than privately insured patients, suggesting that a relatively small group of patients may account for a disproportionately large share of utilization and costs.

Characteristics of Hospital Stays for Nonelderly Medicaid Super-Utilizers, a statistical brief from the Healthcare Cost and Utilization Project, presents data on patient demographics and characteristics of hospital stays for Medicaid super-utilizers compared with stays for other Medicaid patients.

Highlights:

  • In 2012, on average compared with other Medicaid patients, Medicaid super-utilizers had more hospital stays (5.9 vs.1.3 stays), longer length of stay (6.1 vs. 4.5 days), and higher hospital costs per stay ($11,766 vs. $9,032).
  • Medicaid super-utilizers accounted for 14 percent of Medicaid hospital stays and 18 percent of Medicaid hospital costs.
  • Medicaid super-utilizers were more likely than other Medicaid patients to be male and to be aged 45-64 years.
  • The 30-day all-cause readmission rate for super-utilizers was nearly six times higher than for other Medicaid patients (52.4 vs. 8.8 percent). Half of all 30-day readmissions for the Medicaid population were attributable to super-utilizers.
  • Mood disorders and schizophrenia and other psychotic disorders were the two most common reasons for hospitalization among Medicaid super-utilizers. Alcohol-related disorders ranked number six.
  • Other common conditions among super-utilizers included diabetes; cancer treatment, sickle cell anemia; septicemia; congestive heart failure; chronic obstructive pulmonary disease; and complications of devices, implants and grafts.

Select to access Characteristics of Hospital Stays for Nonelderly Medicaid Super-Utilizers.

Page last reviewed November 2014
Internet Citation: Characteristics of Hospital Stays : HCUP Statistical Brief #184. November 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/hcup.html