The Cost of Acute Care Hospital Stays by Medical Condition

Transcription

The Cost of Acute Care
Hospital Stays by Medical Condition
in Canada, 2004–2005
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Canadian Institute for Health Information
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ISBN 978-1-55465-216-7 (PDF)
© 2008 Canadian Institute for Health Information
How to cite this document:
Canadian Institute for Health Information, The Cost of Acute Care Hospital Stays
by Medical Condition in Canada, 2004–2005 (Ottawa: CIHI, 2008).
Cette publication est aussi disponible en français sous le titre Coût des séjours en soins
de courte durée selon l’affection au Canada, 2004-2005.
ISBN 978-1-55465-217-4 (PDF)
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
Table of Contents
Table of Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
1. Introduction and Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2. Study Framework and Overview of the Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
3. Acute Care Inpatient Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
3.1. Acute Care Inpatient Costs by Clinical Chapters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
3.1.1. Total Acute Care Inpatient Costs, All Age Groups and Sexes . . . . . . . . . . . . . . . . . . . .12
3.1.2. Number of Acute Care Inpatient Stays and Estimate of Average Cost
per Stay by Clinical Chapter, 2004–2005, DAD Reporting Jurisdictions . . . . . . . . . . . .14
3.1.3. Share of Total Acute Care Inpatient Costs Due to the Treatment or Presence
of Complexities, Selected Clinical Chapters, All Age Groups and Sexes . . . . . . . . . . .16
3.1.4. Total Acute Care Inpatient Costs by Sex and Clinical Chapter . . . . . . . . . . . . . . . . . . . .18
3.1.5.Total Acute Care Inpatient Costs by Age Group, Sex and Selected Clinical Chapters . .23
3.2.
Acute Care Inpatient Costs for Selected Medical Conditions . . . . . . . . . . . . . . . . . . . . . . . . .26
3.2.1. Total Acute Care Inpatient Costs for the 15 Most Expensive Medical Conditions,
All Age Groups and Sexes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
3.2.2. Number of Acute Care Inpatient Stays and Estimates of Average Cost per Stay
for the 15 Most Expensive Medical Conditions, All Age Groups and Sexes . . . . . . . . . .29
3.2.3. Share of Total Acute Care Inpatient Costs Due to the Treatment or Presence
of Complexities, Selected Medical Conditions, All Age Groups and Sexes . . . . . . . . . .32
3.3. Comparison With Other Studies and Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
3.4. Study Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
4. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
4.1. What We Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
4.2. What We Don’t Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Appendix A. Selection of the Medical Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Appendix B. Data and Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
i
The Cost of Acute Care Hospital Stays by Medical Condition in Canada, 2004–2005
ii
Appendix C. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay
(Unit Cost), Standard Deviation and Number of Stays, All Age Groups, by
Clinical Chapters or Selected Medical Conditions, DAD Reporting Jurisdictions,
All Sexes, and Males and Females, 2004–2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Appendix D. Estimation of Total Acute Inpatient Costs, With Average Cost per Stay (Unit Cost),
Standard Deviation and Number of Stays, by Age Group and Selected Clinical
Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, Males
and Females, 2004–2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Appendix E. Share of Total Acute Care Inpatient Costs Due to the Treatment or Presence of
Complexities, All Age Groups, by Clinical Chapters or Selected Medical Conditions,
DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 . . . . . . .134
References
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
The Canadian Institute for Health Information (CIHI) wishes to acknowledge
the following individuals for their dedicated work on The Cost of Acute Care
Acknowledgements
Acknowledgements
Hospital Stays by Medical Condition in Canada, 2004–2005.
• Mr. Ruolz Ariste, Program Consultant, CIHI, coordination and writing
• Ms. Daniela Panait, Senior Analyst, CIHI, data analysis
• Mr. Marc Lalonde, Senior Analyst, CIHI, data analysis
This report benefits from constructive comments and advice from the
members of the National Health Expenditure Expert Advisory Group:
• Dr. John Horne, University of Victoria
• Dr. Richard Plain
• Dr. Robert G. Evans, University of British Columbia
• Dr. Hu Lu, Health Canada
• Ms. Helen Mcbain, Health Canada
• Dr. Michael Wolfson, Statistics Canada
• Dr. Jeremiah Hurley, McMaster University
• Dr. Stephen Law, Mount Allison University
• Ms. Caroline Boucher, Ministère de la Santé et des Services sociaux
• Ms. Francine Anne Roy, Director, Health Resources Information, CIHI
• Mr. Greg Zinck, Manager, Health Expenditures, CIHI
• Mr. Jean-Marie Berthelot, Vice-President, Programs, CIHI
The production of this report would not have been possible without the
contribution of many areas and individuals in CIHI, and the case-costing
data suppliers.
Individuals in CIHI:
• Mr. David Paton, Senior Methodologist, CIHI
• Ms. Janet Manuel, Classifications Specialist, CIHI
• Mr. Anyk Glussich, Program Lead, CIHI
Case-Costing Data Suppliers:
• Health Authority Funding and Financial Accountability Branch,
Alberta Health and Wellness
• Ontario Case Costing Initiative, Ontario Ministry of Health and
Long-Term Care
iii
Hospital expenditure represents a large share of public-sector health
expenditures: 36.8% in 2005. Its sheer size makes it important to consider
Executive Summary
Executive Summary
when policy planners or researchers want to have a good understanding
of costs of services. The information can be leveraged when reported by
medical condition or illness. Being able to distinguish between the effects
of volume of utilization (number of stays) and magnitude of unit cost (average
cost per stay) on total expenditures will help administrators better understand
the costs of providing health services and will provide an important piece of
the evidence required for health policy and planning.
This report on the cost of acute care hospital stays by medical condition uses
Canadian administrative data to answer the key questions related to total
hospital costs for acute care inpatients:
• What is the contribution (percent and dollar) of each ICD-10-CAi clinical
chapter to total acute care inpatient costs?
• What is the breakdown of total acute care inpatient cost into cost per
stay and volume of utilization for each clinical chapter and selected
medical condition?
• How much of the medical condition costs (in percentages) can be
allocated to the treatment or presence of complexities?
• How do hospital costs for acute care inpatients vary by sex and age
group for each clinical chapter and selected medical condition?
Most Expensive Clinical Chapters
Total acute care inpatient cost is estimated to have been $17,046.6 million
for 2004–2005 in Canada, excluding Quebec. Among the ICD-10-CA chapters,
Diseases of the circulatory system is the most expensive clinical chapter,
representing 19.3% (or $3,294.2 million) of total acute care inpatient costs.
The other four clinical chapters that exhibited the highest total acute care
inpatient costs are Injury, poisoning and certain other consequences of
external causes ($1,734.9 million or 10.2% of total acute care inpatient costs),
Diseases of the respiratory system ($1,619.3 million or 9.5% of total acute
care inpatient costs), Neoplasms ($1,594.2 million or 9.4% of total acute care
inpatient costs) and Diseases of the digestive system ($1,570.6 million or
9.2% of total acute care inpatient costs).
i
International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada.
v
Number of Stays and Average Cost per Stay
However, in terms of the number of stays, these five clinical chapters ranked
below Pregnancy, childbirth and the puerperium and Factors influencing health
status and contact with health services, which were the two clinical chapters
with the highest number of stays (314,535 and 312,539 stays, respectively).
In terms of average cost per stay, the five clinical chapters also ranked below
Congenital malformations, deformations and chromosomal abnormalities, which
was the clinical chapter with the highest average cost per stay ($13,822). For
all the clinical chapters combined, a total of 2.4 million stays were recorded
and each stay cost on average $6,983.
Share of Acute Care Inpatient Costs That Can Be Attributed to
the Treatment or Presence of Complexities
Of the total amount of $17,046.6 million, 27.3% ($4,653.7 million) can be
attributed to the treatment or presence of complexities. Chapters such as
Certain infectious and parasitic diseases and Diseases of the respiratory
system had a substantial share of their costs associated with the treatment
or presence of complexities (47.5% and 45.5%, respectively).
Sex Differences in Acute Care Inpatient Costs
Total acute care inpatient cost has been estimated at $8,381.7 million for
males and $8,658.8 million for females. However, if childbirth is excluded,
total acute care inpatient cost for females dropped to $7,799.1 million.
Sex differences varied depending on the clinical chapters. For example,
costs for males were higher than those for females for Diseases of the
circulatory system ($1,975.3 million versus $1,315.7 million, or 50.1% higher)
and Certain conditions originating in the perinatal period ($293.2 million
versus $230.2 million, or 27.4% higher); while females had higher costs
for Diseases of the genitourinary system ($382.6 million versus $254.1 million,
or 50.6% higher) and Diseases of the musculoskeletal system and connective
tissue $524.5 million versus $391.5 million, or 34.0% higher).
vi
The same information is provided for the 15 most expensive medical
conditions—in terms of acute care inpatient costs—or groups of medical
conditions. These 15 most expensive medical conditions account for 31.4%
Executive Summary
Fifteen Most Expensive Medical Conditions
($5,358.6 million) of total acute care costs. They are: AMI (acute myocardial
infarction or heart attack); cerebrovascular diseases; chronic lower respiratory
diseases, except asthma; heart failure; complications of pregnancy predominantly
during labour and delivery; mood disorders; pneumonia; fracture of femur;
complications of pregnancy predominantly in the antenatal period; disorders
related to short gestation and low birth weight; diabetes mellitus; schizophrenia,
schizotypal and delusional disorders; malignant neoplasms of lymphoid,
hematopoietic and related tissue; arthrosis of the knee; and malignant
neoplasms of colon, rectum and anus.
What We Know and What We Don’t Know
Finally, a list of what we know on the subject of costs by medical condition
and what we don’t know is provided (for example, average day surgery cost
per patient by clinical chapter and medical condition in Canada, impact of the
shift in the mix of treatments and mix of settings).
vii
Hospital expenditure represents a large
share of public-sector health expenditures:
36.8% in 2005.1,ii Its sheer size makes
1. Introduction
and Background
it important to consider when policy
planners or researchers want to have
a good understanding of the costs of
services. The information can be leveraged
when reported by medical condition or
illness. Being able to distinguish between
the effects of volume of utilization (number
of stays) and magnitude of unit cost
(average cost per stay) on total expenditures
will help administrators better understand
the costs of providing health services
and will provide an important piece of
the evidence required for health policy
and planning.
A few studies in Canada have dealt with the costs of
illness. For example, the Economic Burden of Illness in
Canada series reports the direct and indirect costs of
certain illnesses for the specific years 1986, 1993 and
1998.2,3,4 These studies are a primary source of information
ii
For the purpose of the study, 2005 data are used. However, forecasts for 2006 and 2007 are available in the National Health
Expenditure Trends, 1975–2007 report.
on the costs of illnesses in the health care system for each reference year.
They use a top-down approach, as do the majority of studies on the economic
cost of illness. In this top-down approach, the total cost is first determined
for a given category of expenses (for example, hospitals or drugs) and then
broken down by diagnostic category using various techniques and clinical
information databases. So, the top-down approach is a method of allocation
that starts with the highest level of expenditures (total cost) and works its way
down to the lowest possible level. Studies using the top-down approach are
sometimes referred to as general cost of illness (COI) studies. In contrast to
the top-down approach, the bottom-up approach starts with the lowest level
of expenditure (that is, the costs by diagnostic category are determined using
data on the costs for each individual record with the diagnostic category)
and combines the smaller components to estimate the total expenditure
for all diseases. Studies using the bottom-up approach are sometimes
referred to as disease-specific COI studies.
A study commissioned by Health Canada5 deals with the level of costs
associated with heart attacks in Canada using the Case Mix Group (CMG)iii
methodology. In this study, the average costs in 2000–2001 for heart attackiv
were used.6 The bottom-up approach is possible because the illness in
question can be clearly identified using the CMGs from CIHI. However, this is
not possible for most of the illnesses, since CMGs are usually derived using a
combination of diagnosis and intervention codes. With the CMG methodology,
the emphasis is not only on the condition itself, but also on the interventions.
A 2006 CIHI study uses the Discharge Abstract Database (DAD)v and the
Canadian MIS Database (CMDB)vi to estimate the costs of giving birth in
Canada.7 The patient groups also came from the CMG methodology. Hospital
spending was assigned to these clinical groups using case-specific Resource
2
iii
Case Mix Groups (CMGs) are the foundation of acute inpatient grouping, length of stay and Resource Intensity Weight
methodologies. The patient’s most responsible diagnosis (MRDx) is used to assign the case to one of the 25 major clinical
categories (MCCs). Within each MCC, based on the presence or absence of an operative procedure, the case is directed toward a
surgical or medical hierarchy flowchart. As of fiscal year 2007, the CMG methodology was redeveloped to CMG+. The
redevelopment included a confirmation of the overall grouping logic, adjustments to the MCCs, analysis and modification of the
pre-existing comorbidity list, and the creation of the Five-Factor Methodology, which replaces the previous Complexity/Age Overlay.
iv
Heart attack was defined as CMG codes 200 to 208.
v
The DAD contains demographic, administrative and clinical data for hospital discharges (inpatient acute, chronic, rehabilitation) and
some day surgeries in Canada.
vi
The Canadian MIS Database (CMDB) is the national data source for financial and statistical information about hospitals and health
regions. The data are collected according to a standardized framework for collecting and reporting financial and statistical data on
the day-to-day operations of health service organizations.
data. In this example, again, pregnancy and childbirth can be clearly identified
using CIHI’s CMG; otherwise, the estimation would not be possible.
In the annual reports on health costing in Alberta, the Health Authority Funding
and Financial Accountability Branch reports average cost by CMG derived
from the data submitted by some facilities in Alberta. Similarly, the Ontario
Introduction and Background
Intensity Weight (RIW) and hospital-specific cost per weighted case (CPWC)
Case Costing Initiative (OCCI) reports average cost by CMG for some
reporting facilities in Ontario. Moreover, the OCCI publishes average cost for
the top 50 diagnoses, based on either volume or cost. A costing analysis tool
(CAT) that allows the user to select the diagnostic codes and have the
corresponding average cost is also available on the OCCI website. However,
analytical studies on total acute care inpatient costs by medical condition do
not seem to exist in these two case-costing provinces.vii
On the international scene, Australia, like Canada, periodically publishes
reports on the cost of illness. The first report,8 which deals with data from
1993–1994, primarily discusses the level of costs. The second report covers
not only the level of costs in 2000–2001, but also the changes in costs from
1993–1994 to 2000–2001.9 These two reports use the top-down approach.
Also, it should be noted that the Organisation for Economic Co-operation and
Development (OECD), Eurostat and the World Health Organization (WHO)
have examined the feasibility of collecting data by disease category and by
age and gender based on the System of Health Accounts (SHA).10
A recent Dutch study11 compares COI in five countries: Australia, Canada,
France, Germany and the Netherlands. The central question in this study was:
To what extent and why do COI estimates differ internationally? The Dutch
study examined top-down COI studies. The study was a follow-up to a
previous one that compared COI in six countries: Australia, Canada, England,
Germany, the Netherlands and Sweden. That study also examined top-down
COI studies.12, viii
In general COI studies, comorbidity is usually not considered. All costs are
assigned to the main diagnosis.12 Even the disease-specific COI studies
mentioned above do not deal with the issue of segregating costs attributed to
the treatment or presence of complexities from overall costs (costs attributed
vii
However, it is easy to estimate total cost when average cost per case has been estimated.
viii
Large differences were found but exact explanations in COI could not be made except for some medical conditions; for example,
higher cost of cancer and skin diseases in Australia because of a higher prevalence; costs of accidents in Australia and Germany
were high because of more accidents.
3
to the treatment of the primary diagnosis and complexities). Some
other foreign studies address this issue but generally consider only
one specific disease.13,14,15,16
Using survey data and the bottom-up approach, a U.S. study discusses
the medical conditions that are responsible for the growth in health care
expenses.17 It is one of the few studies that estimate the cost of illnesses
for a wide variety of conditions, using the bottom-up approach and
at the same time accounting for complexities.
This report, The Cost of Acute Care Hospital Stays by Medical Condition in
Canada, 2004–2005, uses Canadian administrative data and the bottom-up
approach to answer the key questions related to total hospital costs for acute
care inpatients at the pan-Canadian level:
•
What is the contribution (percentage and dollar) of each ICD-10-CAix
clinical chapter to the total acute care inpatient cost?
•
What is the breakdown of total acute care inpatient cost into cost per
stay and volume of utilization for each clinical chapter and selected
medical condition?
•
How much of the medical condition costs (in percentages) can be
attributed to the treatment or presence of complexities?
•
How do hospital costs for acute care inpatients vary by sex and age
group for each clinical chapter and selected medical condition?
The focus of the report is on the level of acute care inpatient costs in
2004–2005. The contribution of the report is twofold: it breaks down total acute
care inpatient costs into cost per stay and number of stays, and it estimates
the share of total acute care inpatient costs that can be allocated to the
treatment or presence of complexity. Complexity (Plx) is a concept in the CMG
methodology that is related to the number and/or severity of the comorbid
conditions of a patient. So, the term Plx is used to mean complexity-related
comorbidities. Complex cases are identified by Plx level 2, 3 or 4; the higher
the Plx level, the more severe the case.
ix
4
ICD-10-CA is the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada.
Inpatient Curative Care
46.6%
Outpatient Curative Care
Introduction and Background
Figure 1 Total Hospital Cost and Share of Total Cost by
Department, Canada, 2004–2005
17.9%
Inpatient Long-term Nursing Care
8.3%
Day Cases of Curative Care
7.4%
Diagnostic Imaging
6.2%
Clinical Laboratory
4.2%
Research and Development in Health
3.5%
Inpatient Rehabilitative Care
1.4%
Other
4.6%
$0
$2
$4
$6
$8
$10
$12
$14
$16
$18
$20
Hospital Expenses ($ Billion)
Notes:
1. Cost excludes fee-for-service payments to physicians.
2. Other includes Education and training of health personnel; Prevention of non-communicable diseases; Outpatient
rehabilitative care; Services of curative home care; Patient transport and emergency rescue; Day cases of rehabilitative care;
Food, hygiene and drinking water control; Environmental health; Pastoral care; and Social work.
Source:
Canadian MIS Database, 2004–2005, CIHI.
Due to data limitations (see Section 3.4 on Study Limitations), we have
constrained the scope of the study to acute care inpatients. This sector still
constitutes a substantial share of hospital activities. In fact, in 2004–2005,
expenses on acute care inpatient are estimated to have represented 46.6%
of hospital expenses, using the Canadian MIS Database (see Figure 1).
5
However, it should be acknowledged that ambulatory carex is becoming
a more important treatment setting and there is evidence of a substitution
effect between acute care inpatient cases and day surgery cases: more
conditions are being treated in the day surgery setting instead of the
inpatient setting.
The rest of the report is organized as follows. Section 2 presents the
framework of the study and an overview of the methodology. The results
are presented and discussed in Section 3, followed by the conclusion in
Section 4, including a short discussion on what we know and what we
don’t know.
x
6
Ambulatory care includes day surgery and outpatient care provided in clinics and emergency departments.
This report addresses costs of illness
in the acute care inpatient setting for the
jurisdictions submitting data to the Discharge
Abstract Database (DAD). As of 2004–2005,
these jurisdictions included Newfoundland
and Labrador, Nova Scotia, Prince Edward
Island, New Brunswick, Ontario, Manitoba,
Saskatchewan, Alberta, British Columbia,
the Northwest Territories, Nunavut and the
Yukon Territory. In the figures that follow,
these jurisdictions are collectively referred
to as the “DAD reporting jurisdictions” (that
is, all jurisdictions except Quebec).
In the context of the bottom-up approach, cost is defined as
the product of average cost per stay for a given illness times
the number of stays relative to this illness. Note that different
methods can be used to implement the bottom-up approach.
A study by researchers at the Pharmaceutical Health Services
Research Department of the University of Maryland provides
an extensive review of the current methods.18
2. Study Framework
and Overview of
the Methodology
Costs are reported at a two-level classification: a chapter level (based on the
ICD-10-CA chapter), and a group level within these chapters. The chapter
level refers to the 20 clinical chapters of ICD-10-CA.xi Each chapter is further
subdivided: first into blocks, then into categories and usually subcategories.
The blocks divide chapters into sections of similar content and are made
up of varying numbers of three-character categories. The categories may be
assigned to a single disease entity (for example, HIV) or to a group of similar
entities (for example, ischemic heart diseases). The 213 medical conditions
selected in this report refer to these ICD-10-CA categories or to the grouplevel classification. Appendix A provides a listing of the clinical chapters and
the medical conditions discussed in this report; it also includes the ICD-10-CA
code ranges of these chapters and medical conditions.
For the volume component of hospital costs, the data source is the
Discharge Abstract Database (DAD). The DAD contains demographic,
administrative and clinical data for hospital discharges (inpatient acute,
chronic and rehabilitation) and some day surgeries in Canada.xii However,
only acute care inpatients are considered in this study.
A stay is defined as any case admitted and discharged with a most
responsible diagnosis (MRDx)xiii of a specified medical condition in the
acute care inpatient setting.xiv A patient who was admitted and discharged
more than one time within a fiscal year would be counted more than once.
In 2004–2005, the total number of DAD acute care inpatient records in the
database was 2,441,665. However, some 366 records (about 1.5 for every
10,000) were excluded, either because of invalid primary diagnostic codes
or because of unknown age.
For the other component of hospital costs, which is average cost per stay, two
other data sources are used: the Ontario Case Costing Initiative (OCCI) and
the Alberta Case-Costing Database.xv Both databases contain record-specific
costing information about inpatients and day surgery patients admitted to the
8
xi
The three chapters that are excluded from this study are: External causes of morbidity and mortality (Chapter 20); Morphology of
neoplasms (Chapter 22) and Provisional codes for research and temporary assignment (Chapter 23). These chapters do not indicate
anything clinical about the patient and are used only as supplemental codes. They could never be the most responsible diagnosis.
xii
Not all day surgery (DS) is captured in DAD, a separate NACRS (National Ambulatory Care Reporting System) database exists
where DS is captured in some provinces (such as Ontario).
xiii
The 2004 Canadian Coding Standards definition of MRDx is: The one diagnosis or condition that can be described as being most
responsible for the patient’s stay in hospital. If there is more than one such condition, the one held most responsible for the greatest
portion of the length of stay or greatest use of resources should be selected. If no diagnosis was made, the main symptom,
abnormal finding or problem should be selected as the MRDx.
xiv
This corresponds to Institution_type = 1 in the DAD.
xv
There are a small number of case-costing hospitals in other provinces, such as B.C.
are teaching or large/community hospitals. It should be noted that neither of
the databases includes fee-for-services for physicians (for example, surgeon
fees and other fees). So, the inpatient acute care costs presented in this
report are an underestimation of the costs of illnesses as they exclude
payments to physicians. In 2004–2005, the aggregate number of acute care
inpatient records in these two case-costing databases was 458,844, which
represents 18.8% of the population (the total number of DAD acute care
inpatient records).
Cost for each record in the case-costing databases is allocated to the MRDx.
Study Framework and Overview of the Methodology
participating hospitals. In both databases, most of the participating hospitals
However, if it is a complex case (which is identified by the presence of Plx
level 2, 3 or 4 in the record), an adjustment is made to the cost of the record
in order to capture the cost of treating the primary diagnosis exclusively.xvi
This adjustment is made via regression analysis, which is ultimately used to
estimate the share of total acute care inpatient costs due to the treatment
or presence of complexitiesxvii (see Section “Adjusting for Complexities”
in Appendix B for the full details of the methodology).
It is generally agreed that the cost to provide health care is not the same
across the country. This difference should be fully taken into account if
we want to estimate hospital costs for all the jurisdictions. However,
comprehensive data to account for input price differences are not available,
except for compensation. Therefore, only price differences for salaries and
compensation can be considered to adjust for differences in costs to provide
hospital care across the country. This is still a substantial proportion of inputs
used in hospitals; for example, in 2004–2005, salaries and compensationxviii
accounted for up 62% of hospital expenditures, 72% if employment benefits
are included.19 It should be noted that physician fee-for-service payments are
not included in the case-costing databases, and therefore are not included in
the compensation methodology either. Also, the total acute inpatient costs
reported in this study do not include any cost that may be incurred by (or
imputed to) the patient (such as out-of-pocket expenses or mortality or
morbidity costs due to disability).
xvi
Note that this is different from adjustment for outliers.
xvii
In the CMG methodology, complexity level is based upon the number of significant comorbidities, which are based upon whether or
not they are in the same body system or whether or not they were post-admit comorbidities.
xviii
For management and operational support employees (for example, those employees who are involved in the decision-making
process and provide support to those carrying out the mandate of the organization) and unit-producing personnel employees
(those employees called front-line workers who carry out the mandate of the functional centre).
9
Note that in order to capture costs for all stays and levels of complexity, no
adjustment was made for outliers.xix Costs calculated on an average basis for
hospital stays are influenced by the extreme stays of relatively few patients.
Therefore, the average cost will generally be higher than the median.
xix
10
If a trim factor of 1.5 times the inter-quartile range was applied, just over 1.0% of all the cases would
be considered outliers.
This section presents the results of the
analysis on acute care inpatient costs, first
by clinical chapters and then for selected
medical conditions. For a comprehensive
description of the data and the bottom-up
methodology used to produce these results,
see the appropriate sections in Appendix B.
3. Acute Care
Impatient Costs
3.1. Acute Care Inpatient Costs by
Clinical Chapters
3.1.1. Total Acute Care Inpatient Costs, All Age Groups
and Sexes
Acute care inpatient costs are reported below for the 20 clinical chapters for
all age groups and sexes combined. These cost estimates are for stays with
all levels of complexity (this means they include cost for the treatment of the
primary diagnosis and cost for the treatment or presence of complexities—
Plx level 1, 2, 3, 4 and 9 in the CMG methodology) and are labelled “total
acute care inpatient costs.”
Total acute care inpatient cost is estimated to have been $17,046.6 million in
2004–2005 for Canada, excluding Quebec and fee-for-service payments.
Acute care inpatient cost for treating Diseases of the circulatory system is
estimated to have been $3,294.2 million in 2004–2005. This represents 19.3%
of total acute care inpatient costs and makes it the most expensivexx clinical
chapter. The other four clinical chapters with the highest total costs are Injury,
poisoning and certain other consequences of external causes ($1,734.9 million
or 10.2% of total acute care inpatient costs), Diseases of the respiratory
system ($1,619.3 million or 9.5% of total acute care inpatient costs),
Neoplasms ($1,594.2 million or 9.4% of total acute care inpatient costs) and
Diseases of the digestive system ($1,570.6 million or 9.2% of total acute care
inpatient costs) (see Figure 2). To find out some of the diseases or medical
conditions included in these chapters, see Appendix A.
