In 2023, on average the expenses incurred by a non-profit hospital for one inpatient day amounted to 3,288 U.S. dollars, compared to 2,529 U.S. dollars of expenses for for-profit hospitals. State or local government hospitals have costs somewhere in-between.

Interrupted time series (ITS) analyses for total hospital costs, patient cost-sharing, patient sharing ratio, length of stay and 30-day readmission rate of hospitalized patients before and after the DRG.

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.

BackgroundIn January 2019, the Diagnosis-Related Groups (DRG) payment system was introduced in Meishan, China. Using the medical insurance records from 2017 to 2022, we evaluated the impact of the DRG system on medical costs, service efficiency and healthcare quality.MethodsThe sample was divided into three periods: Before DRG reform (2017–2018), the first period of DRG reform (2019–2020), and the second period of DRG reform (2021–2022). We employed an Interrupted Time Series (ITS) model to analyze the monthly changes in total hospital costs, patient cost-sharing, patient sharing ratio, length of stay, and 30-day readmission rate during both periods of DRG reform.ResultsIn the first period of DRG reform, total hospital costs decreased by 1.23% per month (95% CI, 0.88%-1.59%), patient cost-sharing decreased by 1.46% per month (95% CI, 1.09%-1.83%), patient sharing ratio decreased by 0.23% per month (95% CI, 0.06%-0.40%), and length of stay decreased by 0.56% per month (95% CI, 0.27%-0.84%). The monthly change in 30-day readmission rate was not statistically significant (-0.11%, 95% CI, -0.73%-0.50%). In the second period of DRG reform, all monthly changes were not statistically significant.ConclusionsThis study assessed the impact of the DRG payment system on medical costs and service efficiency. The results showed that DRG reduced total hospital costs, patient cost-sharing, patient sharing ratio, and length of stay, but did not significantly affect the rising 30-day readmission rates. Over time, the impact of DRG on cost control and service efficiency stabilized. However, unintended hospital behaviors may have emerged, warranting further investigation. The findings suggest that policymakers should strengthen clinical practice regulation, improve the DRG payment system, and continuously monitor healthcare quality trends.

Monthly and average inpatient costs per bed day and per treated episode (in 2020 USD), along with bed occupancy rate.

Hospital services are currently being stretched at the seams as they struggle to navigate financial constraints and workforce shortages while appointment waiting times remain high. Hospitals faced unrivalled pressure during the COVID-19 outbreak and this necessitated the release of significant government funding to help hospitals boost their capacity to treat afflicted patients. According to the King’s Fund, NHS funding rose from £148.9 billion in 2019-20 to £191 billion in 2020-21. Hospitals are still facing long elective backlogs, growing by around 100,000 cases monthly, according to the BMA. Over the five years through 2024-25, industry revenue is therefore expected to marginally rise at a compound annual rate of 0.2% to reach £115.1 billion. Hospitals are contending with stagnant real-term funding growth, exacerbated by inflationary pressures in the three years through 2024-25 and increasing demand for healthcare services due to a growing and ageing population. NHS England has a planned 2024-25 budget of £165 billion in real terms, which is only a 0.2% rise on 2023-24. In March 2025, the government announced plans to abolish NHS England, in a move to remove administrative hurdles it feels are preventing improvements in the hospital sector. Hospitals have been pressured to manage costs while dealing with a workforce crisis, highlighted by dependency on temporary staff to maintain safe staffing levels. Public healthcare budgets have failed to keep pace with soaring demand. Hospitals are struggling to match pre-COVID-19 activity levels, which has boosted demand for private hospitals as more patients seek private treatment. As a result, industry revenue is projected to grow by 0.9% in 2024-25. Revenue is estimated to climb at a compound annual rate of 2.3% over the five years through 2029-30 to £128.7 billion. Hospitals’ performance will depend on how much funding is available for an already over-burdened institution. The Labour government’s plan for hospitals over the next decade will be released in spring 2025 which will determine what resources are at the industry’s disposal in the coming years. With workforce shortages projected to worsen without substantial investments in training and recruitment, hospitals will need a plan to build a sustainable long-term staffing model. Dependency on international recruitment will become more of a challenge as global healthcare systems grapple with their own workforce shortages. Embracing technological advancements and digitisation like virtual wards will be key to improving efficiency and patient care, with planned capital funding aimed at transforming medical technology.

Average cost (in 2020 USD) per treated patient and per bed day at different bed occupancy rates and by level of disease severity.

The cost of giving birth through cesarean section in the United States varies significantly by state and insurance status. In 2023, the national median charge for a C-section delivery for those without insurance, or using out-of-network services, was ****** U.S. dollars, with New Jersey topping the list of the highest costs at ****** U.S. dollars.
Insurance impact on c-section costs Having insurance significantly reduces the financial burden of childbirth. The national median allowed value for insured, in-network C-sections was ****** U.S. dollars in 2023, less than half the cost for uninsured patients. Even with insurance, costs vary widely by state, with New Jersey again having the highest median allowed value at ****** U.S. dollars. The disparity between insured and uninsured costs underscores the importance of healthcare coverage for expectant mothers. C-section rates and reasons C-section rates in the United States remain higher than national targets. In 2024, the average C-section rate for low-risk first-time mothers was **** percent, above the national target of **** percent. Among all live births, the C-section rate was even higher, at **** percent in 2023. A 2023 survey revealed that about a ******* of women who had C-sections in the past six months did so due to previous C-sections, while over **** reported having emergency C-sections.

BackgroundThe COVID-19 pandemic has profoundly affected the care practices of total joint arthroplasty (TJA) throughout the world. However, the impact of the pandemic on TJA care practices has not yet been studied in China.MethodsThis retrospective multicenter cohort included patients aged 18 years or older who underwent TJA between January 2019 and December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). Data were obtained from the medical records of 17 Chinese hospitals. Interrupted time series (ITS) analysis was used to estimate differences in monthly TJA volume, hospitalization proportion of TJA, preoperative characteristics, postoperative complications, 30-day readmissions, length of stay (LOS), and costs in inpatients undergoing TJA between the prepandemic and pandemic periods. Multivariate regression and propensity score matching (PSM) analyses were used to assess the impact of the COVID-19 pandemic on hospital complications, readmissions at 30 days, LOS, and costs at the patient level.ResultsA total of 752,477 inpatients undergoing TJA in the prepandemic period, 1,291,248 in the pandemic period, with an average 13.1% yearly decrease in the volume of TJA during the pandemic. No significant changes were observed in the proportion of hospitalizations for TJA. ITS analyses showed increases in the proportion of comorbidities (8.5%, 95% CI: 3.4–14.0%) and the number of comorbidities (15.6%, 95% CI: 7.7–24.1%) in TJA cases during the pandemic, without increasing LOS, costs, complications, and readmission rates. Multivariate and PSM analyses showed 6% and 26% reductions in costs and readmission rates during the pandemic, respectively.ConclusionsThe COVID-19 pandemic was associated with more severe preoperative conditions and decreased volume, costs, and readmission rates in patients undergoing TJA in China. These findings demonstrate that the COVID-19 pandemic did not have a dramatic impact on the TJA care pattern in China, which may have resulted from active and strict strategies in combating COVID-19 as well as a rapid response in hospital management.