The U.S., followed by Switzerland, had the highest average cost per day to stay in a hospital as of 2015. At that time the hospital costs per day in the U.S. were on average 5,220 U.S. dollars. In comparison, the hospital costs per day in Spain stood at an average of 424 U.S. dollars. Even Switzerland, also a very expensive country, had significantly lower costs than the United States.

Number of U.S. hospitals

The number of U.S. hospitals has decreased in recent years with some increase in 2017. There are several types of hospitals in the U.S. with different ownerships. In general there are more hospitals with a non-profit ownership in the U.S. than there are hospitals with state/local government or for-profit ownership.

U.S. hospital costs

Health care expenditures in the U.S. are among the highest in the world. By the end of 2019, hospital care expenditures alone across the U.S. are expected to exceed 1.2 trillion U.S. dollars. Among the most expensive medical conditions treated in U.S. hospitals are septicemia, osteoarthritis and live births. There are different ways to pay for hospital costs in the United States. Among all payers of U.S. hospital costs, Medicare and private payers are paying the largest proportion of all costs.

The graph displays the average hospital stay cost per inpatient day in the United States from 1999 to 2022. The x-axis represents the years, starting from 1999 and ending at 2022, while the y-axis indicates the cost in dollars per inpatient day. The costs begin at $1,101.80 in 1999 and steadily increase to $3,025.23 in 2022. The data reveals a consistent upward trend over the 23-year period, with the lowest cost recorded in 1999 and the highest in 2022. Notably, there is a significant rise in costs between 2019 and 2022. This information highlights the escalating expenses associated with hospital inpatient stays in the United States.

Russia Avg Consumer Price: Medical: Hospital Care Costs per Day data was reported at 1,985.580 RUB in Jan 2019. This records a decrease from the previous number of 2,123.330 RUB for Dec 2018. Russia Avg Consumer Price: Medical: Hospital Care Costs per Day data is updated monthly, averaging 2,037.960 RUB from Jan 2018 (Median) to Jan 2019, with 13 observations. The data reached an all-time high of 2,123.330 RUB in Dec 2018 and a record low of 1,954.890 RUB in Jan 2018. Russia Avg Consumer Price: Medical: Hospital Care Costs per Day data remains active status in CEIC and is reported by Federal State Statistics Service. The data is categorized under Russia Premium Database’s Prices – Table RU.PA023: Average Consumer Price: Health Improvement and Medical Services.

Crude rate of cost of admissions for alcohol-related conditions (Broad definition) per head of population.

Rationale Alcohol misuse across the UK is a significant public health problem with major health, social, and economic consequences. This indicator aims to highlight the impact of alcohol-related conditions on inpatient hospital services in England. High costs of alcohol-related admissions are indicative of poor population health and high alcohol consumption. This indicator highlights the resource implications of alcohol-related conditions and supports the arguments for local health promotion initiatives. Publication of this indicator will allow national and local cost estimates to be updated and consistently monitored going forward. This measure accounts for just one aspect of the cost of alcohol to society, but there are others such as primary care, crime, ambulatory services, and specialist treatment services as well as broader costs such as unemployment and loss of productivity.

The Government has said that everyone has a role to play in reducing the harmful use of alcohol. This indicator is one of the key contributions by the Government (and the Department of Health and Social Care) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related admissions can be reduced through local interventions to reduce alcohol misuse and harm.

References: (1) PHE (2020) The Burden of Disease in England compared with 22 peer countries https://www.gov.uk/government/publications/global-burden-of-disease-for-england-international-comparisons/the-burden-of-disease-in-england-compared-with-22-peer-countries-executive-summary

Definition of numerator The total cost (£s) of alcohol-related admissions (Broad). Admissions to hospital where the primary diagnosis is an alcohol-related condition, or a secondary diagnosis is an alcohol-related external cause.

More specifically, hospital admissions records are identified where the admission is a finished episode [epistat = 3]; the admission is an ordinary admission, day case or maternity [classpat = 1, 2 or 5]; it is an admission episode [epiorder = 1]; the sex of the patient is valid [sex = 1 or 2]; there is a valid age at start of episode [startage between 0 and 150 or between 7001 and 7007]; the region of residence is one of the English regions, no fixed abode or unknown [resgor <= K or U or Y]; the episode end date [epiend] falls within the financial year, and an alcohol-attributable ICD10 code appears in the primary diagnosis field [diag_01] or an alcohol-related external cause code appears in any diagnosis field [diag_nn].

For each episode identified, an alcohol-attributable fraction is applied to the primary diagnosis field or an alcohol-attributable external cause code appears in one of the secondary codes based on the diagnostic codes, age group, and sex of the patient. Where there is more than one alcohol-related ICD10 code among the 20 possible diagnostic codes, the code with the largest alcohol-attributable fraction is selected; in the event of there being two or more codes with the same alcohol-attributable fraction within the same episode, the one from the lowest diagnostic position is selected. For a detailed list of all alcohol-attributable diseases, including ICD 10 codes and relative risks, see ‘Alcohol-attributable fractions for England: an update’ (2). Alcohol-related hospital admission episodes were extracted from HES according to the Broad definition and admissions flagged as either elective or non-elective based on the admission method field.

The cost of each admission episode was calculated using the National Cost Collection (published by NHS England) main schedule dataset for the corresponding financial year applied to elective and non-elective admission episodes. The healthcare resource group (HRG) was identified using the HES field SUSHRG [SUS Generated HRG], which is the SUS PbR derived HRG code at episode level. Healthcare Resource Groups (HRGs) are standard groupings of clinically similar treatments which use common levels of healthcare resource. The elective admissions were assigned an average of the elective and day-case costs. The non-electives were assigned an average of the non-elective long stay and non-elective short stay costs. Where the HRG was not available or did not match the National Reference Costs look-up table, an average elective or non-elective cost was imputed. This may result in the cost of these admissions being underestimated. For each record, the AAF was multiplied by the reference cost and the resulting values were aggregated by the required output geographies to provide numerators for the cost per capita indicator.