These five clinical chapters all together represent 57.6% of acute care
inpatient costs and are the most expensive ones. Given the fact that health
care expenditure is mostly concentrated in the last year of life,20 and
cardiovascular diseases (CVD) and malignant neoplasms (cancers) are
among the diseases with the highest mortality rates,21 it is not surprising that
they account for almost 30% of acute care inpatient costs. The two clinical
chapters with the lowest acute care inpatient costs are Diseases of the ear and
mastoid process ($27.5 million or 0.2% of total acute care inpatient costs) and
Diseases of the eye and adnexa ($20.1 million or 0.1% of total acute care
inpatient costs).
xx
12
Throughout the report, the term “expensive” is used to refer to high total cost for acute care inpatients. It is not used to refer to high
average cost per stay.
Diseases of the
Circulatory System
19.3%
$3,294
Injury, Poisoning and Certain Other
Consequences of External Causes
Acute Care Inpatient Costs
Figure 2 Estimated Total Acute Care Inpatient Costs and Share of
Total, by Clinical Chapter, 2004–2005, All Age Groups
and Sexes, DAD Reporting Jurisdictions
10.2%
Diseases of the Respiratory System
9.5%
Neoplasms
9.4%
Diseases of the Digestive System
9.2%
Mental and Behavioural Disorders
6.6%
Diseases of the Musculoskeletal
System and Connective Tissue
Pregnancy, Childbirth
and the Puerperium
Factors Influencing Health Status
and Contact With Health Services
5.4%
5.0%
4.8%
Diseases of the Genitourinary System
3.7%
Symptoms, Signs and Abnormal
Clinical and Lab Findings, NEC
Certain Conditions Originating
in the Perinatal Period
Endocrine, Nutritional and
Metabolic Diseases
Certain Infectious and
Parasitic Diseases
3.7%
3.1%
2.6%
2.2%
Diseases of the Nervous System
2.1%
Congenital Malformations, Deformations
and Chromosomal Abnormalities
Diseases of the Skin and
Subcutaneous Tissue
0.9%
Diseases of the Blood
0.8%
0
00
00
$2
,
,8
00
,6
$1
00
$1
,4
00
$1
,2
00
$1
,0
$1
$8
00
$2
00
0.1%
$6
Diseases of the Eye and Adnexa
00
0.2%
$0
Diseases of the Ear
and Mastoid Process
$4
00
1.2%
Costs ($ Million)
Notes:
1. Fee-for-service payments to physicians as well as other costs such as out-of-pocket payments are excluded.
2. Costs exclude Quebec data.
Sources:
Discharge Abstract Database, Canadian MIS Database, CIHI; Ontario Case Costing Initiative; Alberta Case-Costing Database.
13
3.1.2 Number of Acute Care Inpatient Stays and Estimate of
Average Cost per Stay by Clinical Chapter, 2004–2005, DAD
Reporting Jurisdictions
The decomposition of total acute care inpatient cost into unit cost (average
cost per stay) and number of stays helps to determine the weight of each of
these factors in the total acute care inpatient cost for each chapter. Not
surprisingly, the most expensive clinical chapters are the ones that experience
both high unit cost and high number of stays. For example, Diseases of the
circulatory system had the second-highest unit cost ($11,260) and the thirdhighest number of stays (292,562); Neoplasms had the third-highest unit cost
($10,650) and the seventh-highest number of stays (149,683); Injury, poisoning
and certain other consequences of external causes had the sixth-highest unit
cost ($9,405) and number of stays (184,475) (see Figure 3).
However, even though Pregnancy, childbirth and the puerperium and Factors
influencing health status and contact with health services are the most
common clinical chapters in terms of number of stays (314,535 and 312,539,
respectively), these chapters do not rank high in terms of total costs. This
could be explained by the fact that these chapters experienced relatively low
unit costs ($2,733 and $2,641, respectively); they rank as the last two clinical
chapters in terms of average cost per stay. The chapter Factors influencing
health status and contact with health services includes codes that may be
used to describe scenarios for patients who have already been treated for a
disease or injury, but who are receiving follow-up or prophylactic care,
convalescent care, palliative care or care to consolidate the treatment, to deal
with residual states, to ensure that the condition has not recurred or to prevent
recurrence. Among other things, healthy newborns, live tissue donors,
admissions for chemotherapy and radiotherapy treatments and admissions
for dialysis are included in this chapter.xxi
On the other hand, Congenital malformations, deformations and chromosomal
abnormalities ranks first in terms of unit cost ($13,822), but is among the last
five chapters in terms of total costs because of its low volume (14,904).
The type of cases in this chapter includes the major birth defects, such as
nervous system or heart anomalies, with high unit cost. For all the clinical
chapters combined, a total of 2.4 million stays were recorded and each stay
cost on average $6,983.
xxi
14
Chapter 21 Factors influencing health status and contact with health services contains some items that could be classified in other
chapters (for example, Healthy newborn babies). However, these items were not allocated back because the objective was to report
costs by ICD-10-CA chapter.
Number of Stays
0
50,000
100,000
150,000
200,000
250,000
Figure 3 Number of Acute Care Inpatient Stays and Estimate of
Average Cost per Stay by Clinical Chapter, 2004–2005,
All Age Groups and Sexes, DAD Reporting Jurisdictions
300,000
Diseases of the Circulatory System
Neoplasms
Pregnancy, Childbirth and the Puerperium
Certain Conditions Originating
in the Perinatal Period
Endocrine, Nutritional and Metabolic Diseases
Certain Infectious and Parasitic Diseases
Diseases of the Skin and Subcutaneous Tissue
Diseases of the Ear and Mastoid Process
0
$1
4,
00
0
$1
2,
00
0
00
0,
$1
00
,0
$8
00
,0
$6
00
$4
,0
00
$2
,0
$0
Average Cost per Stay
Number of Stays
Notes:
2. Figures exclude Quebec data.
Sources:
15
3.1.3. Share of Total Acute Care Inpatient Costs Due to
the Treatment or Presence of Complexities, Selected
Clinical Chapters, All Age Groups and Sexes
Patients differ with respect to the extent that their care is complicated.
This can be looked at from the point of view of the number of diagnoses
made, the number of interventions performed or the level of complexity of
the case. This study uses the level of complexity in the CMG methodology
to break down total acute care inpatient costs into costs attributed for
the treatment of the primary diagnosis (that is, costs for stays without
complexity—Plx level 1 and 9) and costs attributed for the treatment or
presence of complex cases (that is, costs for stays with complexity
levels 2, 3 and 4). Both treatment and presence of complexities are
considered because sometimes, the sheer fact of having a complexity
means that potentially more time or additional interventions may be
required to treat the primary diagnosis. Figure 4 reports the share of
costs attributed to the treatment or presence of complexities for each
clinical chapter, except for conditions that are not part of the CMG/Plx
methodology: Mental and behavioral disorders; Pregnancy, childbirth
and the puerperium; Certain conditions originating in the perinatal period; HIV;
and some trauma cases.xxii
Certain infectious and parasitic diseases,xxiii and Diseases of the respiratory
system had a substantial share of their costs associated with the treatment
or presence of complexities (47.5% and 45.5%, respectively). Patients
with infectious diseases such as septicemia or hepatitis usually have
other significant comorbidities. Also, patients admitted for treatment of
respiratory diseases may be at the end of their life and have other
significant complexities. On the other hand, the share of costs due
to complexity is minor for Diseases of the eye and adnexa and Diseases
of the ear and mastoid process (2.7% and 3.4%, respectively).
16
xxii
Plx level 9 (complexity not due to comorbid conditions) is assigned to medical conditions in these clinical categories or chapters.
xxiii
For Certain infectious and parasitic diseases, the share of cost that can be allocated to complexity stands out even though for one
disease in this chapter (HIV), the Plx methodology does not apply.
Figure 4 Estimated Share of Acute Care Inpatient Costs
Attributed to the Treatment or Presence of Complexities,
Selected Clinical Chapters, 2004–2005, All Age Groups
and Sexes, DAD Reporting Jurisdictions
Neoplasms
Total Chapters*
0
5
10
15
20
25
30
Share (%)
35
40
45
50
Notes:
* Excluding the three non-clinical chapters (External causes of morbidity and mortality; Morphology of neoplasms; and Provisional
codes for research and temporary assignment) as well as Mental and behavioral disorders; Pregnancy, childbirth and the
puerperium; Certain conditions originating in the perinatal period; HIV; and some trauma cases.
Sources:
17
3.1.4. Total Acute Care Inpatient Costs by Sex and
Clinical Chapter
males and $8,658.8 million for females. The difference from the totalxxiv is due
to rounding and/or the category “Other”xxv for sex.
It should be noted that the chapter with the highest number of stays is
Pregnancy, childbirth and the puerperium; this factor alone should account for
the higher relative total cost for women: total acute care inpatient cost for this
chapter was $859.7 million. This means that if this chapter is excluded, total
acute care inpatient costs for women become $7,799.1 million or 7.5% lower
than that of men. Besides, sex difference in acute care inpatient costs varied
by clinical chapter. For some chapters, the cost for males was higher than that
for females (for example, Diseases of the circulatory system [$1,975.3 million
versus $1,315.7 million, or 50.1% higher], Certain conditions originating in the
perinatal period [$293.2 million versus $230.2 million, or 27.4% higher],
Diseases of the respiratory system [$873.7 million versus $745.9 million,
or 17.1% higher], Diseases of the nervous system [$187.6 million versus
$169.0 million, or 11.0% higher], Injury, poisoning and certain other
consequences of external causes [$906.6 million versus $827.3 million,
or 9.6% higher] and Neoplasms [$815.5 million versus $778.0 million,
or 4.8% higher]). On the other hand, for some medical conditions, the
cost for females was higher than that for males (for example, Diseases
of the genitourinary system [$382.6 million versus $254.1 million, or 50.6%
higher], Diseases of the musculoskeletal system and connective tissue
[$524.5 million versus $391.5 million, or 34.0% higher], Diseases of the blood
and blood-forming organs and certain disorders involving the immune system
[$77.9 million versus $63.8 million, or 22.1% higher], Mental and behavioural
disorders [$580.5 million versus $537.4 million, or 8.0% higher]). See Figure 5
for estimates of total acute care inpatient costs by clinical chapter. Note that
the chapter Diseases of the genitourinary system includes most of the medical
conditions for which hysterectomies are performed, as well as the medical
conditions leading to genitourinary repairs for birth-related conditions (for
example, prolapse). The analysis by age group and sex in Section 3.1.5
offers more insights in this regard.
18
xxiv
This difference is $6.1 million or 0.04%.
xxv
The category “Other” includes undifferentiated sex, transsexuals and hermaphrodites. It is difficult to get estimates of acute care
costs for this category because the number of records in the case-costing databases is too few or non-existent.
Figure 5 Estimate of Total Acute Care Inpatient Costs by Clinical
Chapter and Sex, All Age Groups, 2004–2005, DAD
Neoplasms
Certain Conditions Originating in the Perinatal Period
00
00
00
,0
$2
,8
$1
00
,6
$1
,4
00
$1
00
,2
$1
$1
,0
00
$8
00
00
$6
$4
00
$2
$0
Costs ($ Million)
Females
Males
Notes:
Sources:
19
Even though the total acute care inpatient cost for males was about 3.2%
lower than that for females,xxvi the average cost per stay for male acute care
inpatients was globally higher than that for females ($7,964 versus $6,236, or
27.7% higher). Again, this is partly explained by the pregnancy stays: higher
volume and lower cost per unit. Higher unit cost for men was observed for
example in the case of Neoplasms ($12,292 versus $9,335, or 31.7% higher),
Endocrine, nutritional and metabolic diseases ($9,318 versus $7,730, or 20.5%
higher) and Diseases of the genitourinary system ($5,652 versus $4,698, or
20.3% higher). See Figure 6 for estimates of average cost per stay by
clinical chapter.
However, the lower number of male acute care inpatient stays (1,052,482
versus 1,388,612, or 24.2% lower) more than compensated for the higher unit
cost (if the chapter Pregnancy, childbirth and the puerperium is excluded, the
number of male acute care inpatient stays is just 2.0% lower than that of the
females’).xxvii The number of male acute care inpatients was particularly lower
for Diseases of the genitourinary system (44,956 versus 81,440, or 44.8%
lower), Diseases of the blood and blood-forming organs and certain disorders
involving the immune mechanism (8,983 versus 11,473, or 21.7% lower) and
Neoplasms (66,340 versus 83,343, or 20.4% lower) (see Figure 7). It should
be noted that for certain clinical chapters, such as Diseases of the circulatory
system, Diseases of the nervous system and Diseases of the respiratory
system, figures for both unit cost and volume are higher for males than for
females. It is reported that women have less heart disease than men,22 even
though CVD is the leading cause of mortality in women.23
xxvi
In 2004, the National Health Expenditure Database (NHEX) estimate of provincial and territorial government hospital expenditure
was $16,819.2 million for men, 10.5% lower than the $18,803.8 million for women.
xxvii The number of hospital stays for women was 1,074,077 if the chapter Pregnancy, childbirth and the puerperium was excluded.
20
Figure 6 Estimate of Average Cost per Stay for Acute Care
Inpatients, by Clinical Chapter and Sex, All Age Groups,
2004–2005, DAD Reporting Jurisdictions
Injury, Poisoning and Certain
Other Consequences of External Causes
Neoplasms
Symptoms, Signs and Abnormal Clinical and Lab Findings, NEC
Congenital Malformations,
Deformations and Chromosomal Abnormalities
00
6,
$1
00
4,
0
0
0
$1
2,
00
0
$1
00
00
0,
$1
,0
$8
00
,0
$6
00
,0
$4
00
$2
,0
$0
Total All Chapters*
Females
Males
Notes:
2. Figures exclude Quebec data.
* Excluding the three non-clinical chapters: External causes of morbidity and mortality; Morphlology of neoplasms; and
Provisional code for research and temporary assignment.
Sources:
Ontario Case Costing Initiative; Alberta Case-Costing Database; Canadian MIS Database, Discharge Abstract Database, CIHI.
21
Figure 7 Number of Acute Care Inpatient Stays by Clinical
Chapter and Sex, All Age Groups, 2004–2005, DAD
Neoplasms
314,535
Symptoms, Signs and Abnormal Clinical and Lab Findings, NEC
Congenital Malformations,
Deformations and Chromosomal Abnormalities
0
20
40
60
80
100
120
140
Number of Stays (Thousands)
Females
Source:
Discharge Abstract Database, CIHI.
22
Males
160
180
Figure 8 reports acute care inpatient costs for the most expensive clinical
chapters by age group and sex.
For all clinical chapters combined, prior to age 75, total acute care inpatient
3.1.5. Total Acute Care Inpatient Costs by Age Group, Sex and
Selected Clinical Chapters
costs in each of the age groups were generally higher for males than for
females, except for the 15-to-44-year age group, where acute care inpatient
costs were about two-thirds higher for females than for males (see Figure 8.1).
This is mainly due to the child-bearing factor; that is, the fact of giving birth,
or the medical conditions arising as a result of giving birth, like soft tissue
damage, prolapse and indications for hysterectomy. In the age group 85 years
and over, acute care inpatient costs for females were about 70.0% higher than
those for males ($974.1 million versus $572.0 million). It should be noted that
the share of women in this age group in the general population was more than
twice that of men (1.0% versus 0.4% in 2004). In other words, this difference in
costs is due to the fact that women live longer than men.
For certain clinical chapters, male patients systematically bear higher costs
than their female counterparts in all of the age groups, up to the age of 84.
This is the case for Diseases of the circulatory system and Diseases of the
respiratory system. For the former chapter, heart attack is the disease that
accounts for the main difference, while for the latter, virtually all diseasesxxviii
within the chapter account for the difference. For Neoplasms, male patients
bear higher costs than their female counterparts only for the 65-to-74 and
75-to-84 age groups, partly due to the effect of prostate cancer. In the case
of Endocrine, nutritional and metabolic diseases, male patients bear higher
costs than their female counterparts for the 45-to-64 and 65-to-74 age groups,
partly due to the effect of diabetes.
Even though male patients prior to age 75 generally bear higher costs than
their female counterparts, females in some of these age groups have higher
acute care inpatient costs for certain clinical chapters. For example, this is
the case for the following diseases where females in the 15-to-44 age group
experienced higher costs than their male counterparts: Diseases of the
genitourinary system ($116.2 million versus $28.5 million); Neoplasms
($116.0 million versus $68.6 million); Diseases of the digestive system
($180.7 million versus $157.5 million); and Endocrine, nutritional and metabolic
diseases ($43.8 million versus $33.5 million). Females in the 45-to-64 age
group also experienced higher costs for Diseases of the genitourinary system.
xxviii Except for asthma, where total acute care cost is slightly higher for females than for males.
23
Moreover, slightly higher costs are generally incurred for Mental and
behavioural disorders for females from the age groups 45 years and over
(see appropriate chart in the set of Figures 8). In the case of Diseases of the
genitourinary system, it is not surprising to see this substantial sex difference
in costs for the 15-to-44 age group, given that this chapter includes medical
conditions related to birth (for example, female genital prolapse). As for
Neoplasms, the impact of breast cancer is seen in the 15-to-44 age group.
The leading cause of cancer death in women under 50 is breast cancer.24
The sex difference in costs for Endocrine, nutritional and metabolic diseases
for this age group is partly due to obesity and other hyperalimentation.
Number of stays for this condition in the 15-to-44 age group was about
nine times as many for women as for men (1,184 versus 128).xxix
Because of greater longevity, acute care costs for females aged 75 and over
are generally higher than those for males. However, for the chapter Injury,
poisoning and certain other consequences of external causes, this difference
is very substantial (for example, $171.3 million for women versus $59.1 million
for men, or almost three times higher in the 85+ age group). This is likely due
to fractures of the femur, resulting from the combined effect of falls and higher
prevalence of osteoporosis. It is well known that prevalence of osteoporosis is
higher in women than in men.25 The sex difference is also large for the chapter
Diseases of the musculoskeletal system and connective tissue (for example,
$144.7 million for women versus $74.5 million for men, or almost twice as high
in the 75-to-84 age group). This is likely due to the impact of arthritis.
xxix
24
Gastric banding surgery for morbid obesity may account for many more females than males.
Figure 8 Total Acute Care Inpatient Costs by Age Group and
Sex for All Clinical Chapters Combined and for the
Most Expensive Clinical Chapters, 2004–2005, DAD
Figure 8.2. Diseases of the Circulatory System
Figure 8.1 All Clinical Chapters
$2,000
Millions
Millions
$2,500
$1,500
$1,000
$500
$0
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
$150
$100
$50
<1
1–4
4
5–1
44 5–64 5
4
6
15–
Age Group
84
75–
Millions
Millions
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
<1
1–4
4
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
4
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
5–1
$300
$250
$200
$150
$100
$50
$0
<1
1–4
5–1
Figure 8.8 Diseases of the Musculoskeletal System
and Connective Tissue
$200
Millions
Millions
$200
Figure 8.6 Neoplasms
$150
$100
$50
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
$0
85+
Figure 8.9 Diseases of the Genitourinary System
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
Figure 8.10 Endocrine, Nutritional and Metabolic Diseases
$80
Millions
Millions
85+
44 5–64 5–74 5–84
4
6
15–
7
Age Group
$300
$0
85+
Figure 8.7 Mental and Behavioural Disorders
$140
$120
$100
$80
$60
$40
$20
$0
5–1
$100
–74
Figure 8.5 Diseases of the Digestive System
$300
$250
$200
$150
$100
$50
$0
4
1–4
$400
$200
Millions
Millions
$250
$300
$250
$200
$150
$100
$50
$0
<1
Figure 8.4 Injury, Poisoning and Other
Figure 8.3 Diseases of the Respiratory System
$0
$700
$600
$500
$400
$300
$200
$100
$0
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
85+
$60
$40
$20
$0
<1
1–4
4
5–1
44 5–64 5–74 5–84
4
6
15–
7
Age Group
Females
85+
Males
Notes:
3. All clinical chapters refer to the 20 clinical chapters, including Pregnancy, childbirth and the puerperium.
Sources:
Discharge Abstract Database, Canadian MIS Database, CIHI; Ontario Case Costing Initiative;
Alberta Case-Costing Database.
25
3.2 Acute Care Inpatient Costs for Selected
Medical Conditions
The other reporting level for acute care inpatient costs is for medical
conditions, which are disease categories within a clinical chapter. Costs are
discussed for the 15 most expensive medical conditions or groups of medical
conditions; that is, the 15 medical conditions or groups of medical conditions
with the highest total acute care inpatient costs.
3.2.1. Total Acute Care Inpatient Costs for the 15 Most
Expensive Medical Conditions, All Age Groups and Sexes
This section presents the level of total acute care inpatient costs for the 15
most expensive medical conditions or group of medical conditions for all age
groups and sexes combined. However, the estimates are reported for each
Table 1
List of the 15 Most Expensive Medical Conditions With
Total Acute Care Inpatient Costs, 2004–2005
Clinical
Chapter
Number
Medical Conditions or Group of Medical Conditions
Total Acute
Care Inpatient
Cost ($ million)
IX
Acute Myocardial Infarction (AMI or heart attack)
510.8
IX
Cerebrovascular diseases
509.4
X
Chronic lower respiratory diseases, except asthma
438.7
IX
Heart failure
425.6
XV
Complication of pregnancy predominantly during labour
and delivery
426.9
V
Mood disorders
409.4
X
Pneumonia
387.0
XIX
Fracture of femur
352.4
XV
Complication of pregnancy predominantly in the
antenatal period
330.6
XVI
Disorders related to short gestation and low birth weight
324.1
IV
Diabetes mellitus
283.9
V
Schizophrenia, schizotypal and delusional disorders
283.8
II
Malignant neoplasms of lymphoid, hematopoietic and
related tissue
237.7
XIII
Gonarthrosis (arthrosis of knee)
224.4
II
Malignant neoplasms of colon, rectum and anus
213.9
Total 15 most expensive medical conditions
5,358.6
Notes:
Sources:
26
age groups and sexes combined (Appendix C). Because costs for specific
illnesses are reported, this section provides more granular information on the
level of total acute care inpatient costs. As in the case of the clinical chapters,
these cost estimates are for stays with all levels of complexity. Section 3.2.3. of
the report shows how to get estimates for the treatment of the primary
of the 213 selected medical conditions or groups of medical conditions for all
diagnosis only, using the share of costs due to complexity.
The 15 most expensive medical conditions account for 31.4% ($5,358.6 million)
of total acute care costs. Table 1 presents the list of these medical conditions,
along with their total acute care inpatient costs.
The top two most expensive diseases were acute myocardial infarction (AMI),
commonly referred to as heart attack ($510.8 million), and cerebrovascular
diseases, commonly referred to as strokexxx ($509.4 million) (see Figure 9).
As expected, they belong to the most expensive clinical chapter, Diseases
of the circulatory system (IX). Heart failure also ranked high in this chapter
($425.6 million). Moreover, with a total acute care inpatient cost of $438.7 million,
Chronic lower respiratory diseases, except asthma ranked third among the
most expensive medical conditions. This group of diseases includes chronic
obstructive pulmonary disease (COPD), bronchitis, emphysema and
bronchiectasis, belonging to the chapter Diseases of the respiratory system (X).
Pneumonia, which ranked seventh in the list ($387.0 million), is also part of the
same chapter. Because of the high number of stays, Complications of
pregnancy predominantly during labour and delivery and Complications of
pregnancy predominantly in the antenatal period made the list of the 15 most
expensive medical conditions ($426.9 million and $330.6 million, respectively).
These medical conditions represented 49.7% and 38.5%, respectively, of the
costs in the chapter Pregnancy, childbirth and the puerperium (XV), suggesting
that most of the pregnancy and childbirth cases involve some complications.
However, this might be partly due to coding practices in Canada. If there is
evidence of any potential or actual problem with the labour and delivery, any
problem with the fetus or an existing condition that complicates the pregnancy,
a complication code will be assigned. Even the presence of a perineal tear (not
episiotomy) that is repaired following delivery warrants an obstetric code in
the MRDx position, bumping the case from a completely normal case to one
with complications.xxxi
xxx
ICD-10-CA codes for stroke are I60–I64 and I66. However, cerebrovascular diseases (I60–I69) are a larger group and include
occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction; cerebrovascular disorders in diseases classified
elsewhere; and sequelae of cerebrovascular disease.
xxxi
A completely normal labour and delivery (vaginal delivery or primary elective Caesarean section) of a singleton fetus will
have a MRDx of Z37.0.
27
Figure 9 Total Acute Care Inpatient Costs for the 15 Most
Expensive Medical Conditions, All Age Groups and
Sexes, 2004–2005, DAD Reporting Jurisdictions
Acute Myocardial Infarction
(AMI or Heart Attack)
510.8
Cerebrovascular Diseases
509.4
Chronic Lower Respiratory
Diseases, Except Asthma
438.7
Heart Failure
425.6
Complication of Pregnancy
Predominantly During Labour and Delivery
426.9
409.4
Mood Disorders
Pneumonia
387
Fracture of Femur
352.4
Complication of Pregnancy Predominantly
in the Antenatal Period
330.6
Disorders Related to Short Gestation
and Low Birth Weight
324.1
Diabetes Mellitus
283.9
Schizophrenia, Schizotypal
and Delusional Disorders
283.8
Malignant Neoplasms of Lymphoid,
Hematopoietic and Related Tissue
237.7
Gonarthrosis (Arthrosis of Knee)
224.4
Malignant Neoplasms of Colon,
Rectum and Anus
213.9
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
$550
Costs ($ Million)
Notes:
Sources:
With total acute care inpatient costs of $409.4 million and $283.8 million,
respectively, mood disorders and schizophrenia ranked among the 15 most
expensive medical conditions. These illnesses, from the chapter Mental and
behavioural disorders (V), have substantial average costs per stay on top of
a relatively high number of stays (see Figure 10).
28
consequences of external causes (XIX), had a total acute care inpatient cost
of $352.4 million and ranked eighth among the 15 most expensive medical
conditions. Demand for the most common procedure associated with this
condition—hip and knee replacement—is consistently high to the point that
it is among the five targeted priority procedures to reduce wait times.
Fracture of femur, from the chapter Injury, poisoning and certain other
With total acute care inpatient costs of $324.1 million, disorders related to
short gestation and low birth weight (from Chapter XVI: Certain conditions
originating in the perinatal period) made the list of the 15 most expensive
medical conditions, because of their relatively high average cost per stay.
Patients with diabetes mellitus (from Chapter IV: Endocrine, nutritional and
metabolic diseases) are also expensive ($283.9 million), ranking eleventh
on the list. Acute care inpatient costs for malignant neoplasm of lymphoid,
hematopoietic and related tissue, and malignant neoplasm of colon, rectum
and anus (from Chapter II: Neoplasms) were $237.7 million and $213.9 million,
respectively, making them the most costly groups of malignancies. Malignant
neoplasm of lymphoid, hematopoietic and related tissue (including among
other diseases, leukemia and Hodgkin’s disease) is the third leading cause of
death from malignant neoplasms for both men and women, while malignant
neoplasm of colon, rectum and anus is the second leading cause of cancer
death for both sexes.24, xxxii Acute care inpatient cost for gonarthrosis or
arthrosis of the knee (from Chapter XIII: Diseases of the muscoskeletal system
and connective tissue) is high enough ($224.4 million) to make the list of the
15 most expensive medical conditions, even though it ranked among the last
two medical conditions in the list.xxxiii
3.2.2. Number of Acute Care Inpatient Stays and Estimates
of Average Cost per Stay for the 15 Most Expensive Medical
Conditions, All Age Groups and Sexes
Average cost per stay (unit cost) and number of stays are presented in
Figure 10 for the 15 most expensive medical conditions or group of medical
conditions for all age groups and sexes combined (for unit cost estimates,
standard deviations and number of stays for the 213 medical conditions, see
appropriate columns in Appendix C). Also, Appendix D provides the same
xxxii The leading cause of cancer death for both sexes is malignant neoplasm of trachea, bronchus and lung, with a total acute care
inpatient cost of $150.9 million.
xxxiii There are other groups of medical conditions or code categories that could make the list of the 15 most expensive medical
conditions, but they are rather very broad and do not particularly identify specific illnesses or groups of illnesses. For example, the
code range Other persons encountering health services for specific procedures and health care as an MRDx are not indicating a
condition but rather a “health care delivery scenario” and include: follow-up care involving plastic surgery; adjustment and
management of implanted device (for example, cardiac pacemaker, infusion pump); care involving dialysis; convalescence; etc.
Total acute care inpatient costs for these stays were substantial ($373.9 million). However, this code range was not chosen.
29
information by age group and sex for selected medical conditions. These
medical conditions were selected depending on the age group.xxxiv These unit
costs include costs for the treatment of the primary diagnosis as well as costs
for the treatment or presence of complexities.
In 2004–2005, among the 15 most expensive medical conditions, Complications
of pregnancy, predominantly during labour and delivery was the medical
condition with the highest number of stays (157,540 stays or 50.1% of the
total number of stays in the chapter). This suggests that half of all deliveries
involved complications. This is partly due to coding standards in Canada.
For example, subsequent C-section in a patient with a previous one is
assigned to a complication code, as is a successful vaginal delivery in a
patient previously delivered by C-section, even if the second delivery is
considered “completely normal.”
Complications of pregnancy predominantly in the antenatal period were the
second-most common medical conditions (108,496 stays or 34.5% of the
total number of stays in the chapter). Again, the coding practices could partly
account for this. Chronic lower respiratory diseases, except asthmaxxxv were
the third-most common medical conditions (54,434 stays) followed by heart
attack (46,252 stays) and mood disorders (44,942 stays).
On the other hand, Malignant neoplasm of lymphoid, hematopoietic and
related tissue had the highest average cost per stay ($22,546) among the
15 most expensive medical conditions.xxxvi Bone marrow transplant and other
procedures, such as high-dose chemotherapy, radiation, isolation, etc.,
partly explain the high cost per stay for patients with leukemia and other
malignancies in this category.
Disorders related to short gestation and low birth weight were the most
expensive medical conditions with the second-highest average cost per stay
($16,379), followed by Cerebrovascular diseases ($14,261); Fracture of femur
($13,565); and Malignant neoplasm of colon, rectum and anus ($13,277).
Both Complications of pregnancy predominantly during labour and delivery and
Complications of pregnancy predominantly in the antenatal period have low
unit cost ($2,710 and $3,047, respectively). They make the list of the 15 most
expensive medical conditions because of their high volume.
xxxiv For example, for age groups younger than 45 years old, Alzheimer’s disease is not selected. However, this medical condition is
selected for age groups 45 years old and over.
xxxv
This corresponds to code categories J40–J44 and J47 and includes chronic obstructive pulmonary disease (COPD), bronchitis,
emphysema and bronchiectasis.
xxxvi Note that adult respiratory distress syndrome had the highest average cost per case among the 213 medical conditions ($83,694),
followed by rheumatic fever with heart involvement ($39,748).
30
00
16
0,0
18
0,0
00
00
0,0
14
12
0,0
0,0
00
00
0
10
0
,00
80
,00
60
,00
40
20
0
,00
0
0
Number of stays
Figure 10 Number of Acute Care Inpatient Stays and Estimates
of Average Cost per Stay for the 15 Most Expensive
Medical Conditions, 2004–2005, All Age Groups and
Sexes, DAD Reporting Jurisdictions
Acute Myocardial Infarction (AMI Or Heart Attack)
Chronic Lower Respiratory Diseases, Except Asthma
Heart Failure
During Labour and Delivery
Mood Disorders
Pneumonia
Fracture of Femur
In the Antenatal Period
Disorders Related To Short Gestation and Low Birth Weight
Diabetes Mellitus
Schizophrenia, Schizotypal and Delusional Disorders
0
$2
5,
00
0
$2
0,
00
0
00
5,
$1
0
00
0,
$1
00
$5
,0
$0
Malignant Neoplasms of Colon, Rectum and Anus
Number of Stays
Notes:
Sources:
31
3.2.3. Share of Total Acute Care Inpatient Costs Due to the
Treatment or Presence of Complexities, Selected Medical
Conditions, All Age Groups and Sexes
As stated previously in Section 3.1, total acute care inpatient costs include
costs attributed for the treatment of the primary diagnosis and costs attributed
for the treatment or presence of complexities. Figure 11 reports the share of
costs attributed to the treatment or presence of complexities for the 15 most
expensive medical conditions, except for those that are not part of the
CMG/Plx methodology: mood disorders; schizophrenia, schizotypal and
delusional disorders; complications of pregnancy predominantly during labour
and delivery; complications of pregnancy predominantly in the antenatal
period; and disorders related to short gestation and low birth weight.xxxvii
The share of total acute care inpatient costs due to the treatment or presence
of complexities for the other medical conditions is reported in Appendix E.
It should be noted that the objective of this section is to investigate the share
of cost due to the treatment or presence of complexities, no matter which
chapter these complexities might come from. Which specific complexities
or comorbidities contribute to the costs is not investigated.xxxviii
Among the selected most expensive medical conditions, Malignant neoplasm
of lymphoid, hematopoietic and related tissue was the disease group with the
highest share of costs due to complexities (56.6%).xxxix Cerebrovascular
diseases ranked second in terms of share of costs due to complexities
(41.4%), followed closely by Diabetes mellitus (41.2%); Pneumonia (41.0%);
Chronic lower respiratory diseases, except asthma (40.8%); and Heart failure
(39.4%). Arthrosis of knee was the condition with the lowest share of costs
due to complexities (6.4%).
For most of the 213 medical conditions,xl the share of cost attributed to the
treatment or presence of complexity can be used to determine the costs of the
treatment of the primary diagnosis only. For this purpose, the numbers in
Appendix E can be used. For example, the total acute care inpatient cost for
heart failure was estimated to be $425.6 million, which represents the cost of
the treatment of the primary diagnosis (heart failure) and the complexities
xxxvii Plx level 9 is assigned to these five groups of medical conditions.
xxxviii If the objective was to assess which comorbidities contribute to the costs of treatment, then the complexities or comorbidities would
have to be cross-linked among chapters or be more specifically specified.
xxxix In the case-costing databases, there were almost as many stays for malignant neoplasm of lymphoid with complexity related to
potentially life-threatening condition(s) as stays with no complexity or comorbidity, and about 18% of all the stays were for patients
aged 75 and over. Moreover, some diseases in this group, such as chronic lymphocytic leukemia, multiple myeloma and mycosis
fungoides, are known to affect mainly adults over 55. Acute lymphoblastic leukemia affects children under 5 but then the disease
has another peak of incidence in adults over 65 years of age.
xl
32
Except for those within the chapters that are not part of the CMG/Plx methodology.
Figure 11 Estimated Share of Acute Care Inpatient Costs Due to
the Treatment or Presence of Complexities, Selected
Medical Conditions, All Age Groups and Sexes,
2004–2005, DAD Reporting Jurisdictions
Acute Myocardial Infarction
(AMI or Heart Attack)
Chronic Lower Respiratory
Diseases, Except Asthma
Heart failure
Pneumonia
Fracture of Femur
Diabetes Mellitus
Malignant Neoplasms of Colon,
Rectum and Anus
0%
5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65%
Share
Notes:
Quebec data are excluded.
Sources:
associated with this disease. The share of cost attributed to the treatment or
presence of complexity for heart failure is 39.4% or 0.394. So, the estimate for
the total acute care inpatient costs for the treatment of heart failure would be
$257.9 million ($425.6 million x [1 - 0.394]), and the costs for complexities
when heart failure was the primary diagnosis would be $167.7 million
($425.6 million x 0.394).
33
3.3. Comparison With Other Studies and Results
A few studies about the level of hospital costs by disease are available in
Canada, among others, the Economic Burden of Illness in Canada series.
Comparisons with these studies remain difficult because they report costs for
years prior to 2004–2005 for all hospital activities and use a top-down
approach, which is generally more comprehensive, though less accurate.
On the other hand, this current study uses a bottom-up approach and does
not cover the whole range of hospital settings because there are some data
and methodology requirements that could not be met with the bottom-up
approach.xli This explains why hospital costs in this report are for acute care
inpatients only. Moreover, because complexity is taken into account using the
CMG methodology, the numbers in the current study exclude institutions in
Quebec. These factors explain why a straight comparison is not possible
between the current study and other cost-of-illness studies.
Some comparison can still be made, as long as caution is exercised and
the limitations are considered. Existing studies,4,9,17 either with the top-down
approach or the bottom-up approach, ranked Diseases of the circulatory
system as the most expensive clinical chapter, as does this report. Also,
a CIHI study26 found that Canadian hospitals outside of Quebec and rural
Manitoba spent an estimated $821 million on pregnancy and childbirth
services for typical maternal inpatients in 2002–2003. This figure is relatively
in line with the $859.7 million estimated in this report for acute care inpatients
hospitalized in 2004–2005 for Pregnancy, childbirth and the puerperium,
even though the two studies use different methodologies.
From the costing analysis tool of the OCCI,27 the following average costs per
stay are derived for some diagnosis codes in 2004–2005.xlii These average
costs are compared with those in this report:
34
xli
For example, there is a need to have a clear definition and identification of day surgery cases across the country.
xlii
Most of the ICD-10-CA codes in the OCCI costing analysis tool are at the four-digit level or more. Therefore, it is not possible to
compare most of the codes in the current study, in which most of the ICD-10-CA codes are at the three-digit level.
Comparison of Average Cost per Stay, OCCI Average
and Average in Current Study, Acute Care Inpatients,
All Stays, 2004–2005
Average in
Current
Study § (SD)
Percent
Difference
Relative to
OCCI Average
Headings
ICD10CA
# Stays
OCCI
OCCI
Average *
(SD) †
# Stays
Current
Study ‡
HIV
B24
232
$18,918
(31,122)
338
$17,246
(27,916)
-8.8%
Malignant neoplasm
of prostate
C61
1,086
$6,313 (4,740)
2,197
$6,697 (4,528)
6.1%
Multiple sclerosis
G35
150
$10,694
(21,790)
282
$10,247
(18,575)
-4.2%
Adult respiratory
distress syndrome
J80
67
$78,860
(79,075)
166
$83,694
(91,690)
6.1%
Hyperplasia of
prostate
N40
1,069
$3,173 (1,865)
1,672
$3,335 (2,216)
5.1%
Single spontaneous
(live) delivery
Z37.0
2,659
$2,140 (1,035)
3,958
$1,986 (961)
-7.2%
Table 2
Notes:
* Average cost per stay for Ontario data, all stays (costing analysis tool).
† SD = standard deviation.
‡ Number of stays is based on Ontario and Alberta case-costing data sets for this table only.
§ Average cost per stay for DAD reporting jurisdictions (Canada, excluding Quebec), all stays.
Fee-for-service payments to physicians as well as other costs such as out-of-pocket payments are excluded in both OCCI
and the current study.
Sources:
35
The comparison reveals that the average costs per stay in this report are
within ±9% of OCCI averages, which is fairly reasonable given that in this
report, Ontario and Alberta data are combined and adjustment is made to
report cost at the pan-Canadian level.
At the global level, comparison can be done using the Canadian
MIS Database (CMDB). From CMDB 2004–2005, total spending on
acute care inpatients was estimated to be $14,570.8 million for Canada,
excluding Quebec. Total acute care inpatient cost in this report was $17,046.6
million for Canada, excluding Quebec, which translates to a difference of
$2,475.8 million or about 17% higher. This difference could be partly due to
the fact that case-costing facilities are not a random sample but are rather
biased toward high-cost facilities, namely teaching facilities. Teaching facilities
made up two-thirds of Ontario and Alberta case-costing records. This sample
bias could result in an overestimation of the figures in the current study.xliii The
difference could also be due to some methodological difference relating to the
allocation of operational support cost.xliv
3.4. Study Limitations
There are some issues to consider in the interpretation and utilization of
the results presented. Even though they are interrelated, they can be
generally classified into two categories: case-costing data issues and
methodological issues.
One costing data issue is coding variation that may exist in some facilities.
If there is coding variation of comorbid conditions, this will cause a bias in cost
per stay at the complexity level. However, coding variations are considered
less critical for the data year considered in this study (2004–2005) and are
unlikely to have any major impact on the results presented.xlv
Another study limitation is the non-random availability of case-cost
data. These data are collected on a voluntary basis and are not likely
representative of all facilities within the province or across Canada. For
example, in 2004–2005, the number of records in the health-costing
databases in Ontario and Alberta represented 30.8% of the inpatient
36
xliii
The overestimation results when the model that fits the high-cost facilities is applied to the whole population.
xliv
For example, the CMDB allocation of most support costs including plant, computer systems and institutional administration is
prorated based on total expenditures recorded in each sector. The intensity of support for the acute inpatient setting in terms of
management and support is higher than this prorated share. The $14.6 billion figure in CMDB would be higher if inpatient costs
were attributed on the same basis.
xlv
Coding variations are considered more critical for the data years 2000–2001 and 2001–2002.
further statistical analyses if it were randomly selected, but it is not. A large
number of facilities submitting cost data are teaching hospitals with higher
volume of interventions than that generally seen in community or rural facilities.
The case-costing facilities tend to have higher costs, but tend to be more
efficient (in terms of lower mortality rate and observed length of stay) for some
activity in these two provinces.xlvi A sample of this size would be adequate for
medical conditions.28 This could offset the cost differences between the types
of facilities and hence, reduce the impact of the non-representative sample.
On the methodological side, in the CMG/Plx methodology, comorbidities
and thus complexity were not applied in the major clinical categories (MCCs)
of Mental Diseases, HIV, Newborns and Neonates, and Pregnancy and
Childbirth. However, in the CMG+ methodology implemented for 2007–2008
data, the comorbidity factor is utilized in all of these MCCs and it will be
possible to allocate complexity costs to these medical conditions. It is
documented that patients with mental disorders experience significant
complexities. A U.S. study29 suggests that the bulk of the cost of treating a
patient with depression in a primary care setting is for care of accompanying
illnesses (up to 72%).
Note also that complexity level is not assigned for some CMGs in the
MCC Significant Trauma.xlvii This suggests that the share of cost attributed
to the treatment or presence of complexity for the chapter Injury, poisoning
and certain other consequences of external causes (30.5%) is likely an
under-estimation.
The inpatient acute care costs presented in this report are generally an
underestimation of the cost of illnesses, as they exclude any fee-for-service
component for physicians or any costs that may be incurred by (or imputed
to) the patient, such as out-of-pocket expenses or mortality or morbidity
costs due to disability.
Moreover, the scope of this study does not include the complete range of
hospital services, such as day surgery, rehabilitation and chronic care; neither
does it analyze the influence of the mix of interventions. Moreover, the data
on which the study is based do not cover all jurisdictions across Canada.
A further study including the complete range of health care settings, treatments
and jurisdictions in Canada may lead to findings different from those of this
study and provide a more comprehensive picture of the full costs of health
care in Canada.
xlvi
For Ontario and Alberta, there were 1,490,140 inpatient records in the DAD and 458,844 inpatient records in the case-costing
databases in 2004–2005.
xlvii
Those CMGs are: CMGs 651–659 and CMGs 674–679.
37
This report focuses on the level of acute care
inpatient costs by clinical chapter and for
selected medical conditions or groups of
medical conditions. It discusses the
contribution of cost per stay and volume
(number of stays) to total acute care inpatient
costs, as well as the share of total inpatient
costs that can be attributed to the treatment
or presence of complexities. Next, the report
discusses variation in acute care inpatient
costs by age group and sex for each clinical
chapter. Finally, acute care inpatient costs for
the 15 most expensive medical conditions are
presented. Note that fee-for-service payments
to physicians are not included in the acute
care inpatient costs reported in this study.
Among the ICD-10-CA chapters, Diseases of the circulatory
system remains the most expensive clinical chapter, representing
19.3% (or $3,294.2 million) of total acute care inpatient costs
in 2004–2005. The other four clinical chapters that exhibited
the highest total acute care inpatient costs were Injury,
poisoning and certain other consequences of external cause
($1,734.9 million or 10.2% of total acute care inpatient costs),
4. Conclusion
Diseases of the respiratory system ($1,619.3 million or 9.5% of total acute
care inpatient costs), Neoplasms ($1,594.2 million or 9.4% of total acute care
inpatient costs) and Diseases of the digestive system ($1,570.6 million or 9.2%
of total acute care inpatient costs).
However, in terms of number of stays, these five clinical chapters ranked
below the chapters Pregnancy, childbirth and the puerperium and Factors
influencing health status and contact with health services, which were the
two clinical chapters with the highest number of stays (314,535 and 312,539,
respectively). In terms of average cost per stay, the five most expensive
clinical chapters also ranked below Congenital malformations, deformations
and chromosomal abnormalities, which was the clinical chapter with the
highest average cost per stay ($13,822). For all the clinical chapters
combined, a total of 2.4 million stays were recorded and each stay cost
on average $6,983.
Certain infectious and parasitic diseases and Diseases of the respiratory
system had a substantial share of the costs associated with the treatment
or presence of complexities (47.5% and 45.5%, respectively).
males and $8,658.8 million for females. Sex difference varied by clinical
chapter: costs for males are higher than those for females in clinical
chapters such as Diseases of the circulatory system; Certain conditions
originating in the perinatal period; Diseases of the respiratory system;
Diseases of the nervous system; Injury, poisoning and certain other
consequences of external causes; and Neoplasms. However, the opposite
is true for some other clinical chapters: costs for females are higher than
those for males in clinical chapters such as Diseases of the genitourinary
system; Diseases of the musculoskeletal system and connective tissue;
Diseases of the blood; and Mental and behavioural disorders.
In terms of total acute care inpatient costs, the 15 most expensive medical
conditions or group of medical conditions are (in order): AMI (heart attack);
cerebrovascular diseases; chronic lower respiratory diseases, except asthma;
heart failure; complications of pregnancy predominantly during labour and
delivery; mood disorders; pneumonia; fracture of femur; complications of
pregnancy predominantly in the antenatal period; disorders related to short
gestation and low birth weight; diabetes mellitus; schizophrenia, schizotypal
40
and related tissue; arthrosis of the knee; and malignant neoplasms of colon,
rectum and anus. They accounted for 31.4% ($5,358.6 million) of total acute
Conclusion
and delusional disorders; malignant neoplasms of lymphoid, hematopoietic
care costs).
4.1. What We Know
• Estimated total acute care inpatient costs by clinical chapter and for
selected medical conditions in the DAD reporting jurisdictions.
• Estimated average cost per inpatient stay by clinical chapter and for
selected medical conditions in the DAD reporting jurisdictions.
• The number of acute care inpatient stays by clinical chapter for selected
medical conditions in the DAD reporting jurisdictions.
• The share of total acute care inpatient costs due to the treatment or
presence of complexities for most of the clinical chapters and selected
medical conditions.
• Total acute care inpatient costs by age group and sex by clinical chapter
and selected medical conditions in the DAD reporting jurisdictions.
4.2. What We Don’t Know
In order to manage each sector of the health care system efficiently, the
questions explored in this study should ideally be studied for all of the other
sectors: day surgery setting, primary care setting, long-term care facilities and
the drug sector. Then, a system-wide perspective could be offered. However,
for some of these sectors or settings, it will not be possible to address these
questions in the near future. Thus, the following list of what we don’t know is
not comprehensive:
• What is the total day surgery cost by clinical chapter and for selected
medical conditions in Canadian facilities?
• What is the average cost per patient in the inpatient and day surgery
settings for each clinical chapter and selected medical conditions in
Canadian facilities?
• How has the shift in the mix of treatments and the mix of settings
changed hospital output and costs in Canadian facilities?
• How are changes in hospital inputs related to changes in hospital output
in Canada?
• How are changes in hospital output related to changes in patient
outcomes in Canada?
41
Appendix A.
Selection of the Medical Conditions
Appendices
The first step in studying hospital costs by medical condition
is to choose the medical conditions to consider. For this
purpose, diseases were chosen in each clinical chapter
based on length of stay (LOS) and episode: the higher the
LOS and/or episode for a given disease, the greater the
likelihood of choosing this disease. For each clinical chapter,
a category called “Other” is defined such that it represents no
more than 25% of the total LOS of the chapter. In this process,
the World Health Organization International Shortlist for
Hospital Morbidity Tabulation (WHO-ISHMT) was also used.30
The ISHMT is a short list that comprises 149 diagnosis
categoriesxlviii compiled for statistical comparison of hospital
activity among member countries. It comprises diagnosis
categories defined by both ICD-9 and ICD-10 codes for
developing time series statistics. It was used to make sure
that the selected codes are well accepted and valid. The
Ontario Case Costing Initiative list of the 50 diagnoses
was also used. These diagnoses are among the top 50 most
responsible diagnoses based on either volume (number of
stays) or on average total cost per stay. Expert advice within
and outside CIHI (Classifications, Case Mix, OCCI, etc.) was
also considered. From this process, 213 medical conditions
were chosen; most of them are listed among the 149 medical
conditions from the WHO shortlist.
xlviii In Canada, the original list of 35 diagnosis categories reported on was expanded in 2005 to include 114 new diagnosis categories,
for a total of 149.
44
Table A.1 shows the listing of the 20 clinical chapters and the 213 medical conditions
discussed in this report.
Appendix A
Table A.1 List of Selected Medical Conditions (213) With Their ICD-10-CA Codes
Heading
ICD-10-CA Codes
Chapter I—Certain infectious and parasitic diseases
A00–B99
Intestinal infectious diseases except diarrhea
A00–A08
Diarrhea and gastroenteritis of presumed infectious origin
A09
Tuberculosis
A15–A19, B90
Septicemia
A40–A41
Viral infections of the central nervous system
A80–A89
Viral infections characterized by skin and mucous membrane lesions
B00–B09
Hepatitis
B15–B19
Human immunodeficiency virus [HIV] disease
B24
Other infectious and parasitic diseases
remainder of A00–B99
Chapter II—Neoplasms
C00–D48
Malignant neoplasms of lip, oral cavity and pharynx
C00–C14
Malignant neoplasm of colon, rectum and anus
C18–C21
Malignant neoplasm of trachea, bronchus and lung
C33–C34
Malignant neoplasms of bone and articular cartilage
C40–C41
Malignant neoplasms of skin
C43–C44
Malignant neoplasms of mesothelial and soft tissue
C45–C49
Malignant neoplasm of breast
C50
Malignant neoplasm of uterus
C53–C55
Malignant neoplasm of ovary
C56
Malignant neoplasm of prostate
C61
Malignant neoplasm of bladder
C67
Malignant neoplasms of eye, brain and other parts of central nervous system
C69–C72
Malignant neoplasms of thyroid and other endocrine glands
C73–C75
Malignant neoplasms of lymphoid, hematopoietic and related tissue
C81–C96
Other malignant neoplasms
remainder of C00–C97
Carcinoma in situ
D00–D09
Benign neoplasm of colon, rectum and anus
D12
Leiomyoma of uterus
D25
Other benign neoplasms and neoplasms of uncertain or unknown behaviour
remainder of D00–D48
Heading
ICD-10-CA Codes
Chapter III—Diseases of the blood and blood-forming organs and certain
disorders involving the immune mechanism
D50–D89
Anemias
D50–D64
Coagulation defects, purpura and other hemorrhagic conditions
D65–D69
Agranulocytosis
D70
Certain disorders involving the immune mechanism
D80–D89
Other diseases of blood and blood-forming organs
remainder of D50–D89
Chapter IV—Endocrine, nutritional and metabolic diseases
E00–E90
Disorders of thyroid gland
E00–E07
Diabetes mellitus
E10–E14
Malnutrition
E40–E46
Obesity and other hyperalimentation
E65–E68
Cystic fibrosis
E84
Other metabolic disorders
E70–E83, E85–E90
Other endocrine, nutritional and metabolic diseases
remainder of E00–E90
Chapter V—Mental and behavioural disorders
F00–F99
Dementia
F00–F03
Mental and behavioural disorders due to use of alcohol
F10
Mental and behavioural disorders due to use of other psychoactive substances
F11–F19
F20–F29
Mood [affective] disorders
F30–F39
Neurotic, stress-related and somatoform disorders
F40–F48
Disorders of adult personality and behaviour
F60–F69
Other mental and behavioural disorders
remainder of F00–F99
Chapter VI—Diseases of the nervous system
G00–G99
Inflammatory diseases of the central nervous system
G00–G09
Systemic atrophies primarily affecting the central nervous system
G10–G13
Extrapyramidal and movement disorders
G20–G26
Alzheimer’s disease
G30
Multiple sclerosis
G35
Epilepsy
G40–G41
Transient cerebral ischemic attacks and related syndromes
G45
Polyneuropathies and other disorders of the peripheral nervous system
G60–G64
Diseases of myoneural junction and muscle
G70–G73
Cerebral palsy and other paralytic syndromes
G80–G83
Other diseases of the nervous system
remainder of G00–G99
Appendices
Table A.1 List of Selected Medical Conditions With Their ICD-10-CA Codes, Cont’d.