References: (2) PHE (2020) Alcohol-attributable fractions for England: an update https://www.gov.uk/government/publications/alcohol-attributable-fractions-for-england-an-update

Definition of denominator Mid-year population estimates.

Caveats Not all alcohol-related conditions require inpatient services, so this indicator is only one measure of the alcohol-related health problems in each local area. However, inpatient admissions are easily monitored, and this indicator provides local authorities with a routine method of monitoring the health impacts of alcohol in their local populations.

The Healthcare Resource Group cost assigned to each hospital admission is for the initial admission episode only and doesn’t include costs related to alcohol in any subsequent episodes in the hospital spell. Where the HRG was not available or did not match the National Reference Costs look-up table, an average elective or non-elective cost was imputed. This may result in the cost of these admissions being underestimated. It must be noted that the numerator is based on the financial year and the denominator on calendar mid-year population estimates, e.g., 2019/20 admission rates are constructed from admission counts for the 2019/20 financial year and mid-year population estimates for the 2020 calendar year. Data for England includes records with geography 'No fixed abode'. Alcohol-attributable fractions were not available for children. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator. This does not include attendance at Accident and Emergency departments. Hospital Episode Statistics overall is well completed. However, year-on-year variations exist due to poor completion from a proportion of trusts.

Analysis has revealed significant differences across the country in the coding of cancer patients in the Hospital Episode Statistics. In particular, in some areas, regular attenders at hospital for treatments like chemotherapy and radiotherapy are being incorrectly recorded as ordinary or day-case admissions. Since cancer admissions form part of the overarching alcohol-related admission national indicators, the inconsistent recording across the country for cancer patients has some implication for these headline measures.

Cancer admissions make up approximately a quarter of the total number of alcohol-related admissions. Analysis suggests that, although most Local Authorities would remain within the same RAG group compared with the England average if cancer admissions were removed, the ranking of Local Authorities within RAG groups would be altered. We are continuing to monitor the impact of this issue and to consider ways of improving the consistency between areas. The COVID-19 pandemic had a large impact on hospital activity with a reduction in admissions in 2020 to 2021. Because of this, NHS Digital has been unable to analyse coverage (measured as the difference between expected and actual records submitted by NHS Trusts) in the normal way. There may have been issues around coverage in some areas which were not identified as a result.

There currently exists no comprehensive and up-to date overview on the financial impact of the different adverse events covered by the Patient Safety Indicators (PSIs) from the Agency for Healthcare Research and Quality. We conducted a retrospective case-control study using propensity score matching on a national administrative data set of 1 million inpatients in Switzerland to compare excess costs associated with 16 different adverse events both individually and on a nationally aggregated level. After matching 8,986 cases with adverse events across the investigated PSIs to 26,931 controls, we used regression analyses to determine the excess costs associated with the adverse events and to control for other cost-related influences. The average excess costs associated with the PSI-related adverse events ranged from CHF 1,211 (PSI 18, obstetric trauma with instrument) to CHF 137,967 (PSI 10, postoperative acute kidney injuries) with an average of CHF 27,409 across all PSIs. In addition, adverse events were associated with 7.8-day longer stays, 2.5 times more early readmissions (within 18 days), and 4.1 times higher mortality rates on average. At a national level, the PSIs were associated with CHF 347 million higher inpatient costs in 2019, which corresponds to about 2.2% of the annual inpatient costs in Switzerland. By comparing the excess costs of different PSIs on a nationally aggregated level, we offer a financial perspective on the implications of in-hospital adverse events and provide recommendations for policymakers regarding specific investments in patient safety to reduce costs and suffering.

During the first year of the COVID-19 pandemic, the Republic of Korea (ROK) experienced three epidemic waves in February, August, and November 2020. These waves, combined with the overarching pandemic, significantly influenced trends in spinal surgery. This study aimed to investigate the trends in degenerative lumbar spinal surgery in ROK during the early COVID-19 pandemic, especially in relation to specific epidemic waves. Using the National Health Information Database in ROK, we identified all patients who underwent surgery for degenerative lumbar spinal diseases between January 1, 2019 and December 31, 2020. A joinpoint regression was used to assess temporal trends in spinal surgeries over the first year of the COVID-19 pandemic. The number of surgeries decreased following the first and second epidemic waves (p<0.01 and p = 0.34, respectively), but these were offset by compensatory increases later on (p<0.01 and p = 0.05, respectively). However, the third epidemic wave did not lead to a decrease in surgical volume, and the total number of surgeries remained comparable to the period before the pandemic. When compared to the pre-COVID-19 period, average LOH was reduced by 1 day during the COVID-19 period (p<0.01), while mean hospital costs increased significantly from 3,511 to 4,061 USD (p<0.01). Additionally, the transfer rate and the 30-day readmission rate significantly decreased (both p<0.01), while the reoperation rate remained stable (p = 0.36). Despite the impact of epidemic waves on monthly surgery numbers, a subsequent compensatory increase was observed, indicating that surgical care has adapted to the challenges of the pandemic. This adaptability, along with the stable total number of operations, highlights the potential for healthcare systems to continue elective spine surgery during public health crises with strategic resource allocation and patient triage. Policies should ensure that surgeries for degenerative spinal diseases, particularly those not requiring urgent care but crucial for patient quality of life, are not unnecessarily halted.