45
46
Heading
ICD-10-CA Codes
Chapter VII—Diseases of the eye and adnexa
H00–H59
Disorders of eyelid, lacrimal system and orbit
H00–H06
Disorders of sclera, cornea, iris and ciliary body
H15–H22
Cataract
H25–H26, H28
Disorders of choroid and retina
H30–H36
Glaucoma
H40–H42
Disorders of vitreous body and globe
H43–H45
Disorders of optic nerve and visual pathways
H46–H48
Disorders of ocular muscles, binocular movement,
accommodation and refraction
H49–H52
Visual disturbances and blindness
H53–H54
Other diseases of the eye and adnexa
remainder of H00–H59
Chapter VIII—Diseases of the ear and mastoid process
H60–H95
Diseases of external ear
H60–H62
Diseases of middle ear and mastoid
H65–H75
Diseases of inner ear
H80–H83
Conductive and sensorineural hearing loss
H90
Other diseases of the ear and mastoid process
remainder of H60–H95
Chapter IX—Diseases of the circulatory system
I00–I99
Rheumatic fever with heart involvement
I01–I02
Chronic rheumatic heart diseases
I05–I09
Hypertensive diseases
I10–I15
Angina pectoris
I20
Acute myocardial infarction (heart attack)
I21–I22
Other ischemic heart diseases
I23–I25
Pulmonary heart disease and diseases of pulmonary circulation
I26–I28
Cardiomyopathy
I42
Atrial fibrillation
I48
Other conduction disorders and cardiac arrhythmias
I44–I47, I49
Heart failure
I50
Other forms of heart diseases
I30–I41, I43, I51, I52
I60–I69
Atherosclerosis
I70
Varicose veins of lower extremities
I83
Other diseases of the circulatory system
remainder of I00–I99
Heading
ICD-10-CA Codes
Chapter X—Diseases of the respiratory system
J00–J99
Acute upper respiratory infections and influenza
J00–J11
Pneumonia
J12–J18
Other acute lower respiratory infections
J20–J22
Chronic diseases of tonsils and adenoids
J35
Other diseases of upper respiratory tract
J30–J34, J36–J39
J40–J44, J47
Asthma
J45–J46
Adult respiratory distress syndrome
J80
Other diseases of the respiratory system
remainder of J00–J99
Chapter XI—Diseases of the digestive system
K00–K93
Disorders of teeth and supporting structures
K00–K08
Other diseases of oral cavity, salivary glands and jaws
K09–K14
Diseases of esophagus
K20–K23
Peptic ulcer
K25–K28
Dyspepsia and other diseases of stomach and duodenum
K29–K31
Diseases of appendix
K35–K38
Inguinal hernia
K40
Other abdominal hernia
K41–K46
Crohn’s disease and ulcerative colitis
K50–K51
Other noninfective gastroenteritis and colitis
K52
Paralytic ileus and intestinal obstruction without hernia
K56
Diverticular disease of intestine
K57
Diseases of anus and rectum
K60–K62
Other diseases of intestine
K55, K58–K59, K63
Alcoholic liver disease
K70
Other diseases of liver
K71–K77
Cholelithiasis
K80
Other diseases of gall bladder and biliary tract
K81–K83
Diseases of pancreas
K85–K87
Other diseases of the digestive system
remainder of K00–K93
Chapter XII—Diseases of the skin and subcutaneous tissue
L00–L99
Infections of the skin and subcutaneous tissue
L00–L08
Bullous disorders
L10–L14
Dermatitis, eczema and papulosquamous disorders
L20–L45
Urticaria and erythema
L50–L54
Decubitus ulcers
L89
Other diseases of the skin and subcutaneous tissue
remainder of L00–L99
Appendices
47
48
Table A.1—List of Selected Medical Conditions With Their ICD-10-CA Codes, Cont’d
Heading
ICD-10-CA Codes
Chapter XIII—Diseases of the musculoskeletal system and connective tissue
M00–M99
Coxarthrosis
M16
Gonarthrosis
M17
Internal derangement of knee
M23
Other arthropathies
M00–M15, M18–M22, M24–M25
Systemic connective tissue disorders
M30–M36
Deforming dorsopathies and spondylopathies
M40–M49
Intervertebral disc disorders
M50–M51
Dorsalgia
M54
Soft tissue disorders
M60–M79
Other disorders of the musculoskeletal system and connective tissue
remainder of M00–M99
Chapter XIV—Diseases of the genitourinary system
N00–N99
Glomerular and renal tubulo-interstitial diseases
N00–N16
Renal failure
N17–N19
Urolithiasis
N20–N23
Other diseases of the urinary system
N25–N39
Hyperplasia of prostate
N40
Other diseases of male genital organs
N41–N51
Disorders of breast
N60–N64
Inflammatory diseases of female pelvic organs
N70–N77
Female genital prolapse
N81
Menstrual, menopausal and other female genital conditions
N91–N95
Other noninflammatory disorders of female genital tract
N80, N82–N90, N96–N98
Other disorders of the genitourinary system
remainder of N00–N99
Chapter XV—Pregnancy, childbirth and the puerperium
O00–O99 and Z37.0
Medical abortion
O04
Other pregnancy with abortive outcome
O00–O03, O05–O08
Complications of pregnancy predominantly in the antenatal period
O10–O48
Complications of pregnancy predominantly during labour and delivery
O60–O75
Single spontaneous delivery
Z37.0
Complications predominantly related to the puerperium
O85–O92
Other obstetric conditions
O95–O99
Heading
ICD-10-CA Codes
Chapter XVI—Certain conditions originating in the perinatal period
P00–P96
Disorders related to short gestation and low birth weight
P07
Other disorders related to length of gestation and fetal growth
P05, P06, P08
Respiratory distress of newborn
P22
Other respiratory and cardiovascular disorders specific to the perinatal period
P20, P21, P23–P29
Hemorrhagic and hematological disorders of fetus and newborn
P50–P61
Digestive system disorders of fetus and newborn
P75–P78
Other conditions originating in the perinatal period
remainder of P00–P96
Chapter XVII—Congenital malformations, deformations and
chromosomal abnormalities
Q00–Q99
Congenital malformations of the nervous system
Q00–Q07
Congenital malformations of the circulatory system
Q20–Q28
Congenital malformations of the respiratory system
Q30–Q34
Cleft palate and cleft lip
Q35–Q37
Other congenital malformations of the digestive system
Q38–Q45
Congenital malformations of the urinary system
Q60–Q64
Congenital malformations and deformations of the musculoskeletal system
Q65–Q79
Chromosomal abnormalities, not elsewhere classified
Q90–Q99
Other congenital malformations, deformations and chromosomal abnormalities
remainder of Q00–Q99
Chapter XVIII—Symptoms, signs and abnormal clinical and laboratory findings,
not elsewhere classified
R00–R99
Pain in throat and chest
R07
Other symptoms and signs involving the circulatory and respiratory systems
R00–R06, R08, R09
Abdominal and pelvic pain
R10
Other symptoms and signs involving the digestive system and abdomen
R11–R19
Symptoms and signs involving the urinary system
R30–R39
Symptoms and signs involving cognition, perception,
emotional state and behaviour
R40–R46
Symptoms and signs involving speech and voice
R47–R49
General symptoms and signs
R50–R69
Other symptoms, signs and abnormal clinical and laboratory findings
remainder of R00–R99
Appendices
49
50
Heading
ICD-10-CA Codes
Chapter XIX—Injury, poisoning and certain other consequences of external causes
S00–T98
Intracranial injury
S06
Other injuries to the head
S00–S05, S07–S09
Injuries to the neck
S10–S19
Injuries to the thorax
S20–S29
Injuries to the abdomen, lower back, lumbar spine and pelvis
S30–S39
Injuries to the shoulder and upper arm
S40–S49
Injuries to the wrist and hand
S60–S69
Fracture of forearm
S52
Other injuries to the elbow and forearm
S50, S51, S53–S59
Fracture of femur
S72
Other injuries to the hip and thigh
S70, S71, S73–S79
Fracture of lower leg, including ankle
S82
Other injuries to the knee and lower leg
S80, S81, S83–S89
Injuries to the ankle and foot
S90–S99
Injuries involving multiple body regions
T00–T07
Injuries to unspecified parts of trunk, limb or body region
T08–T14
Effects of foreign body entering through natural orifice
T15–T19
Burns and corrosions
T20–T32
Frostbite
T33–T35
Poisoning by drugs, medicaments and biological substances
T36–T50
Toxic effects of substances chiefly nonmedicinal as to source
T51–T65
Certain early complications of trauma, not elsewhere classified
T79
Complications of surgical and medical care, not elsewhere classified
T80–T88
Sequelae of injuries, of poisoning and of other consequences of external causes
T90–T98
Other injuriy, poisoning and consequences of external causes
remainder of S00–T98
Chapter XXI—Factors influencing health status and contact with health services
Z00–Z99 (excluding Z37.0)
Medical observation and evaluation for suspected diseases and conditions
Z03
Persons encountering health services for examination and investigation
Z00–Z02, Z04–Z13
Contraceptive management
Z30
Liveborn infants according to place of birth (“healthy newborn babies”)
Z38
Other medical care (including radiotherapy and chemotherapy sessions)
Z51
Other persons encountering health services for specific procedures and health care
Z40–Z50; Z52–Z54
Persons with potential health hazards related to socioeconomic and
psychosocial circumstances
Z55–Z65
Persons encountering health services in other circumstances
Z70–Z76
Other factors influencing health status and contact with health services
remainder of Z00–Z99
(excluding Z37.0)
All Clinical Chapters (Excluding chapters 20, 22, 23)
A00–Z99 (EXCLUDING U, V,
W, X and Y codes)
B.1. Description of the Data
Appendices
Appendix B. Data and Methodology
The Discharge Abstract Database (DAD) was used to determine the number
of acute care inpatient stays. For the estimation of average cost per stay, the
Ontario Case Costing Initiative (OCCI) and the Alberta Case-Costing Database
were used.
The DAD contains demographic, administrative and clinical data for hospital
discharges (inpatient acute, chronic and rehabilitation) and day surgeries in
Canada. For 2004–2005, it included 3,183,205 records, of which 2,441,665xlix
(about 76.7%) were acute care inpatients.
The OCCI’s database is a record-specific costing database for acute care
inpatients and day surgery patients admitted to the participating hospitals.
For each patient there are two sources of data that make up the case-costing
record: the cost datal from the participating hospitals and the patient
discharge abstract from the DAD. Each hospital provides the total costs
incurred by all functional centres for each patient at a minimum of Level 3.
Therefore, costs incurred for nursing, clinical laboratory, diagnostic imaging,
pharmacy, social work, finance, housekeeping, food services, health records
and other functional centres are reported.31 The Alberta Case-Costing
Database has generally the same reporting approach as OCCI. However,
some minor differences may exist between these two case-costing units.
For example, in Alberta, the case costing does not include costs such as
amortization of building and leasehold improvements, contributed services or
full cost of ancillary operations,32 while in the case of Ontario, amortization and
leasing costs must be assigned to functional centres using the equipment.33
For 2004–2005, the OCCI and Alberta Case-Costing databases contain a
combined total of 458,844 inpatient records, which represents 18.8% of the
population (the acute care inpatients in the DAD reporting jurisdictions).
B.2. Approaches in Estimating Acute Care Hospital Costs
by Medical Condition
Two approaches can be used in the estimation of hospital costs by disease:
the top-down approach and the bottom-up approach. Theses two approaches
are different and each presents advantages and disadvantages.
xlix
From the DAD in SAS format (the statistical software).
l
In Ontario, the cost data are reported according to the Ontario Hospital Reporting System (OHRS), the chart of accounts of which is
based on the National Standards for Management Information Systems for Health Services Organizations (MIS Standards).
51
B.2.1. Differences Between Top-Down and
Bottom-Up Approaches
The top-down approach, also known as “gross costing,” is obtained using
total expenditure divided by number of stays in each disease category. This
approach is more comprehensive and less resource-intensive than the
bottom-up approach. However, it is less detailed and less accurate for each
diagnosis or procedure. The top-down approach requires some knowledge of
the relative costs of the diagnoses in order to allocate the aggregate costs for
a group of diseases/procedures to the individual ones.li The simplicity of the
top-down approach may be offset by a lack of sensitivity, which in turn
depends on the type of administrative data available.34
On the other hand, the bottom-up approach, also known as “micro-costing,”
individually assigns costs to all resources associated with an activity. This
approach refers to detailed analysis of the resources used in a particular
intervention. It is more accurate for each diagnosis or procedure; however, it
may exclude some elements of costs and it is more expensive and more timeconsuming than the top-down approach.
The decision to use micro-costing or gross costing depends on the research
question and the needs of the analysis. The costs and benefits of each
approach have to be assessed. Though detailed and comprehensive microcosting is desirable in principle, practicality may restrict its use. This explains
why many studies use a mixture of the two, using micro-costing for the direct
costs of the intervention or the diagnosis, and gross costing for other costs.
Also, bottom-up (disease-specific) studies are generally meant to show the
economic impact of a particular disease, while top-down (general COI) studies
are generally used to ascertain demographic and epidemiological
determinants of health expenditure and to make comparisons.
B.2.2. Defining Acute Care Inpatient Costs by
Medical Condition
In this study, the bottom-up approach is used in order to estimate the costs of
selected medical conditions. Acute care inpatient cost for a given condition is
defined as the product of average cost per stay for this condition multiplied by
the number of stays relative to this condition (Equation 1):
Hospital Cost i = ( ACS) i * (Number of Stays)
i
(1)
Where:
i = 1, 2, 3, …, 213 (one of the 213 medical conditions);
ACS = average cost per stay.
li
52
For this purpose, the Resource Intensity Weight (RIW) values from the Case Mix Group (CMG) methodology can be used.
Average cost per stay is estimated using micro-level cost data. Cost in each
record of the case-costing data of both provinces (Ontario and Alberta) was
Appendices
B.3. Estimating Average Cost per Stay
used in Equation 2. Cost includes both direct or absorbing cost (for example,
nursing, laboratory, drugs) and indirect or transient cost (for example, finance,
housekeeping, health records) incurred by the facility or health region.
However, it does not include any fee-for-service component for physicians or
any costs that may be incurred by (or imputed to) the patient (such as out-ofpocket expenses or mortality or morbidity costs due to disability).
ni
(ACS) i =
∑
j =1
(Actual _Cost ij )
ni
(2)
Where:
i = 1, 2, 3, …, 213 (one of the 213 medical conditions);
j = 1, 2, 3, …, ni (number of inpatient records (stays) for that medical
condition i in the Ontario and Alberta case-costing data set.)
Note that the number of stays for any medical condition in Equation 1 exceeds
the number of stays in the case-costing records for that same medical
condition in Equation 2.
In the process of estimating average cost per stay, some adjustment is
required. Adjustments are made for compensation differences across the
country. In order to estimate average cost per stay exclusively for the most
responsible diagnosis (MRDx), adjustments were also made for complexities.
The approaches used for each of these adjustments are described below.
B.3.1. Adjusting for Compensation Differences
This analysis of hospital costs is done for all jurisdictions reporting to the DAD
(Newfoundland and Labrador, Nova Scotia, Prince Edward Island, New
Brunswick, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, the
Northwest Territories, Nunavut and the Yukon Territory). One component of
hospital costs—volume—is available for all these jurisdictions. However, the
other component—unit cost—is available for Ontario and Alberta only.
Therefore, it is necessary to extrapolate average cost per stay in Ontario and
Alberta to the other DAD reporting jurisdictions.
It is generally agreed that the cost to provide health care is not the same
across the country. This difference should be fully taken into account if we
want to estimate hospital costs for all the DAD jurisdictions. Unfortunately,
data to account for input price differences are not fully available, except for
53
compensation. Therefore, only price difference for salaries and compensation
can be considered to adjust for differences in cost to provide hospital care
across the country.
Adjustments for wage differences between jurisdictions are made for
management and operational support employees (for example, those
employees who are involved in the decision-making process and provide
support to those carrying out the mandate of the organization) and unitproducing personnel employees (those employees called front-line workers
who carry out the mandate of the functional centre) using financial and
statistical data from the Canadian MIS Database (CMDB) for 2004–2005.
Total compensation and total earned hourslii are used to estimate average
hourly earnings for management and operational support employees and
unit-producing personnel employees in each DAD jurisdiction. These earnings
are compared to the average earning in Ontario and Alberta in order to
calculate the compensation index for the jurisdiction. This compensation
index is applied to Ontario and Alberta average cost per stay in order to
extrapolate average cost per stay for each non-costing DAD jurisdiction
(see Section B.5.1, paragraph 2 for the mathematical representation of this
heuristic description). This adjustment is based on the tacit assumption that
the non-compensation costs vary from jurisdiction to jurisdiction in the same
way that compensation costs do.
Average cost per stay for all the DAD jurisdictions is estimated by summing
across the jurisdictions the average cost per stay by selected medical
condition, weighted by the share of acute inpatient volume discharged by
selected medical condition in each DAD jurisdiction (see Section B.5.1,
paragraph 3 for the mathematical representation of this heuristic description).
The estimates suggest that average cost per acute care inpatient stay for
Ontario and Alberta combined is about 1.8% higher than the average cost
per stay for the DAD reporting jurisdictions.liii The underlying assumption
behind this approach is that the same quantity and mix of inputs is used for
each stay in the DAD jurisdictions as in Ontario and Alberta.liv
54
lii
Compensation includes worked salaries and benefit salaries (accounts 31010, 31030, 35010 and 35030 in the MIS financial
account). Earned hours include worked hours and benefit hours (accounts 31010, 31030, 35010 and 35030 in the MIS
statistical account).
liii
However, the average cost per acute care inpatient case for Ontario and Alberta combined is about 8.8% higher than the average
cost per case for the other DAD reporting jurisdictions.
liv
Another implicit assumption is that the demographic structure of the population is the same across jurisdictions. Jurisdictions with a
higher proportion of seniors would have higher severity of illness and higher average cost per case. However, when using the cost
model to estimate adjusted average cost, this factor is controlled for by including age and sex in the regression.
Since some admissions are associated with more than one condition
(complexities), there is a risk of over-estimating the costs of some diseases.
Appendices
B.3.2. Adjusting for Complexities
In order to estimate the share of costs due to complexities, regression
analysis was used to assess the relationship between cost and the presence
of other medical conditions. Note that different methods can be used in
implementing the bottom-up approach and accounting for complexities.
Akobundu et al. gave an overview of these methods after reviewing 365
studies about cost of illness (COI).
In this current study, complexities were specifically accounted for by using the
Case Mix Group Complexity Overlay (CMG/Plx)lv as a measurement for the
total number of complexities for a certain medical condition.
Table B.1. Categorization of Cost-of-Illness Methods*
COI Method
Brief Description
Number of
Articles
1. Sum_All Medical
Identify all patients with a diagnosis and sum costs
64
2. Sum_Diagnosis
Specific
Identify all patients with a primary diagnosis and sum costs for
treatment for that diagnosis
222
3. Matched Control
Identify all patients with a diagnosis and sum costs. Subtract out
the average cost of the sample to find incremental costs for
treatment; alternatively, subtract out the average cost of a
matched cohort instead.
69
Identify all patients with a diagnosis, complete a regression
analysis and indicate the individual coefficient for each diagnosis.
4. Regression
Identify all patients with a diagnosis, find a matched cohort
(similar to a clinical trial) and complete a regression analysis
to quantify the individual coefficient (ß) for each diagnosis—
gold standard.
32
Notes:
* The use of multiple methods within some articles caused the total number to exceed 365 articles.
Combinations: 1, 3 = 1; 2, 3 = 5; 2, 4 = 11; 3, 4 = 5.
Source:
Table 1 in E. Akobundu, J. Ju, L. Blatt and C. D. Mullins, “Cost-of-Illness Studies: A Review of Current Methods” Pharmaceutical
24, 9 (2006): pp. 869–890.
lv
CIHI’s CMG/Plx is intended to enhance the prediction of resource utilization in acute care. It identifies diagnoses in the DAD, over
and above the main diagnoses for which prolonged length of stay and most costly treatment could reasonably be expected. These
additional diagnoses are then used to further subdivide a CMG into four sub-groups. These sub-groups, called Plx groups, contain
a more homogeneous aggregation of patients with regards to length of stay and resource use than the CMG as a whole.
55
B.3.2.1. Specification of the Model: Transformed Cost
In this model, cost is the dependent variable while Plx, age category, sex,
CMG and province are the explanatory variables. The dependent variable
being continuous and the explanatory variables being categorical, we define
the relationship between these output and input variables by performing an
analysis of variance (ANOVA). Plotting the cost data reveals that the
distribution of cost is far from being a normal distribution (Figure B.1).
Figure B.1. Distribution of Observed Cost per Staylvi
19
18
17
16
15
14
13
Percent
12
11
10
9
8
7
6
5
4
3
2
1
0
< 1 2 3 4 5 6 7 8 9
1 < < < < < < < < <
2 3 4 5 6 7 8 9 1
0
1
0
<
1
1
1
1
<
1
2
1
2
<
1
3
1
3
<
1
4
1
4
<
1
5
1
5
<
1
6
1
6
<
1
7
1
7
<
1
8
1
8
<
1
9
1
9
<
2
0
2
0
<
2
1
2
1
<
2
2
2
2
<
2
3
2
3
<
2
4
2
4
<
2
5
Cost per Stay ($ Thousands)
Sources:
Ontario Case Costing Initiative; Alberta Case-Costing Database.
lvi
56
The last bar shows that about 5% of the records cost $25,000 and over per stay. The highest cost per stay was $1,361,666.
>
=
2
5
the distribution and nonlinearity of the regression function. The Box-Cox
procedure35 automatically identifies a transformation from the family of the
Appendices
Therefore we perform a transformation in order to correct the skewness of
power transformations of the form:
Y’ = Yλ , and Y’ =ln(Y)
Where λ is a parameter to be determined from the data. For our data, the best
transformation is as follows:
Transformed Cost = ln(cost) {referred hereafter as ln_cost} (3)
Further, the main model is defined as:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex ) k +α 4 ( CMG ) k +α 5 (Pr ov ) k + ε
( 4)
Where:
• k = 1, 2, 3, …, N (number of inpatient records or stays in the Ontario
and Alberta case-costing data set);
• α0 = intercept;
• α1, α2, α3, α4 and α5 are coefficients (vector of values) to be determined;
• ε = residuals or error terms.
Plx = Complexity level.
There are four complexity levels that are related to the number and/or severity
of the comorbid conditions and that were used in the equation:
1. No Complexity or comorbidity
2. Complexity related to chronic condition(s)
3. Complexity related to serious/important condition(s)
4. Complexity related to potentially life-threatening condition(s)
There is a fifth level of complexity (Plx level = 9) that has some impact on
cost, but the impact is already embedded in the condition itself (for example,
neonates) and is not due to comorbid conditions. So, this Plx level was not
used in the equation.
• AgeCat = < 1, 1–4, 5–14, 15–44, 45–64, 65–74, 75–84 and 85+ (for a total
of eight age categories);
• Sex = Male, female or other;lvii
• CMG = the 474 Case Mix Groups that identify homogenous patients in
terms of resource use;
• Prov = Case-costing province, Ontario and Alberta.
lvii
Other includes those of undifferentiated sex (for stillborns only), transsexuals and hermaphrodites.
57
This specification has the advantage of convenience. There is no need to have
a pre-defined list of comorbidities and the weight of the comorbid condition is
taken into account with the Plx variable.
Both the Plx variable and the AgeCat variable are included in the regression.
One might argue that there might be some interaction effect between the
variables Plx and AgeCat. However, these variables are independent; they
only complement each other in the sense that Plx is an overlay that is
applied to already existing CMG/age combinations. Nonetheless, to try a
different specification, an alternative model was run without the AgeCat
(Alternative model I):
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( Sex ) k +α 3 ( CMG ) k +α 4 (Pr ov ) k + ε
( 4 a)
The results were not significantly different from the main model in equation 4
(see Section B.3.2.3 on regression results).
Besides, one might argue that it can be tricky to work with a transformed scale
such as ln_cost.lviii An alternative model was run directly on the dollar scale;
that is, without any transformation of the cost variable (alternative model II).
The results were generally similar as the ln_cost model.lix
The ln_cost variable has an approximate normal distribution with
mean = 8.141 (see Figure B.2)
58
lviii
That is because when ln_cost is modelled, the parameters in the regression are multiplicative on the untransformed dollar scale,
which means that the size of the effect (in costs) depends on the underlying level of cost.
lix
Results for alternative model II are available upon request.
Appendices
Figure B.2. Distribution of ln_Cost per Stay
6
5
4
Percent
3
2
1
0
-0.9 -0.3 0.3 0.9 1.5 2.1 2.7 3.3 3.9 4.5 5.1 5.7 6.3 6.9 7.5 8.1 8.7 9.3 9.9 10.5 11.1 11.7 12.3 12.9 13.5 14.1
In_cost per Stay
Normal
Sources:
59
B.3.2.2. Residual Analysis
Residual analysis was performed in order to evaluate the appropriateness of
analysis of variance model. First, the residuals are plotted against the fitted
values, in order to assure constant error variance. Then, from a histogram for
all the residuals, normality of the error terms is checked. From the graphical
approach, the errors appear to have an approximate normal distribution
(Figure B.3). However, because the data set is so large, the data do not
perfectly fit the normal curve.
The GLM procedurelx of SASlxi was used and the model selected included
Plx level, age category, sex, CMG and province as explanatory variables.
Figure B.3. Normality Check for the Residuals
8
7
6
5
Percent
4
3
2
1
0
-10.2 -9.45 -8.7 -7.95 -7.2 -6.45 -5.7 -4.95 -4.2 -3.45 -2.7 -1.95 -1.2 -0.45 0.3 1.05 1.8 2.55 3.3 4.05 4.8 5.55 6.3 7.05
Residuals
Normal
Source:
60
lx
The GLM (General Linear Model) procedure handles models relating one or several continuous dependent variables to one or
several explanatory variables. The explanatory variables may be either “categorical” variables, which divide the observations into
discrete groups, or “continuous” variables.
lxi
The Mixed Procedure handles models relating one or several continuous dependent variables to one or several categorical or
continuous explanatory variables while at the same time expanding the possibilities of the error term to accommodate either a fixed
effect model or a random effect model. Mixed procedure is a generalization of the GLM procedure in the sense that the GLM
procedure fits standard linear models, and the Mixed procedure fits a wider class of mixed linear models.
Output for the GLM procedure is presented in Box B.1. The value of the
R2 is 0.6312, meaning that the model explains about 63% of the total variability
Appendices
B.3.2.3. Regression Results
within the data; and the F test is significant, meaning the explanatory variables
explain a statistically significant proportion of the variability of costs.
Box B.1. Regression Coefficients From SAS Output
The GLM Procedure
Dependent Variable: lntot
Source
DF
Sum of
Squares
Mean Square
F Value
Pr > F
Model
487
396370.0694
813.9016
1610.70
<.0001
Error
458356
231611.2936
0.5053
Corrected Total
458843
627981.3630
Coeff Var
Root MSE
lntot Mean
0.631181
8.731989
0.710851
8.140765
Source
R-Square
plx_level
cmg
age_cat
gender
prov
Source
plx_level
cmg
age_cat
gender
prov
Parameter
Intercept
plx_level
plx_level
plx_level
plx_level
plx_level
DF
Type I SS
Mean Square
F Value
Pr > F
4
473
7
2
1
183869.4217
207993.2154
1807.8458
15.4182
2684.1683
45967.3554
439.7320
258.2637
7.7091
2684.1683
90968.9
870.22
511.10
15.26
5311.94
<.0001
<.0001
<.0001
<.0001
<.0001
DF
Type III SS
Mean Square
F Value
Pr > F
3
473
7
2
1
37063.2678
168282.8066
1854.5770
16.0393
2684.1683
12354.4226
355.7776
264.9396
8.0196
2684.1683
24449.3
704.08
524.31
15.87
5311.94
<.0001
<.0001
<.0001
<.0001
<.0001
Estimate
2
3
4
8
9
6.690534658
0.531870574
0.737859627
1.397435550
0.486801960
0.000000000
B
B
B
B
B
B
Standard
Error
t Value
Pr > |t|
0.35613167
0.00452990
0.00537662
0.00576524
0.02393911
0
18.79
117.41
137.23
242.39
20.34
0
<.0001
<.0001
<.0001
<.0001
<.0001
0
61
When fitting an ANOVA model or other linear model with categorical
explanatory variables and an intercept term, one level of each categorical
variable must be chosen as the default or reference level. These were the
reference levels of the explanatory variables:
• Complexity level=1lxii (the complexity level with the lowest average cost—
no comorbid condition);
• Age Category < 1 (age category with the lowest average cost);
• Sex = female (the sex with the lowest average cost);
• CMG=619 [the group with the lowest average cost—false labour
LOS < 3 days, may not require hospitalization (MNRH)];
• Prov = Ontario (the province with the lowest average cost).
This combination of values has been chosen so that the group of stays with
the reference level for all explanatory variables would have the lowest average
cost. The intercept value (6.6905) represents the mean ln_cost of the group
of stays with the reference level for all explanatory variables.
As expected, the values for the calculated Plx coefficients increase with the
level of complexity: 0.5319 for Plx 2; 0.7379 for Plx 3 and 1.3974 for Plx 4.
They are all significant at the 5% level. The alternative model I given by
Equation 4a (without the age category) produces about the same results.lxiii
B.3.2.4. Producing estimates of the contribution of complexity
to costs on the dollar scale
From the model given by Equation 4, we have for stay k:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k + ε k
An estimate of what the cost of this stay would have been, without complexity is:
ln_ cos t k (Plx _ adjusted) = α 0 +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov )k + ε k
That is the same thing, but without the α1 coefficient. This can also be written:
ln_ cos t k (Plx _ adjusted) = ln_ cos t k - α 1 ( Plx ) k
( 5 .1)
Equation 5.1 can also be written using the fitted values
ln_ cos t k (Plx _ adjusted) = ln_ cos t k - α 1 ( Plx ) k
62
( 5 .2)
lxii
This corresponds to complexity level 9 in Box B.1.
lxiii
: 0.63120 for the R2; 6.7602 for the intercept; 0.5560 for Plx 2; 0.7619 for Plx 3 and 1.4284 for Plx 4.
back to the original scale of a log-normal distribution, an adjustment is
needed to preserve the mean. So the dollar cost adjusted for complexity
Appendices
When transforming from the log scale (where the distribution is normal)
level (Plx_Adj_Cost) is obtained by reversing the log transformation of
ln_cost(Plx_adjusted) to get the complexity-adjusted dollar-scale cost with
this formula:
( Plx_Adj_Cost )k = exp
{
(
ln_ cos t k - α ( Plx ) k + δ
2
2
)}
( 5 .3)
Where:
• α is the vector coefficient of the Plx variable.
( )
• δ2
is half the mean of the square error, as per the property of the log2 normal distribution36 (
δ = 0.5053 for this model).
For the complexity level = 1 (Plx level = 9 in Box B.1) the adjustment factor is
zero because there is no complexity or comorbidity. The same is true for
complexity level=9,lxiv since the increase in cost for this level is due to causes
other than complexities.
Otherwise, adjustment was made for each stay with a Plx level 2, 3 or 4. For a
hypothetical example where the fitted ln_cost for a record was 9.95 with a Plx
level of 3, the adjusted untransformed cost of this record would be $11,382.
This would represent only the cost for the MRDx in this record and is obtained
by replacing the parameters in Equation 5.3 by their values:
exp
{
(
2
9 .95 − 0 .7379 + 0 .5053
2
)}
Once the complexity-adjusted cost for each record was computed, the
average cost adjusted for complexity was computed for each clinical chapter
and selected medical condition.
Note that the regression was also used to estimate total average cost per stay
(Fitted_Cost); that is, the fitted average cost for the treatment of the primary
diagnosis and complexities (as opposed to the “actual” average cost for the
treatment of the primary diagnosis and complexities where no regression is
involved). The untransformed fitted cost was obtained by the following reversion:
( Fitted_Cos t ) k = exp
lxiv
{
( )}
ln_ cos t k + δ
2
2
( 6)
This corresponds to complexity level 8 in Box B.1.
63
Using the same hypothetical example, where the fitted ln_cost for a stay was
9.95 with a Plx level of 3, the fitted untransformed total cost of this stay would
be $23,805. This would represent the cost for the MRDx and the associated
complexities in this record and is obtained by replacing the parameters in
Equation 6 by their values:
exp
{
9 .95 +
(
0 .5053 2
2
)}
Note that the Ontario and Alberta data sets have actual cost for the MRDx
and the associated complexities for each record. Using the regression to
estimate this cost is a necessary step to estimate the share of cost that can
be attributed to the treatment or presence of complexities. This share is
defined as:
Share of cost due to comorbidity =
(Cost of primary diagnosis and comorbidity − Cost of primary diagnosis)
Cost of primary diagnosis and comorbidity
The numerator and the denominator must be on the same scale, hence the
importance of using the regression in both cases. However, the acute care
inpatient costs reported in the study came from the actual (observed) cost.
B.4. Estimating Quantity or Number of Stays
Quantity is defined as the number of hospital stays for a given category of
disease within a given fiscal year. Thus, the focus of the analysis is on hospital
inpatient stays. This is conceptually different than the definition of quantity
based on the number of patients, since one patient may have multiple stays
during the year.
The number of stays is obtained from the DAD, which contains data on
hospital discharges across Canada. Note that, as of 2004–2005, discharge
data are included in the DAD for all jurisdictions except Quebec. In order to
include institutions in Quebec, the alternative would be to use the Hospital
Morbidity Database (HMDB). However, complexity is not reported in the
HMDB. Moreover, discharge data from psychiatric facilities are not captured in
this database. While it would still be possible to include these facilities using
the Hospital Mental Health Database (HMHDB), the DSM-IV (Diagnostic and
Statistical Manual of Mental Disorders IV) coding structure of this database
was not straightforwardly compatible with the ICD-10-CA coding structure at
the time of the analysis. Consequently, it was decided to use the DAD; and
hence, institutions in Quebec are excluded from the analysis.
64
( 7)
Appendices
B.5. Summary of the Steps to Estimate Total Acute Care
Inpatient Costs
B.5.1. Estimation of Total Acute Care Inpatient Costslxv (Actual)
The Actual_Mean_Costlxvi for Ontario and Alberta was computed.
ni
(Actual _ Mean _ Cost)i =
∑
j =1
(Actual _Cost ij )
ni
Where i = 1, 2, 3, …, 212 (one of the 212 medical conditions);
j = 1, 2, 3, …, ni (number of inpatient records or stays for that medical condition i)
2. A compensation index specific to each DAD jurisdiction (h) was calculated
and then a mean cost for each medical condition and each DAD
jurisdiction was estimated (Adjusted_Mean_Cost)i,h
Adj _ Mean _ Cost i ,h = Compensation_ index h * Actual _ Mean _ Cost i
Where h = 1, 2, 3, …,12 (each reporting DAD jurisdiction)
Average_ Hourly _ Earning h
Compensation _ index h =
Average_ Hourly _ Earning in ON & AB
and
Average _ Hourly _ Earning h =
( Total Compensation for MOS & UPP )h
( Total Earned Hours for MOS & UPP )h
(See Section B.3.1.)
3. The DAD_Cond_Total_Cost was estimated for each medical condition (i)
as follows:
DAD _ Cond _ Total _ Cost i =
∑h ni ,h * Adj _ Mean _ Cost i ,h
Where ni,h = the number of stays in jurisdiction h with conditioni.
This number of stays is obtained from the DAD and includes all Plx levels
(1, 2, 3, 4 and 9).
4. A (DAD_Cond_Mean_Cost)i is the average cost of a stay for each
condition. It is calculated as the ratio of the total cost for the condition to
the total number of stays with the condition.
DAD _ Cond _ Mean_ Cost i =
Note that
ni =
DAD _ Cond _ Total _ Cost i
ni
∑h ni ,h
lxv
Total acute care costs refer to acute care costs for the treatment of the primary diagnosis and the comorbidities.
lxvi
Actual_Mean_Cost means that no regression is involved in the computation of the average cost.
65
B.5.2. Estimation of Acute Care Inpatient Costs For the
Primary Diagnosis
5. Using case-costing data from Ontario and Alberta, the following regression
was run:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k + ε
and used to calculate fitted values:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k
Where k=1, 2, 3, …, N (number of inpatient records or stays in the Ontario
and Alberta case-costing data_set)
(See Section B.3.2.1.)
6. An estimated ln_cost adjusted for Plx level was calculated for each stay:
Plx _ Adj _ ln_ cos t k = α 0 +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k
= ln_ cos t k - α 1 ( Plx ) k
This is the estimated ln_cost of a stay with the same condition (CMG), age,
sex and province as stay k, but with the reference Plx (no complexity) instead
of the actual complexity of stay k.
7. The transformation of ln_cost was reversed to get the Plx-adjusted cost
for each stay:
( Plx_Adj_Cost )k = exp
The
( )
δ2
{
ln_ cos t k - α1 ( Plx ) k +
(δ )}
2
2
2 adjustment is needed to ensure that the modelling and
transformation preserve the mean.
8. The Plx_Adj_Mean_Cost for Ontario and Alberta was computed for each
medical condition (i):
(Plx _ Adj _ Mean _ Cost) i =
ni
(Plx _ Adj _Cost ij )
∑
j =1
ni
9. The Plx_Adj_Mean_Cost for Ontario and Alberta was further adjusted for
wage differences by applying a compensation index factor specific to each
DAD jurisdiction. The Plx_Adj_Mean_Cost was obtained for each medical
condition and each DAD jurisdiction (Plx_Adj_Mean_Cost)i,h. (As in Step 2.)
66
Plx_Adj_Mean_Cost of each DAD jurisdiction, weighted by the number
of stays for each condition in the jurisdiction—was calculated for each
Appendices
10.A Plx_Adj_DAD_Cond_Total_Cost—which is the weighted sum of the
medical condition (as in Step 3).
11. The Plx_Adj_DAD_Cond_Mean_Cost was estimated for each medical
condition (i) as follows (as in Step 4):
Plx _ Adj _ DAD _ Cond _ Mean _ Cost i =
Plx_ Adj_ DAD_ Cond_ Total _ Cost i
ni
The number of stays is obtained from the DAD and includes all Plx levels
(1, 2, 3, 4 and 9).
B.5.3. Estimation of Total Acute Care Inpatient Costslxvii (Fitted)
12. The regression model from Step 5 of the previous section was used.
Using case-costing data from Ontario and Alberta, the following regression
was run:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k + ε
and used to calculate fitted values:
ln_ cos t k = α 0 +α 1 ( Plx ) k +α 2 ( AgeCat ) k +α 3 ( Sex )k +α 4 ( CMG ) k +α 5 (Pr ov ) k
13.The transformation of ln_cost was reversed to get the fitted cost for
each stay:
( Fitted_Cost )k = exp
{
(
ln_ cos t k + δ
2
2
)}
(This is different from Step 7, where some value has been deducted from
ln_cost in the process of controlling for complexity.)
14. The Fitted_Mean_Cost was computed for Ontario and Alberta for each
clinical chapter or medical condition (i):
ni
(Fitted _ Mean _ Cost) i =
∑
j =1
(Fitted _Cost ij )
ni
15. The Ontario and Alberta Fitted_Mean_Cost was further adjusted for wage
differences by applying a compensation index factor specific to each DAD
jurisdiction. A fitted mean cost was obtained for each medical condition
and each DAD jurisdiction (Adj_Fitted_Mean_Cost)i,h (as in steps 2 and 9
of the previous sections).
lxvii
Total acute care costs refer to acute care costs for the treatment of the primary diagnosis and the comorbidities.
67
16. A Fitted_DAD_Cond_Total_Cost—which is the weighted sum of the
Adj_Fitted_Mean_Cost of each DAD jurisdiction, weighted by the number
of stays for each condition in the jurisdiction—was calculated for each
medical condition (as in steps 3 and 10 of the previous sections).
17. The Fitted_DAD_Cond_Mean_Cost was estimated for each medical
condition (i) as follows:
Fitted _ DAD _ Cond _ Mean _ Cost i =
Fitted _ DAD_ Cond_ Total _ Cost i
ni
The number of stays is obtained from the DAD and includes all Plx levels (1, 2,
3, 4 and 9).
B.5.4. Estimation of the Share of Total Acute Care Inpatient
Costs Attributed to Complexity
18. The share of total acute care inpatient cost due to the treatment or
presence of complexity was obtained as the ratio of:
(Share of cost due to comorbidity)i =
(Fitted_ DAD _ Cond _ Total _ Cost)i - (Plx_ Adj_ DAD_ Cond_ Total _ Cost)i
(Fitted_ DAD _ Cond _ Total _ Cost)i
68
$10,586
$4,271
$4,250
$16,131
$19,418
$8,225
$8,015
$11,704
$17,246
$8,796
$10,650
$16,628
$13,277
$11,665
$24,112
$6,805
$16,881
$4,755
$7,195
$9,900
$6,697
$6,293
Diarrhea and gastroenteritis of presumed
infectious origin
Tuberculosis
Septicemia
Viral infections characterized by skin
and mucousmembrane
Hepatitis
Unit $
10,576
4,528
12,037
6,633
4,613
44,643
9,145
33,193
21,075
15,301
21,406
18,229
19,237
27,916
23,663
14,884
21,335
40,044
23,916
5,852
10,183
25,557
SD
$65,609,364
$23,558,036
$7,092,624
$16,198,315
$8,825,425
$183,985,550
$12,711,228
$7,131,500
$44,725,912
$369,837,954
Total $
6,888
9,228
2,341
4,319
11,590
1,515
1,329
514
12,939
16,107
2,124
$43,346,184
$61,799,916
$23,175,900
$31,075,205
$55,110,450
$25,574,715
$9,043,845
$12,393,568
$150,933,435
$213,852,639
$35,317,872
149,683 $1,594,181,448
7,459
1,366
606
2,021
1,073
9,475
788
1,678
10,472
34,938
Number
Cost attributed to the treatment of primary
diagnosis and complexities, All sexes
Clinical Chapters
or Medical Conditions
$6,365
$6,697
$0
$0
$3,893
$17,992
$6,561
$26,076
$12,263
$13,738
$16,316
$12,292
$7,609
$17,060
$12,341
$7,430
$7,646
$19,232
$16,431
$3,961
$4,526
$10,819
Unit $
10,438
4,528
0
0
1,608
57,517
6,860
37,861
26,253
16,220
20,609
21,727
14,501
29,701
27,096
12,502
18,506
44,538
25,292
6,042
12,944
27,578
SD
5,297
9,228
0
0
81
847
758
291
7,165
8,928
1,398
66,340
3,750
1,032
335
959
560
4,964
469
696
4,690
17,455
Number
$33,715,405
$61,799,916
$0
$0
$315,333
$15,239,224
$4,973,238
$7,588,116
$87,864,395
$122,652,864
$22,809,768
$815,469,641
$28,533,750
$17,605,920
$4,134,235
$7,125,370
$4,281,760
$95,467,648
$7,706,139
$2,756,856
$21,226,940
$188,838,618
Total $
diagnosis and complexities, Males
$6,047
$0
$9,900
$7,195
$4,759
$15,473
$7,153
$20,631
$10,910
$12,688
$17,270
$9,335
$10,092
$17,981
$10,805
$8,641
$8,840
$19,618
$15,587
$4,488
$4,030
$10,367
Unit $
11,054
0
12,037
6,633
4,622
18,148
11,662
22,472
11,591
14,020
22,989
14,627
23,280
19,428
17,915
17,099
24,041
34,593
21,355
5,704
6,598
23,106
SD
1,591
0
2,341
4,319
11,509
668
571
223
5,774
7,179
726
83,343
3,709
334
271
1,062
513
4,511
319
982
5,782
17,483
Number
$9,620,777
$0
$23,175,900
$31,075,205
$54,771,331
$10,335,964
$4,084,363
$4,600,713
$62,994,340
$91,087,152
$12,538,020
$778,015,857
$37,431,228
$6,005,654
$2,928,155
$9,176,742
$4,534,920
$88,496,798
$4,972,253
$4,407,216
$23,301,460
$181,254,426
Total $
diagnosis and complexities, Females
Appendix C. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit Cost),
Standard Deviation and Number of Stays, All Age Groups, by Clinical Chapters or Selected Medical
Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005
Appendices
69
$14,994
$5,201
$22,546
$12,713
$5,088
$8,002
$4,131
$9,002
$6,938
$6,314
$7,038
$6,754
$21,628
$11,414
$8,449
$4,197
$10,278
$14,789
$5,340
$20,180
$5,836
$7,107
Malignant neoplasms of thyroid and other
endocrine glands
Malignant neoplasms of lymphoid, hematopoietic
and related tissue
Carcinoma in situ
Leiomyoma of uterus
Other benign neoplasms and neoplasms of
uncertain or unknown behaviour
Chapter III—Diseases of the blood and blood-forming
organs and certain disorders involving the immune
mechanism
Anemias
Coagulation defects, purpura and other hemorrhagic
conditions
Agranulocytosis
Chapter IV—Endocrine, nutritional and metabolic
diseases
Diabetes mellitus
Malnutrition
Cystic Fibrosis
Unit $
18,491
10,204
30,032
4,407
17,687
19,117
4,249
16,517
15,666
78,551
10,983
16,315
11,526
17,778
21,796
1,685
7,846
5,071
15,919
29,311
9,843
20,718
SD
2,739
15,180
1,089
2,118
351
27,620
3,661
52,758
422
407
5,175
2,908
11,544
20,456
16,184
11,001
1,651
2,331
32,479
10,542
3,391
3,210
Number
$19,466,073
$88,590,480
$21,976,020
$11,310,120
$5,190,939
$283,878,360
$15,365,217
$445,777,209
$4,816,708
$8,802,596
$34,951,950
$20,466,504
$72,888,816
$141,926,574
$145,688,368
$45,445,131
$13,211,302
$11,860,128
$412,905,527
$237,679,932
$17,636,591
$48,130,740
Total $
Malignant neoplasms of eye, brain and other parts
of central nervous system
Clinical Chapters
$8,819
$6,346
$17,180
$7,175
$10,882
$10,507
$4,580
$9,318
$9,648
$21,303
$7,233
$6,372
$6,626
$7,108
$11,219
$0
$8,576
$8,297
$12,993
$22,134
$6,783
$14,853
Unit $
27,670
12,433
22,147
7,309
13,068
19,335
4,757
18,221
12,308
50,074
11,019
11,196
14,012
14,936
30,640
0
8,531
10,700
16,676
28,712
14,027
21,015
SD
1,144
5,939
473
265
151
15,131
668
23,771
207
186
2,229
1,483
4,878
8,983
5,274
0
864
383
17,270
5,973
769
1,814
Number
$10,088,936
$37,688,894
$8,126,140
$1,901,375
$1,643,182
$158,981,417
$3,059,440
$221,489,384
$1,997,136
$3,962,358
$16,122,357
$9,449,676
$32,321,628
$63,853,155
$59,169,006
$0
$7,409,664
$3,177,751
$224,389,110
$132,206,382
$5,216,127
$26,943,342
Total $
$5,885
$5,477
$22,500
$5,075
$18,819
$9,991
$4,101
$7,730
$12,799
$21,896
$6,386
$7,735
$6,068
$6,788
$7,898
$4,131
$7,245
$4,549
$12,381
$23,131
$4,721
$15,179
Unit $
6,089
8,264
34,804
3,759
20,867
18,840
4,110
14,954
17,859
96,476
10,949
20,334
9,110
19,809
15,504
1,685
6,794
2,978
14,969
30,144
8,109
20,344
SD
1,595
9,241
616
1,853
200
12,489
2,993
28,987
215
221
2,946
1,425
6,666
11,473
10,910
11,001
787
1,948
15,209
4,569
2,622
1,396
Number
$9,386,575
$50,612,957
$13,860,000
$9,403,975
$3,763,800
$124,777,599
$12,274,293
$224,079,199
$2,751,785
$4,839,016
$18,813,156
$11,022,375
$40,449,288
$77,875,620
$86,167,180
$45,445,131
$5,701,815
$8,861,452
$188,302,629
$105,685,539
$12,378,462
$21,189,884
Total $
Appendix C. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit Cost), Standard Deviation and Number of Stays, All Age
Groups, by Clinical Chapters or Selected Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
70
$8,878
$17,676
$6,368
$5,061
$10,949
$9,110
$4,257
$4,478
$13,229
$9,837
$20,981
$19,182
$14,916
$18,278
$10,247
$7,786
$3,545
$15,244
$14,690
$7,887
$9,287
$2,872
$3,206
$4,242
Dementia
Mental and behavioural disorders due to use of
other psychoactive substances
Systemic atrophies primarily affecting the
central nervous system
Multiple sclerosis
Epilepsy
Transient cerebral ischemic attacks and
related syndromes
Polyneuropathies and other disorders of the
peripheral nervous system
Unit $
4,686
3,582
2,358
21,778
9,834
39,069
42,665
4,115
10,794
18,575
18,782
21,825
39,375
34,577
21,638
19,479
9,071
8,523
11,647
16,298
6,442
11,508
16,646
13,722
SD
Total $
466
1,089
6,999
10,229
773
617
901
7,497
7,407
1,236
3,241
2,247
645
1,466
36,259
9,747
4,186
15,597
44,942
25,918
8,112
12,210
5,186
$1,976,772
$3,491,334
$20,101,192
$94,996,723
$6,096,651
$9,063,730
$13,734,844
$26,576,865
$57,670,902
$12,665,292
$59,238,998
$33,516,252
$12,372,390
$30,758,146
$356,690,793
$128,943,063
$18,744,908
$66,396,429
$409,421,620
$283,776,182
$41,054,832
$77,753,280
$91,667,736
125,898 $1,117,758,050
Number
Clinical Chapters
$3,946
$3,374
$2,835
$10,189
$7,112
$14,068
$15,059
$3,166
$7,927
$10,543
$17,660
$14,696
$21,761
$24,063
$10,133
$12,962
$5,187
$4,164
$9,047
$10,441
$4,850
$6,763
$19,727
$8,821
Unit $
3,954
3,657
2,411
25,828
8,530
19,408
50,314
3,344
11,627
20,614
16,307
15,851
43,114
41,702
23,896
20,719
12,324
6,261
11,240
17,426
5,722
12,561
20,159
14,383
SD
226
515
3,762
5,384
419
292
523
3,595
4,089
418
1,388
1,280
359
766
18,513
4,474
1,574
6,243
17,821
15,041
5,018
8,449
2,307
60,927
Number
$891,796
$1,737,610
$10,663,961
$54,857,576
$2,979,928
$4,107,856
$7,875,857
$11,381,770
$32,413,503
$4,406,974
$24,512,080
$18,810,880
$7,812,199
$18,432,258
$187,590,881
$57,991,988
$8,164,338
$25,995,852
$161,226,587
$157,043,081
$24,337,300
$57,140,587
$45,510,189
$537,409,922
Total $
$4,487
$3,051
$2,903
$8,320
$8,811
$15,143
$15,456
$3,930
$7,626
$10,064
$18,710
$15,243
$15,237
$17,463
$9,527
$13,441
$4,099
$4,326
$9,150
$11,623
$5,433
$5,435
$16,195
$8,935
Unit $
5,231
3,521
2,293
16,317
11,192
48,774
31,972
4,743
9,766
17,248
20,361
28,529
32,845
23,600
18,963
18,437
6,689
9,862
11,902
14,645
7,537
8,460
13,385
13,081
SD
240
574
3,237
4,845
354
325
378
3,902
3,316
818
1,853
967
286
700
17,744
5,273
2,611
9,354
27,121
10,877
3,094
3,761
2,879
64,970
Number
$1,076,880
$1,751,274
$9,396,880
$40,310,400
$3,119,094
$4,921,475
$5,842,368
$15,334,860
$25,287,816
$8,232,352
$34,669,630
$14,739,981
$4,357,782
$12,224,100
$169,039,858
$70,874,393
$10,702,489
$40,465,404
$248,157,150
$126,423,371
$16,809,702
$20,441,035
$46,625,405
$580,498,949
Total $
Appendices
71
$2,662
$2,489
$2,818
$3,047
$3,311
$3,141
$3,573
$2,870
$4,187
$3,751
$3,182
$2,471
$19,453
$11,619
$11,260
$39,748
$33,678
$11,351
$5,639
$11,043
$13,015
$8,582
$21,287
$24,096
$5,966
$9,795
Glaucoma
Angina pectoris
AMI (heart attack)
Pulmonary HD
Cardiomyopathy
Atrial fibrillation
Heart failure
Unit $
15,697
8,377
41,707
38,841
16,373
14,742
14,114
8,051
19,418
48,632
52,732
19,540
13,583
15,218
1,984
2,497
4,174
6,597
3,540
4,447
2,436
2,970
3,571
3,370
1,097
1,081
SD
$3,241,701
$7,294,875
$7,173,313
$8,387,752
$1,436,633
$27,534,274
$1,084,685
$639,567
$549,675
$433,741
$1,931,798
$946,848
$8,139,030
$907,742
Total $
43,450
20,045
1,967
8,325
5,803
45,873
46,252
32,289
6,561
1,326
43
$425,592,750
$119,588,470
$47,396,832
$177,214,275
$49,801,346
$597,037,095
$510,760,836
$182,077,671
$74,473,911
$44,657,028
$1,709,164
292,562 $3,294,179,752
279
375
2,903
2,636
383
6,576
378
179
175
131
634
336
3,270
341
Number
Cataract
Clinical Chapters
$10,392
$5,785
$23,941
$20,206
$9,326
$13,196
$11,105
$5,858
$11,712
$38,318
$35,314
$11,624
$8,550
$20,068
$2,402
$3,308
$4,316
$4,265
$3,060
$2,869
$2,439
$2,776
$3,383
$2,898
$2,489
$2,433
Unit $
18,105
8,037
36,881
26,680
20,388
14,348
13,908
9,020
19,295
55,564
30,072
18,790
11,454
15,464
2,027
2,594
5,331
6,230
4,007
2,051
1,318
1,281
4,392
4,300
1,096
994
SD
$1,222,650
$3,491,832
$2,565,336
$4,776,752
$755,300
$12,811,870
$584,423
$263,948
$241,461
$163,784
$1,173,901
$408,618
$4,826,171
$372,249
Total $
21,644
10,081
1,317
5,279
2,682
33,532
29,356
18,961
2,757
581
20
$224,924,448
$58,318,585
$31,530,297
$106,667,474
$25,012,332
$442,488,272
$325,998,380
$111,073,538
$32,289,984
$22,262,758
$706,280
169,935 $1,975,317,970
143
174
1,068
1,444
175
3,004
191
92
99
59
347
141
1,939
153
Number
$9,168
$6,153
$24,403
$23,354
$7,949
$12,453
$10,926
$5,274
$10,950
$30,413
$43,443
$10,729
$15,040
$18,773
$2,527
$3,009
$3,106
$4,112
$2,648
$4,176
$3,880
$3,713
$2,639
$2,753
$2,489
$2,877
Unit $
12,658
8,713
50,033
55,029
11,919
15,894
14,501
6,095
19,569
42,879
69,270
20,676
15,011
15,333
1,952
2,352
2,138
6,979
3,024
5,755
3,078
3,759
2,132
2,403
1,099
1,118
SD
$2,045,440
$3,773,373
$4,637,045
$3,583,719
$646,048
$14,685,625
$495,235
$363,312
$294,880
$267,336
$757,393
$536,835
$3,312,859
$540,876
Total $
21,806
9,963
650
3,046
3,121
12,341
16,896
13,328
3,804
745
23
$199,917,408
$61,302,339
$15,861,950
$71,136,284
$24,808,829
$153,682,473
$184,605,696
$70,291,872
$41,653,800
$22,657,685
$999,189
122,625 $1,315,665,266
136
201
1,835
1,191
208
3,571
187
87
76
72
287
195
1,331
188
Number
72
$10,848
$14,261
$14,129
$6,931
$13,485
$8,629
$3,494
$7,812
$4,763
$1,662
$3,314
$8,060
$2,570
$83,694
$21,120
$6,732
$4,955
$5,289
$6,915
$7,574
$5,680
$3,819
$3,245
$6,044
$9,364
$3,984
Atherosclerosis
Pneumonia
Asthma
Peptic ulcer
Dyspepsia and other diseases of stomach
and duodenum
Inguinal hernia
Unit $
8,567
15,468
10,623
2,870
4,129
10,023
15,921
13,970
8,686
4,137
17,094
48,983
91,690
4,400
17,181
8,087
814
11,511
16,718
6,631
28,006
25,498
15,091
16,473
21,942
13,886
SD
$300,944,745
$8,289,476
$56,600,774
$509,388,659
$188,646,720
Total $
$545,635,200
$62,268,336
$43,499,820
$438,738,040
$21,418,382
$13,621,752
$67,310,716
$386,998,668
$39,800,154
18,391
9,374
13,110
13,171
22,967
7,164
7,745
7,554
1,992
4,960
$73,269,744
$87,778,136
$79,236,840
$42,739,895
$87,710,973
$40,691,520
$58,660,630
$52,235,910
$10,535,688
$24,576,800
233,302 $1,570,593,432
25,835
744
16,926
54,434
6,463
8,196
14,132
49,539
11,391
187,660 $1,619,291,068
22,317
1,196
4,006
35,719
17,390
Number
Clinical Chapters
$3,712
$9,727
$6,260
$3,195
$3,745
$5,019
$7,212
$6,731
$5,777
$4,509
$6,706
$21,556
$88,705
$2,344
$8,353
$3,167
$1,694
$4,616
$7,871
$3,578
$8,926
$14,586
$4,399
$14,257
$13,426
$12,732
Unit $
5,775
14,390
11,634
2,908
3,438
7,393
14,733
15,189
9,581
3,716
17,574
49,285
96,072
4,282
18,553
9,362
898
10,492
17,162
7,460
29,127
27,594
5,404
18,500
21,364
15,573
SD
7,593
4,301
5,788
12,121
12,603
3,377
4,474
3,969
998
2,042
115,092
14,353
385
8,500
27,901
3,721
3,733
7,799
25,707
5,782
97,881
13,257
434
2,416
18,289
9,329
Number
$28,185,216
$41,835,827
$36,232,880
$38,726,595
$47,198,235
$16,949,163
$32,266,488
$26,715,339
$5,765,446
$9,207,378
$771,839,213
$309,393,268
$34,151,425
$19,924,000
$233,057,053
$11,784,407
$6,323,702
$36,000,184
$202,339,797
$20,687,996
$873,661,832
$193,366,602
$1,909,166
$34,444,912
$245,548,114
$118,776,828
Total $
$4,192
$9,042
$5,865
$3,676
$3,912
$6,255
$8,140
$7,173
$4,733
$5,261
$6,746
$20,555
$77,463
$2,815
$7,772
$3,521
$1,625
$4,974
$7,747
$3,399
$8,308
$11,568
$9,165
$13,938
$15,181
$8,709
Unit $
10,197
16,364
9,712
2,495
4,859
11,823
17,615
12,061
7,522
4,377
16,585
48,592
86,153
4,513
15,715
5,835
702
12,848
16,213
5,549
26,664
21,226
19,867
12,902
22,527
11,291
SD
10,798
5,073
7,321
1,050
10,364
3,787
3,271
3,585
994
2,918
118,207
11,482
359
8,426
26,533
2,742
4,463
6,333
23,832
5,609
89,779
9,059
762
1,590
17,430
8,061
Number
$45,265,216
$45,870,066
$42,937,665
$3,859,800
$40,543,968
$23,687,685
$26,625,940
$25,715,205
$4,704,602
$15,351,598
$797,376,919
$236,012,510
$27,809,217
$23,719,190
$206,214,476
$9,654,582
$7,252,375
$31,500,342
$184,626,504
$19,064,991
$745,854,187
$104,794,512
$6,983,730
$22,161,420
$264,604,830
$70,203,249
Total $
Appendices
73
$7,155
$6,745
$4,269
$12,867
$14,239
$19,786
$4,977
$6,772
$8,896
$8,204
$7,281
$5,951
$20,792
$4,369
$4,985
$29,325
$8,432
$8,297
$9,991
$8,464
$3,347
$6,429
$15,205
$12,534
$5,998
Cholelithiasis
Chapter XII—Diseases of the skin and
subcutaneous tissue
Bullous disorders
Decubitus ulcers
Chapter XIII—Diseases of the musculoskeletal
system and connective tissue
Coxarthrosis
Gonarthrosis
Other arthropathies
Unit $
5,587
15,792
32,509
9,738
1,657
3,356
4,792
11,070
13,077
33,391
11,343
5,597
35,808
7,873
13,464
19,744
28,045
9,519
9,694
44,866
26,429
26,106
6,827
11,666
13,591
SD
10,507
8,710
2,508
16,099
2,846
26,510
16,362
110,195
1,910
1,081
809
1,115
95
16,692
21,702
20,548
13,219
7,385
26,648
4,908
3,590
10,086
6,266
12,877
21,347
Number
$63,020,986
$109,171,140
$38,134,140
$103,500,471
$9,525,562
$224,380,640
$163,472,742
$914,250,633
$16,105,120
$31,700,325
$4,032,865
$4,871,435
$1,975,240
$99,334,092
$158,019,077
$168,575,792
$117,596,224
$50,011,220
$132,627,096
$97,109,688
$51,118,010
$129,776,562
$26,749,554
$86,855,365
$152,737,785
Total $
Clinical Chapters
$5,701
$11,755
$14,125
$6,603
$3,380
$8,356
$9,875
$7,874
$7,883
$30,470
$4,172
$3,667
$38,256
$5,449
$7,023
$7,811
$10,297
$7,426
$5,635
$20,002
$13,860
$14,176
$3,533
$6,463
$6,810
Unit $
5,265
15,637
32,634
7,753
1,551
3,847
4,348
10,493
10,432
34,897
5,893
3,194
51,894
7,332
14,166
15,302
34,808
10,572
8,064
45,590
24,121
25,267
5,660
10,743
13,786
SD
5,598
4,142
864
6,780
1,694
10,637
7,027
49,713
846
631
361
514
40
8,906
11,298
10,305
7,010
3,362
9,084
2,621
2,466
4,060
3,377
5,752
9,789
Number
$31,914,198
$48,689,210
$12,204,000
$44,768,340
$5,725,720
$88,882,772
$69,391,625
$391,459,857
$6,669,018
$19,226,570
$1,506,092
$1,884,838
$1,530,240
$48,528,794
$79,345,552
$80,492,355
$72,181,970
$24,966,212
$51,188,340
$52,425,242
$34,178,760
$57,554,560
$11,930,941
$37,175,176
$66,663,090
Total $
$6,358
$13,311
$15,692
$6,303
$3,301
$8,532
$10,085
$8,672
$8,945
$27,320
$5,563
$4,873
$8,318
$6,551
$7,564
$8,587
$7,237
$6,079
$4,588
$19,493
$15,089
$11,996
$5,161
$7,002
$7,464
Unit $
5,936
15,911
32,480
10,955
1,801
3,003
5,121
11,532
15,151
30,718
13,995
6,797
8,440
8,436
12,625
23,273
16,687
8,205
10,520
43,905
31,036
26,624
7,925
12,449
13,410
SD
4,909
4,568
1,644
9,319
1,152
15,873
9,335
60,482
1,064
450
448
601
55
7,786
10,404
10,243
6,209
4,023
17,564
2,287
1,124
6,026
2,888
7,124
11,558
Number
$31,211,422
$60,804,648
$25,797,648
$58,737,657
$3,802,752
$135,428,436
$94,143,475
$524,498,436
$9,517,480
$12,294,000
$2,492,224
$2,928,673
$457,490
$51,006,086
$78,695,953
$87,956,641
$44,934,533
$24,455,817
$80,583,632
$44,580,491
$16,960,036
$72,287,896
$14,904,968
$49,882,248
$86,268,912
Total $
74
$5,360
$6,504
$9,716
$5,044
$5,447
$13,824
$2,965
$5,536
$3,335
$4,392
$3,229
$3,228
$3,954
$3,393
$4,042
$6,116
$2,733
$3,138
$1,709
$3,047
$2,710
$1,986
$3,493
$2,489
Other disorders of the musculoskeletal system
and connective tissue
Renal failure
Urolithiasis
Disorders of breast
Menstrual, menopausal and other female
genital conditions
Medical abortion
Complications of pregnancy predominantly
in the antenatal period
during labour and delivery
Complications predominantly related to the puerperium
Other obstetric conditions
Unit $
5,482
5,015
961
1,894
2,749
2,119
2,547
2,427
13,607
4,550
1,641
2,048
3,122
1,341
13,819
2,216
8,358
3,681
24,595
8,055
10,203
14,479
13,160
6,757
SD
8,945
2,037
23,910
157,540
108,496
12,171
1,436
314,535
2,511
11,335
14,543
10,742
3,451
6,155
3,268
11,336
24,734
14,009
10,797
13,517
126,398
11,252
9,765
5,636
Number
$22,264,105
$7,115,241
$47,485,260
$426,933,400
$330,587,312
$20,800,239
$4,506,168
$859,691,725
$15,357,276
$45,816,070
$49,344,399
$42,473,868
$11,139,828
$19,874,495
$14,353,056
$37,805,560
$136,927,424
$41,536,685
$149,257,728
$73,627,099
$637,513,488
$109,324,432
$63,511,560
$30,208,960
Total $
Dorsalgia
Clinical Chapters
$0
$0
$0
$0
$0
$0
$0
$0
$9,092
$0
$0
$0
$0
$2,499
$4,392
$3,335
$5,736
$2,893
$14,211
$6,055
$5,652
$9,058
$5,669
$5,069
Unit $
0
0
0
0
0
0
0
0
20,625
0
0
0
0
1,545
13,819
2,216
10,371
3,232
23,600
9,732
12,669
14,762
10,913
6,647
SD
0
0
0
0
0
0
0
0
557
0
0
0
0
164
3,268
11,336
9,597
8,703
5,840
5,491
44,956
5,237
5,406
2,328
Number
$0
$0
$0
$0
$0
$0
$0
$0
$5,064,244
$0
$0
$0
$0
$409,836
$14,353,056
$37,805,560
$55,048,392
$25,177,779
$82,992,240
$33,248,005
$254,099,112
$47,436,746
$30,646,614
$11,800,632
Total $
$2,489
$3,493
$1,986
$2,710
$3,047
$1,709
$3,138
$2,733
$5,236
$4,042
$3,393
$3,954
$3,228
$3,253
$0
$0
$5,388
$3,095
$13,336
$4,990
$4,698
$10,489
$7,581
$5,573
Unit $
5,482
5,015
961
1,894
2,749
2,119
2,547
2,427
10,559
4,550
1,641
2,048
3,122
1,327
0
0
6,472
4,374
25,799
6,485
8,503
14,105
15,523
6,839
SD
8,945
2,037
23,910
157,540
108,496
12,171
1,436
314,535
1,954
11,335
14,543
10,742
3,451
5,990
0
0
15,137
5,305
4,957
8,026
81,440
6,015
4,359
3,308
Number
$22,264,105
$7,115,241
$47,485,260
$426,933,400
$330,587,312
$20,800,239
$4,506,168
$859,691,725
$10,231,144
$45,816,070
$49,344,399
$42,473,868
$11,139,828
$19,485,470
$0
$0
$81,558,156
$16,418,975
$66,106,552
$40,049,740
$382,624,202
$63,091,335
$33,045,579
$18,435,484
Total $
Appendices
75
$7,378
$16,379
$2,946
$5,103
$5,150
$2,530
$15,208
$3,662
$13,822
$14,665
$25,240
$25,836
$4,927
$8,577
$8,900
$12,685
$9,295
$7,078
$4,545
$2,923
$6,170
Disorders related to short gestation and
low birth weight
Other disorders related to length of gestation
and fetal growth
Other respiratory and cardiovascular disorders
specific to the perinatal period
Hemorrhagic and hematological disorders
of fetus and newborn
Chapter XVII—Congenital malformations, deformations
and chromosomal abnormalities
Cleft palate and cleft lips
Congenital malformations and deformations
of the musculoskeletal system
Other congenital malformations, deformations
Chapter XVIII—Symptoms, signs and abnormal clinical
and laboratory findings, not elsewhere classified
Other symptoms and signs involving the circulatory
and respiratory systems
Unit $
15,793
2,527
9,226
53,329
9,399
42,582
19,091
29,462
3,171
102,885
53,031
22,553
46,463
6,854
28,602
4,197
8,692
11,189
7,357
29,544
19,103
SD
12,761
33,104
138,485
2,495
337
2,722
933
2,432
1,136
445
3,767
637
14,904
16,041
344
11,728
6,493
10,951
5,632
19,786
70,975
Number
$78,735,370
$96,762,992
$629,360,576
$17,659,610
$3,132,415
$34,528,570
$8,303,700
$20,859,264
$5,597,072
$11,497,020
$95,079,080
$9,341,605
$205,998,336
$58,742,142
$5,231,552
$29,671,840
$33,438,950
$55,882,953
$16,591,872
$324,074,894
$523,634,203
Total $
Chapter XVI—Certain conditions originating
in the perinatal period
Clinical Chapters
$5,742
$2,788
$4,502
$4,693
$9,695
$15,775
$9,473
$6,809
$4,885
$22,535
$25,517
$14,877
$13,001
$3,504
$14,102
$2,621
$5,532
$5,084
$2,732
$17,207
$7,505
Unit $
12,237
2,352
9,152
9,162
9,752
57,769
22,385
21,039
2,692
48,833
52,821
24,769
39,132
5,238
25,573
4,914
9,333
11,460
5,794
31,504
19,774
SD
6,472
16,735
64,612
1,574
179
1,261
565
1,603
641
220
1,967
308
8,318
8,650
193
6,410
3,712
6,680
2,906
10,515
39,066
Number
$37,162,224
$46,657,180
$290,912,618
$7,386,782
$1,735,405
$19,892,275
$5,352,245
$10,914,827
$3,131,285
$4,957,700
$50,191,939
$4,582,116
$108,144,574
$30,309,600
$2,721,686
$16,800,610
$20,534,784
$33,961,120
$7,939,192
$180,931,605
$293,198,597
Total $
53,352
20,631
54,167
8,417
32,431
3,126
7,736
10,757
8,713
27,221
18,253
SD
$6,635
$3,064
$4,582
$11,148
$8,863
$10,028
$7,776
$11,811
$4,976
18,908
2,690
9,294
86,892
9,112
22,195
9,910
40,429
3,652
$28,849 134,808
$24,895
$14,488
$14,808
$3,855
$16,653
$2,420
$4,643
$5,133
$3,173
$15,481
$7,253
Unit $
6,289
16,369
73,871
917
156
1,461
367
829
495
225
1,799
328
6,577
7,221
151
5,318
2,778
4,271
2,726
9,268
31,733
Number
$41,727,515
$50,154,616
$338,465,536
$10,222,716
$1,382,628
$14,650,908
$2,853,792
$9,791,319
$2,463,120
$6,491,025
$44,786,105
$4,752,064
$97,393,677
$27,836,955
$2,514,603
$12,869,560
$12,898,254
$21,923,043
$8,649,598
$143,477,908
$230,169,921
Total $
76
$2,977
$4,853
$3,535
$5,704
$4,079
$6,141
$5,918
$9,405
$18,458
$6,450
$17,477
$9,819
$10,413
$6,175
$4,156
$5,127
$4,351
$13,565
$5,935
$5,850
$4,501
$5,476
$12,479
Other symptoms and signs involving the digestive
system and abdomen
Symptoms and signs involving cognition, perception,
emotional state and behaviour
Other symptoms, signs and abnormal clinical
and laboratory findings
Chapter XIX—Injury, poisoning and certain other
consequences of external causes
Intracranial injury
Injuries to the abdomen, lower back, lumbar
spine and pelvis
Fracture of forearm
Fracture of femur
Unit $
26,341
6,299
7,419
7,675
10,115
13,105
6,916
9,294
6,431
10,300
27,685
17,429
39,884
13,635
32,831
20,269
7,962
11,217
3,036
10,643
4,435
8,316
4,574
SD
$28,696,382
$228,064,458
$925,933
$53,737,384
$18,919,320
$45,113,488
$78,405,249
Total $
775
2,770
3,358
20,291
2,431
25,976
4,304
923
10,614
9,027
11,977
7,688
2,793
9,879
8,457
$9,671,225
$15,168,520
$15,114,358
$118,702,350
$14,427,985
$352,364,440
$18,726,704
$4,732,221
$44,111,784
$55,741,725
$124,716,501
$75,488,472
$48,813,261
$63,719,550
$156,099,306
184,475 $1,734,932,056
4,849
37,138
227
9,421
5,352
9,296
26,337
Number
Clinical Chapters
$15,405
$5,540
$4,536
$5,731
$4,853
$14,135
$4,278
$4,955
$4,308
$5,387
$11,079
$8,990
$17,835
$6,536
$19,318
$9,498
$5,515
$6,051
$4,105
$6,052
$3,263
$5,482
$2,874
Unit $
31,628
6,307
8,249
8,060
6,745
15,963
6,971
9,574
7,111
7,851
34,113
15,277
42,711
14,222
34,465
22,267
6,999
11,455
2,423
13,749
3,908
9,673
5,967
SD
424
1,905
2,123
10,908
1,338
8,204
3,310
659
5,370
4,408
6,280
4,962
1,837
7,066
5,726
95,458
2,099
18,098
87
4,180
4,238
3,840
8,863
Number
$6,531,720
$10,553,700
$9,629,928
$62,513,748
$6,493,314
$115,963,540
$14,160,180
$3,265,345
$23,133,960
$23,745,896
$69,576,120
$44,608,380
$32,762,895
$46,183,376
$110,614,868
$906,629,756
$11,575,985
$109,510,998
$357,135
$25,297,360
$13,828,594
$21,050,880
$25,472,262
Total $
$7,226
$5,300
$4,408
$5,999
$7,956
$13,287
$4,576
$5,903
$3,991
$7,109
$9,453
$11,729
$16,707
$6,138
$16,470
$9,294
$6,210
$6,234
$4,065
$5,408
$4,689
$4,360
$3,027
Unit $
10,342
6,291
4,613
7,162
14,247
11,450
6,753
8,024
5,588
12,538
13,855
21,482
33,060
11,269
28,625
17,527
8,589
10,970
3,349
7,005
6,069
7,038
3,721
SD
351
865
1,235
9,383
1,093
17,772
994
264
5,244
4,619
5,697
2,726
956
2,813
2,731
89,014
2,750
19,040
140
5,241
1,114
5,455
17,473
Number
$2,536,326
$4,584,500
$5,443,880
$56,288,617
$8,695,908
$236,136,564
$4,548,544
$1,558,392
$20,928,804
$32,836,471
$53,853,741
$31,973,254
$15,971,892
$17,266,194
$44,979,570
$827,328,887
$17,077,500
$118,695,360
$569,100
$28,343,328
$5,223,546
$23,783,800
$52,890,771
Total $
Appendices
77
$23,180
$21,186
$4,871
$9,720
$12,595
$10,962
$4,409
$7,133
$2,641
$1,731
$2,435
$2,248
Frostbite
Poisoning by drugs, medicaments and biological
substances
Toxic effects of substances chiefly nonmedicinal
as to source
Certain early complications of trauma, not elsewhere
classified
Complications of surgical and medical care,
Sequelae of injuries, of poisoning and of other
Other injuriy, poisoning and consequences
of external causes
Chapter XXI—Factors influencing health status and
contact with health services
Medical observation and evaluation for suspected
diseases and conditions
Other persons encountering health services for
examination and investigation
$7,139
$5,967
$2,781
$7,076
Other medical care (including radiotherapy and
chemotherapy sessions)
specific procedures
Persons with potential health hazards related to
socioeconomic and psychosocial circumstances
Persons encountering health services in
other circumstances
$824
$2,928
Liveborn infants according to place of birth
(“healthy newborn babies”)
$3,946
Unit $
34,013
6,260
21,377
11,886
506
1,188
3,884
1,695
9,397
17,208
3,622
23,503
20,407
46,244
9,789
28,287
50,366
5,061
3,950
SD
6,274
442
62,665
31,297
204,446
298
2,722
2,056
312,539
1,818
177
42,146
440
1,723
12,397
191
2,064
1,853
403
Number
$44,394,824
$1,229,202
$373,922,055
$223,429,283
$168,463,504
$669,904
$6,628,070
$3,558,936
$825,289,698
$12,967,794
$780,393
$462,004,452
$5,541,800
$16,747,560
$60,385,787
$4,046,526
$47,843,520
$5,425,584
$1,590,238
Total $
Injuries to unspecified parts of trunk, limb or
body region
Clinical Chapters
$7,226
$2,024
$6,075
$6,844
$834
_
$2,466
$1,806
$2,601
$8,657
$5,693
$11,225
$11,093
$11,677
$5,504
$20,647
$23,595
$2,945
$4,293
Unit $
29,794
3,555
20,901
10,884
504
_
3,914
1,741
9,175
21,641
4,056
23,027
17,548
58,105
12,185
27,991
55,974
5,402
4,332
SD
2,846
189
29,174
16,006
102,526
11
1,494
1,040
153,398
986
109
20,774
333
1,040
4,780
149
1,497
1,075
195
Number
$20,565,196
$382,536
$177,232,050
$109,545,064
$85,506,684
_
$3,684,204
$1,878,240
$398,978,214
$8,535,802
$620,537
$233,188,150
$3,693,969
$12,144,080
$26,309,120
$3,076,403
$35,321,715
$3,165,875
$837,135
Total $
$6,953
$3,597
$5,855
$7,472
$815
$2,248
$2,396
$1,656
$2,678
$5,273
$2,392
$10,694
$18,761
$6,514
$4,422
$24,693
$21,961
$2,904
$3,698
Unit $
37,201
8,253
21,876
12,918
508
1,188
3,858
1,649
9,614
9,062
1,296
23,976
29,180
10,549
7,621
34,399
28,326
4,562
3,741
SD
3,428
253
33,488
15,291
101,919
287
1,228
1,016
159,137
832
68
21,369
107
683
7,617
42
567
778
208
Number
$23,834,884
$910,041
$196,072,240
$114,254,352
$83,063,985
$645,176
$2,942,288
$1,682,496
$426,209,255
$4,387,136
$162,656
$228,520,086
$2,007,427
$4,449,062
$33,682,374
$1,037,106
$12,451,887
$2,259,312
$769,184
Total $
78
$6,983
All chapters (excluding chapters 20, 22, 23)
2,339
Number
$2,993,920
Total $
16,684 2,441,299 $17,046,561,538
1,551
SD
$7,964
$1,645
Unit $
112
Number
$184,240
Total $
18,970 1,052,482 $8,381,714,727
1,998
SD
-: Data not published due to small cell size
The value “0” is attributed if the medical condition is not relevant to the specified sex.
Some discrepancies may exist for total acute care inpatient costs due to rounding and/or the category “Other” (undifferentiated, transsexuals, hermaphrodites) for sex.
Notes:
$1,280
Unit $
Other factors influencing health status and
contact with health services
Clinical Chapters
$6,236
$1,259
Unit $
2,227
Number
$2,803,793
Total $
14,660 1,388,612 $8,658,820,378
1,523
SD
Appendices
79
$5,701
$28,406
$14,840
$9,667
$11,101
$3,408
$18,349
$6,584
$2,387
$8,567
$5,574
$19,314
$2,748
$34,543
$6,276
$3,722
$22,812
$5,373
organs and certain disorders involving the immune
mechanism
diseases
Pneumonia
Asthma
subcutaneous tissue
Chapter XIII—Diseases of the musculoskeletal system
Unit $
10,819
26,692
3,900
19,955
82,321
3,233
47,142
14,422
16,015
2,455
24,202
44,548
2,245
15,133
23,151
34,086
38,051
11,389
SD
1,994
161
512
3,036
416
918
109
7,529
2,417
1,662
13,082
357
177
670
504
241
260
2,590
Number
$10,713,943
$3,672,692
$1,905,895
$19,053,700
$14,369,888
$2,522,664
$2,105,226
$41,966,646
$20,706,439
$3,967,194
$86,134,896
$6,550,741
$603,163
$7,437,934
$4,872,148
$3,576,362
$7,385,562
$14,764,761
Total $
Clinical Chapters
$5,957
$5,038
$3,236
$6,298
$37,014
$2,754
$27,139
$4,543
$6,398
$2,452
$5,691
$18,010
$1,461
$10,347
$5,314
$13,939
$28,266
$5,148
Unit $
12,885
4,326
3,256
21,379
92,674
3,745
58,836
7,438
11,782
2,853
23,316
49,953
1,473
15,649
5,743
38,033
55,335
9,060
SD
1,228
92
266
1,902
240
638
65
4,548
1,443
960
7,918
198
103
382
262
138
116
1,409
Number
$7,315,103
$463,509
$860,863
$11,978,916
$8,883,360
$1,757,052
$1,764,035
$20,661,564
$9,232,314
$2,353,920
$45,063,050
$3,566,057
$150,432
$3,952,692
$1,392,328
$1,923,599
$3,278,837
$7,253,892
Total $
$4,117
$49,156
$3,688
$5,873
$32,071
$2,731
$6,599
$7,026
$11,501
$2,303
$7,836
$16,990
$2,400
$14,134
$12,587
$15,269
$11,842
$6,308
Unit $
3,257
34,935
4,279
16,495
72,993
1,014
9,673
20,503
20,206
1,835
25,405
38,511
2,388
14,515
33,087
27,999
17,138
13,506
SD
766
69
246
1,134
176
280
44
2,981
974
702
5,164
159
74
288
242
103
144
1,181
Number
$3,153,299
$3,391,741
$907,334
$6,660,388
$5,644,496
$764,680
$290,356
$20,944,506
$11,201,974
$1,616,706
$40,462,718
$2,701,466
$177,621
$4,070,695
$3,045,964
$1,572,691
$1,705,305
$7,449,870
Total $
Appendix D-1. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $),
Standard Deviation and Number of Stays, Age Group <1, by Selected Clinical Chapters or Medical
80
7,260
$2,912
$5,093
$5,015
$2,528
$15,208
$3,573
$16,730
$15,850
$31,709
$41,603
$4,807
$7,338
$6,719
$17,013
$9,417
$11,779
$4,250
$5,091
Other disorders related to length of gestation
and fetal growth
Other respiratory and cardiovascular disorders
specific to the perinatal period
Hemorrhagic and hematological disorders
of fetus and newborn
Chapter XVIII—Symptoms, signs and abnormal
clinical and laboratory findings, not elsewhere classified
8,605
7,488
97,160
9,687
60,966
22,271
29,750
4,488
141,638
65,457
28,896
60,179
6,523
28,602
4,185
8,580
11,191
29,504
Disorders related to short gestation and low birth weight $16,251
SD
19,041
Unit $
1,057
3,936
934
296
1,437
473
2,034
641
280
2,080
292
8,467
15,998
342
11,725
6,468
10,950
5,631
19,784
70,898
Number
$5,381,612
$16,726,866
$11,001,586
$2,787,432
$24,447,681
$3,178,087
$14,925,492
$3,081,287
$11,648,840
$65,954,720
$4,628,200
$141,653,325
$57,160,854
$5,201,136
$29,640,800
$32,437,020
$55,768,350
$16,397,472
$321,509,784
$518,115,416
Total $
$7,308
Chapter XVI—Certain conditions originating in the
perinatal period
Clinical Chapters
$5,409
$4,248
$3,927
$9,643
$23,246
$7,335
$5,974
$4,489
$31,462
$35,320
$19,192
$15,905
$3,422
$14,102
$2,616
$5,353
$5,073
$2,665
$17,068
$7,428
Unit $
8,354
7,032
9,846
9,994
83,577
25,176
19,208
3,180
61,685
74,477
35,609
50,062
5,141
25,573
4,893
9,195
11,454
5,539
31,454
19,727
SD
623
2,103
650
160
652
327
1,389
378
140
1,145
153
4,994
8,630
192
6,408
3,701
6,679
2,906
10,515
39,031
Number
$3,369,713
$8,933,430
$2,552,550
$1,542,880
$15,156,392
$2,398,545
$8,297,886
$1,696,842
$4,404,680
$40,441,400
$2,936,376
$79,427,551
$29,531,860
$2,707,584
$16,763,328
$19,811,453
$33,882,567
$7,744,490
$179,470,020
$289,911,302
Total $
52,220
20,398
72,794
7,875
32,431
3,133
7,686
10,771
8,721
27,198
18,175
SD
9,485
32,719
6,764
43,974
5,943
$5,513
$4,260
9,336
8,045
$33,089 186,432
$9,171
$12,018
$4,696
$10,122
$5,280
$53,433 198,492
$27,188
$12,604
$18,229
$3,756
$16,653
$2,424
$4,574
$5,124
$3,175
$15,365
$7,194
Unit $
434
1,833
281
135
785
145
645
263
140
934
138
3,466
7,198
150
5,317
2,764
4,271
2,725
9,266
31,691
Number
$2,392,509
$7,808,977
$9,298,009
$1,238,085
$9,434,130
$680,920
$6,528,690
$1,388,640
$7,480,620
$25,393,592
$1,739,352
$63,182,038
$27,035,688
$2,497,950
$12,888,408
$12,642,536
$21,884,604
$8,651,875
$142,372,090
$227,973,151
Total $
Appendix D-1. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard Deviation and Number of Stays, Age Group <1,
by Selected Clinical Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
Appendices
81
$4,698
$5,317
$1,998
$1,214
$3,250
Other medical care (including radiotherapy
and chemotherapy sessions)
Other persons encountering health services
for specific procedures
other circumstances
Other factors influencing health status
and contact with health services
14,849
878
2,961
7,823
9,170
506
1,114
1,328
679
SD
$89,836
$2,421,576
$2,823,327
$695,304
$168,463,504
$185,100
$946,970
$175,641,073
Total $
315,380 $1,025,067,653
74
1,212
531
148
204,446
150
562
207,139
Number
$3,386
$1,261
$2,365
$3,127
$5,490
$834
$1,311
$1,646
$858
Unit $
14,687
816
3,860
6,006
10,875
504
1,303
1,171
700
SD
164,971
39
610
375
89
102,526
94
299
104,041
Number
$558,660,202
$49,179
$1,442,650
$1,172,625
$488,610
$85,506,684
$123,234
$492,154
$89,283,848
Total $
Notes:
$824
$1,234
Liveborn infants according to place of birth
(“healthy newborn babies”)
$1,685
$848
Unit $
Chapter XXI—Factors influencing health status
Clinical Chapters
$3,082
$1,145
$1,638
$9,058
$2,849
$815
$1,059
$1,721
$836
Unit $
15,018
1,006
1,615
9,084
1,825
508
607
1,468
656
SD
150,225
35
602
156
59
101,919
56
263
103,097
Number
$462,964,191
$40,075
$986,076
$1,413,048
$168,091
$83,063,985
$59,304
$452,623
$86,189,922
Total $
Appendix D-1. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard Deviation and Number of Stays, Age Group <1,
by Selected Clinical Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
82
$3,161
$1,882
$1,814
$11,277
$4,645
$4,849
$2,855
$34,453
$7,843
$8,376
$4,201
$7,801
$6,964
$2,584
$6,718
$29,933
$14,058
$4,118
$3,897
$3,144
$4,102
infectious origin
Septicemia
and mucous membrane
organs and certain disorders involving the
immune mechanism
Anemias
Chapter IV—Endocrine, nutritional
and metabolic diseases
Pneumonia
Unit $
7,494
6,149
13,567
5,299
35,198
9,819
10,393
2,323
13,546
14,267
8,047
14,464
18,378
50,932
3,548
7,302
3,805
27,716
1,241
4,232
9,675
SD
5,397
2,510
19,248
156
326
15
663
280
523
1,282
1,124
385
989
566
889
395
56
206
168
2,343
4,077
Number
$22,138,494
$7,891,440
$75,009,647
$642,408
$4,582,890
$448,995
$4,453,953
$723,543
$3,642,172
$10,000,484
$4,721,578
$3,224,760
$7,756,714
$19,500,477
$2,538,095
$1,915,355
$260,120
$2,323,062
$304,752
$4,409,526
$12,888,960
Total $
Clinical Chapters
$4,143
$3,093
$3,894
$3,849
$10,062
$23,245
$7,229
$2,526
$8,075
$8,257
$5,019
$7,880
$8,275
$33,467
$2,622
$3,188
$5,133
$9,217
$1,239
$2,062
$3,005
Unit $
8,785
6,845
15,605
5,646
20,686
15,083
8,693
2,395
16,624
16,539
9,983
14,409
22,853
63,951
2,768
2,992
4,283
28,164
859
5,465
10,842
SD
2,990
1,574
11,682
100
189
8
390
146
317
729
612
211
564
288
480
214
38
98
85
1,259
2,188
Number
$12,387,570
$4,868,382
$45,489,772
$384,900
$1,901,728
$185,960
$2,819,208
$368,822
$2,559,775
$6,019,091
$3,071,491
$1,662,680
$4,667,088
$9,638,583
$1,258,560
$682,232
$195,054
$903,266
$105,315
$2,596,058
$6,575,055
Total $
$4,049
$3,213
$3,818
$4,542
$19,971
$34,391
$6,649
$2,564
$5,093
$6,410
$3,705
$8,828
$7,020
$33,227
$3,183
$6,233
$3,669
$13,484
$2,082
$1,670
$3,142
Unit $
5,361
5,062
9,321
4,906
49,778
398
12,524
2,292
4,927
10,589
4,580
14,661
11,757
38,114
4,425
9,356
2,875
27,564
1,314
1,916
8,093
SD
2,407
936
7,566
56
137
7
273
134
206
552
512
174
425
278
409
181
18
108
83
1,084
1,889
Number
$9,745,943
$3,007,368
$28,890,325
$254,352
$2,735,970
$240,737
$1,815,160
$343,571
$1,049,158
$3,538,408
$1,896,880
$1,536,072
$2,983,438
$9,237,037
$1,301,847
$1,128,173
$66,042
$1,456,272
$172,806
$1,810,280
$5,935,420
Total $
Appendix D-2. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard
Deviation and Number of Stays, Age Group 1 to 4, by Selected Clinical Chapters or Medical Conditions,
DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005
Appendices
83
$4,568
$1,783
$5,160
$2,089
$3,718
$2,627
$2,587
$11,414
$2,470
$5,548
$12,878
$1,861
$6,481
$4,307
$3,564
$3,578
$6,627
$4,699
$6,178
$6,102
$4,210
$15,285
$20,302
$36,800
Asthma
and duodenum
subcutaneous tissue
Other arthropathies
Unit $
75,188
26,730
43,421
4,068
11,530
17,951
4,885
14,429
2,976
3,067
5,820
9,410
2,085
13,910
4,188
3,065
14,357
2,131
1,743
19,356
3,165
9,989
947
10,963
SD
371
47
1,734
1,300
140
277
157
699
755
958
245
176
3,290
41
182
184
139
167
170
5,027
5,568
213
1,875
2,985
Number
$13,652,800
$954,194
$26,504,455
$5,472,367
$854,280
$1,711,306
$737,743
$4,632,089
$2,701,390
$3,413,931
$1,055,215
$1,140,656
$6,122,690
$527,998
$1,009,736
$454,480
$1,586,546
$432,029
$446,590
$18,688,697
$11,631,552
$1,099,080
$3,343,125
$13,635,480
Total $
Clinical Chapters
$26,935
$26,045
$12,254
$3,401
$2,803
$3,914
$3,083
$4,683
$3,462
$3,395
$4,730
$5,395
$1,764
$16,193
$4,286
$3,036
$9,913
$2,349
$2,807
$3,410
$2,089
$4,606
$1,780
$4,634
Unit $
27,425
34,718
28,616
2,886
2,793
1,986
1,670
6,829
2,385
2,793
6,789
5,063
1,671
17,493
3,543
3,450
12,786
2,412
1,854
13,828
3,439
9,940
1,043
12,151
SD
179
30
1,017
495
82
172
85
409
397
518
147
115
1,773
21
101
91
75
88
91
2,771
3,686
149
1,127
1,746
Number
$4,821,365
$781,350
$12,461,949
$1,683,627
$229,846
$673,208
$262,055
$1,915,446
$1,374,414
$1,758,442
$695,310
$620,425
$3,127,572
$340,053
$432,886
$276,276
$743,475
$206,712
$255,437
$9,449,651
$7,700,054
$686,294
$2,006,060
$8,090,964
Total $
8,580
57,298
4,723
17,206
26,612
6,313
19,770
3,476
3,333
2,527
16,950
2,494
7,867
4,487
746
16,760
1,774
1,418
25,933
2,519
10,367
788
8,697
SD
$47,228 103,448
$13,124
$19,970
$4,700
$10,814
$8,928
$6,190
$8,307
$3,692
$3,665
$3,346
$9,737
$1,977
$9,011
$6,652
$1,056
$14,058
$2,872
$2,030
$3,935
$2,087
$6,567
$1,788
$4,459
Unit $
192
17
717
805
58
105
72
290
358
440
98
61
1,517
20
81
93
64
79
79
2,256
1,882
64
748
1,239
Number
$9,067,776
$223,108
$14,318,620
$3,783,871
$627,212
$937,440
$445,680
$2,408,892
$1,321,736
$1,612,804
$327,908
$593,957
$2,999,109
$180,220
$538,812
$98,208
$899,712
$226,888
$160,370
$8,877,818
$3,927,734
$420,288
$1,337,424
$5,524,701
Total $
Appendix D-2. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard Deviation and Number of Stays, Age
Group 1 to 4, by Selected Clinical Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
84
$13,467
$5,230
$17,613
$12,607
$13,198
$4,448
$3,913
$7,805
$1,994
$2,674
$3,711
$6,237
$15,448
$2,190
$2,508
$1,838
$4,162
$7,471
$2,109
$18,478
clinical and laboratory findings,
Other symptoms and signs involving the
circulatory and respiratory systems
digestive system and abdomen
Intracranial injury
Fracture of femur
Unit $
25,841
2,836
12,242
3,250
642
1,975
2,857
33,833
25,336
7,410
3,904
1,557
33,567
12,968
3,494
37,714
16,433
23,069
1,908
23,339
SD
273
343
32
289
242
536
474
272
4,083
2,765
396
219
374
3,945
451
358
117
86
232
64
Number
$5,044,494
$723,387
$239,072
$1,202,818
$444,796
$1,344,288
$1,038,060
$4,201,856
$25,466,377
$10,260,915
$1,058,904
$436,686
$2,919,070
$15,435,430
$2,006,048
$4,724,884
$1,475,019
$1,514,718
$1,213,360
$861,888
Total $
Clinical Chapters
$23,618
$2,364
$9,917
$4,658
$1,845
$2,286
$2,023
$10,775
$5,553
$3,461
$3,045
$2,250
$5,379
$3,611
$3,989
$17,357
$11,181
$10,439
$5,426
$12,042
Unit $
29,266
2,712
14,029
3,475
656
1,766
2,074
21,998
11,626
5,860
4,640
1,736
8,567
6,087
2,802
51,079
15,116
9,318
1,946
16,529
SD
152
181
16
197
138
266
278
155
2,320
1,535
198
121
229
2,193
369
183
63
37
115
37
Number
$3,589,936
$427,884
$158,672
$917,626
$254,610
$608,076
$562,394
$1,670,125
$12,882,433
$5,312,635
$602,910
$272,250
$1,231,791
$7,918,587
$1,471,941
$3,176,331
$704,403
$386,243
$623,990
$445,554
Total $
$12,430
$1,825
$1,356
$3,147
$1,830
$2,933
$2,413
$26,233
$7,364
$4,000
$2,380
$1,534
$13,015
$4,346
$6,614
$8,577
$14,237
$24,787
$5,037
$15,249
Unit $
20,216
2,972
1,407
2,500
649
2,288
3,680
51,476
37,200
8,873
3,233
1,092
58,613
17,974
5,306
9,062
18,255
29,829
1,869
30,308
SD
121
162
16
92
104
270
196
117
1,763
1,230
198
98
145
1,752
82
175
54
49
117
27
Number
$1,504,030
$295,650
$21,696
$289,524
$190,320
$791,910
$472,948
$3,069,261
$12,983,112
$4,920,000
$471,240
$150,332
$1,887,175
$7,613,679
$542,348
$1,500,975
$768,798
$1,214,563
$589,329
$411,723
Total $
Appendices
85
$2,497
$13,809
$4,865
$2,488
$3,102
$5,299
$3,230
$36,686
$5,160
as to source
other circumstances
20,142
126,025
7,087
4,724
4,968
1,734
21,039
51,190
5,032
1,189
SD
48,183
48
786
718
124
133
1,813
629
111
404
Number
$248,603,598
$1,760,928
$2,538,780
$3,804,682
$384,648
$330,904
$8,819,942
$8,685,861
$277,167
$509,848
Total $
$4,814
$967
$2,837
$5,497
$2,456
$2,863
$3,761
$8,324
$1,257
$1,346
Unit $
16,887
810
4,979
5,405
3,769
1,685
5,101
11,773
899
1,384
SD
27,604
33
457
402
77
76
1,049
378
65
200
Number
$132,892,166
$31,911
$1,296,509
$2,209,794
$189,112
$217,588
$3,944,914
$3,146,472
$81,705
$269,200
Total $
Notes:
$1,262
Unit $
Poisoning by drugs, medicaments and
biological substances
Clinical Chapters
9,016
4,016
7,208
1,810
30,185
77,526
9,650
1,009
SD
$5,506
23,901
$62,201 164,585
$3,709
$5,115
$4,671
$1,889
$5,362
$21,388
$5,909
$1,186
Unit $
20,578
15
329
316
47
57
764
251
46
204
Number
$113,300,030
$933,015
$1,220,261
$1,616,340
$219,537
$107,673
$4,096,826
$5,368,388
$271,814
$241,944
Total $
86
$3,882
$2,152
$3,122
$20,743
$3,577
$4,632
$24,261
$54,642
$42,723
$38,800
$7,273
$7,369
$3,230
$10,264
$4,786
$3,076
$16,290
$3,632
infectious origin
Septicemia
and mucous membrane
endocrine glands
and related tissue
immune mechanism
Anemias
Coagulation defects, purpura and other
hemorrhagic conditions
Agranulocytosis
Chapter IV—Endocrine, nutritional and
metabolic diseases
Diabetes mellitus
Cystic fibrosis
Unit $
6,184
7,415
3,522
6,259
12,669
5,091
14,784
12,448
53,357
72,826
78,215
45,972
4,050
2,879
31,361
3,486
4,001
8,158
SD
451
254
1,368
2,192
490
420
543
1,495
289
34
129
1,119
282
178
126
93
1,145
2,739
Number
$1,638,032
$4,137,660
$4,207,968
$10,490,651
$5,029,360
$1,356,600
$4,001,367
$10,872,586
$11,213,200
$1,452,582
$7,048,818
$27,148,055
$1,306,224
$636,706
$2,613,618
$290,346
$2,464,040
$10,633,844
Total $
Clinical Chapters
$3,636
$14,155
$2,722
$4,098
$9,685
$2,814
$8,009
$7,107
$33,140
$77,290
$58,182
$23,245
$4,180
$3,463
$15,311
$3,249
$2,568
$3,870
Unit $
6,912
7,511
2,601
5,900
10,430
3,662
17,678
12,324
42,337
97,727
79,652
45,276
3,739
2,825
15,487
3,562
5,145
6,173
SD
272
110
644
1,081
264
244
254
783
186
15
64
600
152
104
64
43
621
1,445
Number
$988,992
$1,557,050
$1,752,968
$4,429,871
$2,556,840
$686,616
$2,034,286
$5,564,748
$6,164,040
$1,159,350
$3,723,648
$13,947,043
$635,360
$360,152
$979,904
$139,707
$1,594,728
$5,591,865
Total $
$3,625
$17,923
$3,358
$5,434
$10,896
$3,841
$6,971
$7,238
$45,927
$8,155
$50,040
$24,146
$5,084
$3,722
$23,912
$3,033
$1,596
$3,788
Unit $
4,693
7,095
4,103
6,558
14,837
6,681
12,763
12,600
64,771
5,916
80,322
46,919
4,429
3,010
38,054
3,622
1,250
10,002
SD
179
144
724
1,111
226
176
289
712
103
19
65
519
130
74
62
50
524
1,294
Number
$648,875
$2,580,912
$2,431,192
$6,037,434
$2,462,496
$676,016
$2,014,619
$5,153,131
$4,730,481
$154,945
$3,252,600
$12,531,668
$660,920
$275,428
$1,482,544
$151,650
$836,304
$4,902,052
Total $
Standard Deviation and Number of Stays, Age Group 5 to 14, by Selected Clinical Chapters or Medical
Appendices
87
$11,525
$13,504
$11,070
$7,376
$18,711
$14,500
$7,435
$10,927
$6,746
$7,566
$3,675
$3,583
$4,098
$2,818
$3,269
$10,820
$26,843
$3,595
$2,697
$7,177
$4,106
$1,655
$3,499
$2,170
$13,769
Epilepsy
Pneumonia
Asthma
Unit $
22,858
2,136
3,441
777
4,557
26,707
3,524
13,492
36,776
22,840
1,924
1,407
3,410
4,572
3,646
6,614
10,079
18,792
16,473
15,457
18,077
8,678
13,553
15,602
14,559
SD
467
3,228
590
3,687
292
2,198
1,433
11,959
72
933
586
71
762
209
325
92
923
118
1,975
1,800
77
931
1,064
165
4,282
Number
$6,430,123
$7,004,760
$2,064,410
$6,101,985
$1,198,952
$15,775,046
$3,864,801
$42,997,853
$1,932,696
$10,094,789
$1,915,634
$200,078
$3,122,620
$748,847
$1,194,391
$696,072
$6,226,558
$1,289,386
$14,684,655
$26,100,000
$1,440,747
$6,867,056
$11,778,480
$2,228,160
$49,349,631
Total $
Clinical Chapters
$16,279
$2,000
$3,788
$1,690
$4,872
$6,615
$2,702
$3,613
$25,778
$11,455
$3,543
$2,457
$4,183
$3,271
$3,341
$6,754
$7,564
$5,820
$6,587
$14,734
$12,944
$8,996
$10,950
$14,796
$12,278
Unit $
27,051
2,137
4,370
850
5,185
18,402
3,649
11,139
37,980
26,889
2,042
1,639
3,441
2,426
2,114
7,334
11,466
5,513
12,168
16,047
12,271
9,625
12,173
11,519
15,037
SD
256
2,046
310
1,734
161
1,196
822
6,564
44
519
336
35
429
119
177
56
494
56
1,055
1,093
42
356
300
91
1,994
Number
$4,167,424
$4,092,000
$1,174,280
$2,930,460
$784,392
$7,911,540
$2,221,044
$23,712,966
$1,134,232
$5,945,241
$1,190,448
$85,995
$1,794,451
$389,249
$591,366
$378,224
$3,736,616
$325,920
$6,949,354
$16,104,262
$543,648
$3,202,576
$3,285,000
$1,346,436
$24,481,922
Total $
$9,669
$2,420
$3,086
$1,615
$3,065
$7,857
$2,692
$3,519
$31,633
$10,725
$2,965
$3,448
$3,122
$3,949
$3,281
$8,812
$5,614
$12,522
$7,517
$13,992
$41,778
$6,364
$11,116
$12,730
$10,908
Unit $
12,834
2,112
1,206
688
3,420
34,234
3,375
16,128
43,891
17,728
1,750
568
3,390
6,306
4,884
5,306
7,688
21,235
20,658
14,158
22,512
7,978
14,120
18,170
13,909
SD
211
1,182
280
1,953
131
1,002
611
5,395
28
414
250
36
333
90
148
36
429
62
920
707
35
575
764
74
2,288
Number
$2,040,159
$2,860,440
$864,080
$3,154,095
$401,515
$7,872,714
$1,644,812
$18,984,320
$885,724
$4,440,133
$741,250
$124,128
$1,039,630
$355,410
$485,525
$317,232
$2,408,406
$776,364
$6,915,449
$9,892,344
$1,462,230
$3,659,300
$8,492,624
$942,020
$24,957,274
Total $
88
$4,998
$3,317
$7,313
$8,223
$5,658
$4,568
$8,023
$2,441
$8,578
$15,299
$5,893
$16,595
$3,687
$3,549
$2,087
$3,571
$4,100
$8,495
$6,327
$7,449
$28,572
$2,043
$5,830
$6,006
and duodenum
Cholelithiasis
subcutaneous tissue
Other arthropathies
Dorsalgia
Unit $
9,743
9,144
393
30,687
12,094
5,003
16,154
3,861
4,154
1,179
5,040
4,988
25,901
8,945
44,954
8,092
4,620
7,165
3,585
11,129
6,036
10,082
1,915
7,882
SD
862
363
42
272
181
712
2,482
83
105
95
893
1,189
121
177
86
223
1,512
363
4,039
209
130
217
363
8,429
Number
$5,177,172
$2,116,290
$85,806
$7,771,584
$1,348,269
$4,504,824
$21,085,125
$340,300
$374,955
$198,265
$3,169,257
$4,383,605
$2,007,995
$1,043,061
$1,315,714
$1,912,894
$3,690,792
$2,912,349
$18,450,152
$1,182,522
$1,068,990
$1,586,921
$1,204,071
$42,126,770
Total $
Clinical Chapters
$4,986
$6,716
$2,166
$32,230
$6,462
$6,626
$7,305
$5,695
$3,265
$1,656
$3,163
$3,211
$39,772
$3,530
$21,230
$8,901
$2,942
$6,564
$4,480
$6,951
$7,586
$6,420
$3,634
$5,285
Unit $
3,526
10,837
422
28,837
7,421
5,504
10,618
3,940
4,999
995
3,440
3,637
38,202
1,330
56,167
7,248
6,129
5,832
3,188
14,362
4,902
8,321
1,922
8,700
SD
515
229
19
75
87
382
1,322
49
71
55
495
675
59
63
46
132
784
196
2,453
107
74
115
182
4,768
Number
$2,567,790
$1,537,964
$41,154
$2,417,250
$562,194
$2,531,132
$9,657,484
$279,055
$231,815
$91,080
$1,565,685
$2,167,635
$2,346,548
$222,390
$976,580
$1,174,932
$2,306,528
$1,286,544
$10,989,440
$743,757
$561,364
$738,300
$661,388
$25,197,056
Total $
$7,489
$3,977
$1,798
$27,738
$9,341
$5,951
$9,947
$1,309
$3,992
$2,395
$4,060
$4,022
$8,870
$7,413
$4,622
$8,201
$1,896
$9,424
$4,723
$3,935
$9,589
$8,704
$2,778
$4,844
Unit $
14,594
3,075
199
31,275
18,323
4,304
20,536
1,020
2,880
1,263
6,586
6,307
15,534
11,291
5,399
9,180
1,839
8,103
4,194
4,426
8,248
12,472
1,811
6,523
SD
347
134
23
197
94
330
1,160
34
34
40
398
514
62
114
40
91
728
167
1,586
102
56
102
181
3,661
Number
$2,598,683
$532,918
$41,354
$5,464,386
$878,054
$1,963,830
$11,538,625
$44,506
$135,728
$95,800
$1,615,880
$2,067,397
$549,940
$845,082
$184,880
$746,291
$1,380,288
$1,573,808
$7,490,678
$401,370
$536,984
$887,808
$502,818
$17,733,253
Total $
Appendices
89
$5,333
$5,877
$20,713
$2,668
$4,823
$3,087
$9,909
$13,350
$15,127
$4,589
$20,711
$10,162
$6,947
$2,920
$5,738
$1,923
$3,137
$10,112
$1,904
$3,294
$2,573
Renal failure
Urolithiasis
Congenital malformations and deformations of the
musculoskeletal system
Symptoms and signs involving cognition,
perception, emotional state and behaviour
Unit $
1,783
5,460
1,358
17,053
4,064
2,199
13,944
6,011
6,520
10,845
52,114
1,539
11,466
12,014
15,523
1,953
6,851
1,895
17,849
4,666
6,536
SD
142
1,602
221
87
646
1,675
224
4,663
400
72
83
169
362
73
1,565
139
491
94
92
952
2,229
Number
$365,366
$5,276,988
$420,784
$879,744
$2,026,502
$3,221,025
$1,285,312
$13,614,903
$2,778,800
$731,664
$1,719,013
$775,541
$5,475,974
$974,550
$15,507,729
$429,132
$2,368,093
$250,792
$1,905,596
$5,594,904
$11,887,569
Total $
Clinical Chapters
$2,445
$2,917
$1,717
$4,939
$2,979
$2,147
$5,100
$2,749
$6,911
$11,508
$25,494
$4,343
$13,206
$11,736
$10,146
$0
$5,393
$2,505
$14,302
$5,873
$4,941
Unit $
1,735
5,933
1,939
7,777
3,603
2,815
10,549
5,352
5,863
17,751
67,067
991
7,664
8,345
19,726
0
9,694
2,337
12,482
4,204
6,077
SD
76
863
89
62
317
800
128
2,372
198
39
53
91
189
36
830
0
149
52
47
373
949
Number
$185,820
$2,517,371
$152,813
$306,218
$944,343
$1,717,600
$652,800
$6,520,400
$1,368,378
$448,812
$1,351,182
$395,213
$2,495,934
$422,496
$8,421,415
$0
$803,557
$130,260
$672,194
$2,190,629
$4,689,083
Total $
$2,794
$3,716
$2,021
$29,081
$3,309
$1,703
$6,903
$3,172
$6,976
$9,320
$13,195
$4,798
$17,203
$14,716
$9,724
$3,087
$4,522
$2,994
$25,293
$5,880
$5,601
Unit $
1,927
4,865
986
29,202
4,533
1,324
18,977
6,682
7,071
4,405
9,277
1,885
14,325
14,627
10,376
1,953
4,810
673
20,458
4,962
6,851
SD
66
739
132
25
329
875
96
2,291
202
33
30
78
173
37
735
139
342
42
45
579
1,280
Number
$184,404
$2,746,124
$266,772
$727,025
$1,088,661
$1,490,125
$662,688
$7,266,147
$1,409,152
$307,560
$395,850
$374,244
$2,976,119
$544,492
$7,147,113
$429,132
$1,546,524
$125,748
$1,138,185
$3,404,520
$7,169,364
Total $
90
$5,801
$14,621
$6,391
$1,715
$6,902
$6,774
$2,984
$2,671
$3,082
$5,957
$3,412
$3,373
$3,673
$2,964
$1,365
$23,785
$3,608
$3,089
$9,417
$3,708
$4,406
$2,685
Intracranial injury
Injuries to the abdomen, lower back,
lumbar spine and pelvis
Fracture of femur
substances
as to source
Unit $
1,708
5,823
4,514
28,839
3,598
4,506
45,795
935
2,829
4,113
1,971
2,034
4,187
3,076
2,051
3,405
10,804
8,590
1,698
19,534
29,550
16,886
SD
191
142
3,374
1,641
103
532
185
234
160
130
1,180
87
574
287
2,420
1,525
735
121
152
902
976
12,322
Number
$512,835
$625,652
$12,510,582
$15,453,297
$318,167
$1,919,456
$4,400,225
$319,410
$474,240
$477,490
$3,980,140
$296,844
$3,419,318
$884,534
$6,463,820
$4,550,600
$4,978,890
$835,142
$260,680
$5,764,682
$14,270,096
$71,482,162
Total $
Chapter XIX—Injury, poisoning and certain
other consequences of external causes
Clinical Chapters
$2,821
$7,697
$3,795
$8,880
$1,553
$1,821
$26,478
$1,280
$2,719
$3,986
$3,226
$3,775
$5,967
$3,385
$2,750
$2,799
$6,187
$7,157
$1,436
$7,499
$14,634
$5,910
Unit $
2,025
7,443
4,865
16,409
1,406
1,363
51,189
904
1,859
4,264
2,014
1,945
3,936
3,758
2,255
1,494
8,095
9,240
730
23,687
32,170
15,370
SD
103
83
1,858
864
63
119
133
137
97
93
788
61
403
198
1,634
885
503
81
90
593
662
7,637
Number
$290,563
$638,851
$7,050,520
$7,672,320
$97,839
$216,699
$3,521,574
$175,360
$263,743
$370,698
$2,542,088
$230,275
$2,404,701
$670,230
$4,493,500
$2,477,115
$3,112,061
$579,717
$129,240
$4,446,907
$9,687,708
$45,132,251
Total $
$2,571
$1,116
$3,450
$10,010
$6,161
$4,278
$13,910
$1,474
$3,454
$1,164
$3,624
$2,565
$5,938
$2,570
$2,516
$3,232
$7,821
$5,754
$2,271
$4,692
$14,599
$5,578
Unit $
1,476
656
4,067
38,187
4,789
5,079
12,676
986
4,234
191
1,883
2,378
4,730
1,242
1,576
4,907
14,479
7,175
2,878
10,298
24,922
19,023
SD
88
59
1,516
777
40
413
52
97
63
37
392
26
171
89
786
640
232
40
62
309
314
4,685
Number
$226,248
$65,844
$5,230,785
$7,777,770
$246,440
$1,766,814
$723,320
$142,978
$217,602
$43,068
$1,420,608
$66,690
$1,015,398
$228,730
$1,977,576
$2,068,480
$1,814,472
$230,160
$140,802
$1,449,828
$4,584,086
$26,133,822
Total $
Appendices
91
$2,037
$5,822
14,551
2,712
5,368
SD
64,182
1,336
1,578
Number
$373,668,109
$2,721,432
$7,979,946
Total $
$5,757
$1,922
$5,348
Unit $
13,634
2,178
6,174
SD
35,063
745
864
Number
$201,866,724
$1,431,890
$4,620,672
Total $
Notes:
$5,057
Unit $
Clinical Chapters
$5,844
$2,196
$4,752
Unit $
15,620
3,315
4,364
SD
29,119
591
714
Number
$170,162,254
$1,297,836
$3,392,928
Total $
92
$11,110
$3,381
$2,995
$14,829
$30,047
$7,878
$7,953
$6,687
$16,196
$8,996
$12,660
$12,210
$12,672
$25,032
$5,314
$14,349
$5,455
$6,416
$8,510
$7,056
infectious origin
Tuberculosis
Septicemia
and mucous membrane
Hepatitis
Unit $
1,328
6,590
3,462
6,564
16,896
4,799
32,993
14,147
13,550
15,198
17,502
23,528
15,109
19,393
25,176
81,026
25,062
2,138
3,738
35,192
SD
48
328
670
1,344
219
123
189
271
567
232
20,664
917
243
274
539
945
341
431
1,520
7,401
Number
$338,688
$2,791,280
$4,298,720
$7,331,520
$3,142,431
$653,622
$4,731,048
$3,434,112
$6,923,070
$2,937,120
$185,897,231
$14,851,732
$1,624,941
$2,179,122
$4,246,242
$28,394,415
$5,056,689
$1,290,845
$5,139,120
$82,223,849
Total $
Clinical Chapters
$7,056
$0
$0
-
$12,072
$4,892
$27,393
$12,906
$10,782
$14,735
$13,979
$16,537
$5,874
$4,855
$5,093
$31,310
$16,072
$2,532
$3,253
$11,015
Unit $
1,328
0
0
-
10,945
2,754
36,570
12,066
11,233
17,118
22,214
24,843
15,349
8,700
17,571
98,102
26,084
1,414
3,205
40,366
SD
48
0
0
-
109
67
123
114
300
128
4,908
669
121
146
270
485
178
197
659
3,761
Number
$338,688
$0
$0
-
$1,315,848
$327,764
$3,369,339
$1,471,284
$3,234,600
$1,886,080
$68,610,967
$11,063,253
$710,754
$708,830
$1,375,110
$15,185,350
$2,860,816
$498,804
$2,143,727
$41,428,792
Total $
$0
$8,510
$6,416
$5,455
$16,398
$5,660
$17,478
$12,433
$14,472
$9,572
$7,361
$14,839
$7,741
$11,646
$10,249
$28,429
$13,183
$3,597
$3,478
$11,134
Unit $
0
6,590
3,462
6,564
20,733
6,014
15,312
16,158
16,438
11,254
14,645
17,517
15,015
26,897
30,092
52,087
23,886
2,714
4,104
27,756
SD
0
328
670
1,340
110
56
66
157
267
104
15,756
248
122
128
269
460
163
234
861
3,640
Number
$0
$2,791,280
$4,298,720
$7,309,700
$1,803,780
$316,960
$1,153,548
$1,951,981
$3,864,024
$995,488
$115,980,185
$3,680,072
$944,402
$1,490,688
$2,756,981
$13,077,340
$2,148,829
$841,698
$2,994,558
$40,526,378
Total $
Standard Deviation and Number of Stays, Age Group 15 to 44, by Selected Clinical Chapters or
Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005
Appendices
93
$9,790
$12,672
$4,441
$27,599
$12,438
$5,272
$11,034
$4,052
$6,964
$6,632
$8,238
$6,443
$7,036
$6,628
$3,689
$6,024
$10,204
$5,345
$21,220
$7,308
$4,125
$4,927
Malignant neoplasms of eye, brain and other
parts of central nervous system
endocrine glands
Malignant neoplasms of lymphoid,
hematopoietic and related tissue
Carcinoma in situ
Leiomyoma of uterus
immune mechanism
Anemias
Agranulocytosis
metabolic diseases
Diabetes mellitus
Malnutrition
Cystic fibrosis
Unit $
6,068
5,458
13,084
33,092
4,136
14,208
15,566
2,095
17,019
7,651
8,962
27,454
14,271
16,107
1,599
6,890
5,770
20,870
33,832
5,825
12,317
24,034
SD
6,616
5,265
69,348
690
1,312
45
6,420
1,237
11,655
123
877
519
1,650
3,273
5,133
87
526
2,446
1,575
1,447
702
125
Number
$32,597,032
$21,718,125
$506,771,167
$14,641,800
$7,012,640
$459,180
$38,674,080
$4,563,293
$77,244,376
$865,428
$5,650,511
$4,275,522
$10,942,800
$22,791,837
$20,798,916
$959,958
$2,773,072
$30,423,348
$43,468,425
$6,426,127
$8,895,744
$1,223,750
Total $
Clinical Chapters
$4,932
$4,356
$7,227
$17,814
$6,878
$13,331
$5,720
$3,874
$6,880
$6,054
$7,263
$7,087
$6,994
$6,938
$0
$14,130
$31,727
$11,981
$25,899
$4,808
$12,842
$4,889
Unit $
5,924
5,855
12,822
23,965
7,996
19,496
13,399
1,777
15,944
5,752
9,395
12,560
17,757
14,715
0
7,565
30,480
19,081
31,175
5,724
12,303
5,940
SD
4,204
3,472
35,180
306
128
18
3,462
184
4,864
66
345
219
670
1,350
0
39
6
1,277
895
236
388
84
Number
$20,734,128
$15,124,032
$254,237,927
$5,451,084
$880,384
$239,958
$19,802,640
$712,816
$33,463,007
$399,564
$2,505,735
$1,552,053
$4,685,980
$9,366,182
$0
$551,070
$190,362
$15,299,737
$23,179,605
$1,134,688
$4,982,696
$410,676
Total $
$4,917
$3,517
$7,373
$24,280
$5,136
$7,077
$6,380
$3,656
$6,449
$8,083
$5,806
$9,389
$6,315
$6,901
$4,052
$8,415
$4,763
$12,956
$29,876
$4,363
$12,456
$19,215
Unit $
6,354
4,189
13,346
39,367
3,283
6,307
17,784
2,148
17,764
9,358
8,595
36,844
10,322
17,238
1,599
5,089
3,209
22,741
37,029
5,850
12,381
39,476
SD
2,412
1,793
34,167
384
1,184
27
2,958
1,053
6,791
57
532
300
980
1,923
5,133
48
520
1,169
680
1,211
314
41
Number
$11,859,804
$6,305,981
$251,928,006
$9,323,520
$6,081,024
$191,079
$18,872,040
$3,849,768
$43,792,918
$460,731
$3,088,792
$2,816,700
$6,188,700
$13,270,153
$20,798,916
$403,920
$2,476,760
$15,145,564
$20,315,680
$5,283,593
$3,911,184
$787,815
Total $
Appendix D-4. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard Deviation and Number of Stays, Age Group
15 to 44, by Selected Clinical Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
94
$10,250
$7,826
$3,940
$3,984
$8,548
$14,226
$29,740
$9,332
$10,247
$8,521
$2,659
$7,186
$7,613
$6,295
$2,987
$3,907
$3,113
$2,517
$2,019
$3,847
$2,722
$3,311
$2,753
Multiple sclerosis
Epilepsy
related syndromes
Glaucoma
Unit $
2,140
2,454
1,434
6,146
1,189
1,197
2,433
3,661
2,819
8,291
8,999
14,687
2,262
12,301
19,104
8,774
57,265
19,478
18,416
6,468
9,143
11,142
16,882
SD
41
38
49
86
42
428
131
177
1,066
196
175
222
193
2,554
508
132
63
485
7,844
3,216
9,401
24,597
16,874
Number
$112,873
$125,818
$133,378
$330,842
$84,798
$1,077,276
$407,803
$691,539
$3,184,646
$1,233,820
$1,332,275
$1,595,292
$513,187
$21,762,634
$5,205,476
$1,231,824
$1,873,620
$6,899,610
$67,051,822
$12,812,544
$37,039,940
$192,496,122
$172,958,500
Total $
Clinical Chapters
$2,268
$2,100
$1,916
$4,688
$1,507
$2,535
$3,047
$4,789
$3,066
$7,878
$14,868
$4,923
$2,367
$8,940
$7,309
$9,390
$9,373
$15,148
$8,977
$4,028
$3,800
$7,870
$9,960
Unit $
1,966
1,740
1,244
7,455
1,015
1,228
1,972
4,798
3,392
10,991
14,709
3,715
1,706
13,408
8,871
10,231
10,207
18,505
19,464
6,778
6,279
9,869
17,779
SD
17
21
18
58
26
289
72
85
634
99
69
112
101
1,396
142
61
28
248
3,907
1,198
3,956
10,031
11,048
Number
$38,556
$44,100
$34,488
$271,904
$39,182
$732,615
$219,384
$407,065
$1,943,927
$779,922
$1,025,892
$551,376
$239,067
$12,480,240
$1,037,878
$572,790
$262,444
$3,756,704
$35,073,577
$4,825,544
$15,032,800
$78,943,970
$110,038,080
Total $
$3,157
$4,523
$3,089
$2,277
$2,750
$2,486
$3,163
$3,071
$2,854
$4,712
$5,260
$9,448
$3,048
$8,076
$11,816
$9,272
$43,318
$13,262
$8,282
$3,961
$4,049
$7,797
$10,772
Unit $
2,368
2,692
1,392
1,349
1,034
1,146
2,794
1,853
1,613
3,803
4,124
20,323
2,838
11,008
22,644
7,250
71,601
20,539
17,425
6,309
10,862
11,934
15,124
SD
24
17
31
28
16
139
59
92
432
97
106
110
92
1,157
366
71
35
237
3,936
2,017
5,445
14,566
5,826
Number
$75,768
$76,891
$95,759
$63,756
$44,000
$345,554
$186,617
$282,532
$1,233,132
$457,064
$557,560
$1,039,280
$280,416
$9,343,932
$4,324,656
$658,312
$1,516,130
$3,143,094
$32,599,154
$7,989,337
$22,046,805
$113,571,102
$62,757,672
Total $
Appendices
95
$3,367
$3,817
$2,969
$2,121
$7,154
$10,211
$19,284
$11,360
$4,466
$9,304
$9,496
$6,901
$18,454
$25,400
$5,078
$12,755
$6,304
$17,245
$10,524
$3,486
$6,344
$2,352
$6,537
$2,410
$1,427
$2,376
Angina pectoris
AMI (heart attack)
Pulmonary HD
Cardiomyopathy
Atrial fibrillation
Heart failure
Atherosclerosis
Pneumonia
Unit $
2,676
494
1,610
12,799
2,911
25,712
3,447
6,512
29,897
10,113
19,403
6,193
38,083
71,847
13,500
7,229
11,199
4,223
21,250
10,858
28,711
10,521
1,512
1,655
4,866
4,518
SD
3,133
2,501
462
5,013
2,787
22,163
295
63
1,500
1,786
549
910
366
1,474
992
1,755
2,250
1,250
738
105
16,559
80
397
667
124
1,353
Number
$7,444,008
$3,568,927
$1,113,420
$32,769,981
$6,555,024
$140,598,439
$1,028,370
$663,012
$25,867,500
$11,258,944
$7,002,495
$4,620,980
$9,296,400
$27,201,196
$6,845,792
$16,665,480
$20,934,000
$5,582,500
$8,383,680
$2,024,820
$169,078,609
$572,320
$842,037
$1,980,323
$473,308
$4,555,383
Total $
Chapter VIII—Diseases of the ear and
mastoid process
Clinical Chapters
$2,194
$1,452
$2,213
$7,339
$2,638
$7,064
$4,611
$9,260
$15,881
$6,833
$10,402
$4,963
$23,852
$14,747
$9,058
$9,633
$8,876
$4,675
$12,845
$22,421
$9,914
$10,561
$2,003
$3,140
$5,954
$3,955
Unit $
2,368
522
1,045
14,956
3,570
25,497
5,610
6,112
24,320
10,442
13,402
6,482
31,195
27,221
18,721
7,300
9,918
4,431
25,376
9,695
17,516
12,750
974
1,918
6,975
5,300
SD
1,768
824
183
2,701
1,182
10,581
98
32
756
853
304
716
259
1,015
407
1,432
1,852
902
419
43
10,343
37
137
349
44
617
Number
$3,878,992
$1,196,448
$404,979
$19,822,639
$3,118,116
$74,740,649
$451,878
$296,320
$12,006,036
$5,828,549
$3,162,208
$3,553,508
$6,177,668
$14,968,205
$3,686,606
$13,794,456
$16,438,352
$4,216,850
$5,382,055
$964,103
$102,542,459
$390,757
$274,411
$1,095,860
$261,976
$2,439,954
Total $
6,458
6,888
16,048
3,635
14,344
11,206
40,846
711
1,894
1,163
1,299
3,225
SD
$2,616
$1,404
$2,635
$5,389
$2,096
$5,636
$2,923
$12,210
$18,672
$5,900
$16,416
$5,559
$29,560
3,025
469
2,099
8,719
2,135
25,959
1,817
7,955
34,787
9,849
25,848
4,860
52,725
$27,314 125,329
$5,169
$8,851
$11,441
$3,936
$9,469
$17,664
$10,759
$2,042
$2,233
$2,729
$2,291
$2,693
Unit $
1,365
1,677
279
2,312
1,605
11,582
197
31
744
933
245
194
107
459
585
323
398
348
319
62
6,216
43
260
317
80
735
Number
$3,570,840
$2,354,508
$735,165
$12,459,368
$3,364,080
$65,275,413
$575,831
$378,510
$13,891,968
$5,504,700
$4,021,920
$1,078,446
$3,162,920
$12,537,126
$3,023,865
$2,858,873
$4,553,518
$1,369,728
$3,020,611
$1,095,168
$66,876,887
$87,806
$580,580
$865,093
$183,280
$1,979,609
Total $
96
$9,137
$2,784
$74,038
$5,378
$5,590
$5,090
$4,783
$4,493
$4,087
$3,189
$2,528
$4,557
$8,861
$4,551
$5,711
$4,755
$3,247
$11,128
$11,813
$21,637
$3,559
$5,483
$7,844
$5,942
$4,565
Asthma
Peptic ulcer
and duodenum
Inguinal hernia
Cholelithiasis
subcutaneous tissue
Unit $
6,412
13,403
30,431
7,715
3,918
49,285
19,031
23,549
4,471
8,179
8,971
16,321
15,810
4,816
1,256
2,839
5,668
5,553
8,469
10,308
4,347
15,902
69,720
5,410
24,397
SD
4,443
5,801
4,079
1,811
9,124
771
557
1,626
1,848
1,903
3,029
3,393
5,692
2,487
2,581
12,897
1,872
1,045
1,478
643
3,382
63,138
135
3,326
1,077
Number
$20,282,295
$34,469,025
$31,995,676
$9,929,713
$32,472,316
$16,682,127
$6,579,841
$18,094,128
$6,000,456
$9,048,765
$17,298,619
$15,441,543
$50,436,812
$11,333,259
$6,524,768
$41,128,533
$7,650,864
$4,695,185
$7,069,274
$3,272,870
$18,905,380
$339,549,489
$9,995,130
$9,259,584
$9,840,549
Total $
Clinical Chapters
$4,421
$6,054
$9,695
$6,523
$4,521
$22,752
$9,942
$11,841
$2,930
$4,942
$4,995
$3,457
$9,175
$4,633
$2,504
$3,125
$2,899
$4,416
$4,863
$5,784
$5,189
$5,306
$57,775
$3,022
$8,492
Unit $
6,024
14,248
39,247
9,037
6,710
60,561
17,159
16,342
3,620
9,200
6,173
5,901
13,112
6,109
1,259
2,303
4,036
5,859
9,613
11,447
4,044
16,120
42,035
8,177
15,681
SD
2,631
3,307
2,122
534
1,757
388
321
556
1,108
1,275
1,450
1,296
2,604
1,092
2,421
7,188
913
713
851
345
1,351
29,683
60
1,080
454
Number
$11,631,651
$20,021,277
$20,572,790
$3,483,282
$7,943,397
$8,827,776
$3,191,382
$6,583,596
$3,246,440
$6,301,050
$7,242,750
$4,480,272
$23,891,700
$5,059,236
$6,062,184
$22,462,500
$2,646,787
$3,148,608
$4,138,413
$1,995,480
$7,010,339
$157,486,822
$3,466,500
$3,263,760
$3,855,368
Total $
$4,786
$5,876
$5,895
$4,856
$3,290
$20,312
$13,881
$10,612
$3,739
$4,249
$6,310
$5,267
$8,595
$4,501
$3,015
$3,274
$5,021
$4,678
$4,640
$4,221
$5,857
$5,402
$87,799
$2,660
$9,729
Unit $
6,978
12,109
16,533
6,749
2,596
31,236
20,859
27,661
5,515
4,350
10,737
20,436
17,784
3,591
1,249
3,419
6,541
4,775
5,954
8,679
4,521
15,692
85,884
3,115
30,349
SD
1,812
2,494
1,957
1,277
7,367
383
236
1,070
739
627
1,579
2,097
3,088
1,394
160
5,709
959
332
627
298
2,031
33,452
75
2,246
623
Number
$8,672,232
$14,653,972
$11,536,515
$6,201,112
$24,237,430
$7,779,496
$3,275,916
$11,354,840
$2,763,121
$2,664,123
$9,963,490
$11,044,899
$26,541,360
$6,274,394
$482,400
$18,691,266
$4,815,139
$1,553,096
$2,909,280
$1,257,858
$11,895,567
$180,715,476
$6,584,925
$5,974,360
$6,061,167
Total $
Appendices
97
Unit $
$3,141
$5,812
$27,342
$5,894
$10,787
$6,618
$3,420
$4,504
$13,816
$13,741
$4,914
$3,524
$5,887
$6,511
$3,723
$3,903
$14,814
$2,404
$4,893
$2,354
$2,516
$3,187
$2,922
$3,827
$3,350
Decubitus ulcers
Coxarthrosis
Gonarthrosis
Other arthropathies
Dorsalgia
Renal failure
Urolithiasis
Disorders of breast
genital conditions
1,496
1,813
2,825
1,167
3,061
214
7,163
2,410
18,413
4,663
5,709
7,071
13,226
3,484
3,529
11,479
22,264
4,446
1,570
3,295
4,537
8,632
29,296
17,043
SD
4,941
9,428
1,322
2,508
3,897
851
18
3,083
4,976
1,004
4,559
39,050
2,838
1,952
1,442
4,629
1,141
641
3,916
2,274
388
608
19,829
303
291
Number
260
$31,583,800
$5,059,294
$7,328,376
$12,419,739
$2,141,116
$42,372
$15,085,119
$11,962,304
$14,873,256
$17,793,777
$145,366,280
$18,478,218
$11,491,424
$5,081,608
$22,746,906
$15,678,481
$8,856,056
$17,637,664
$7,777,080
$2,567,784
$6,558,496
$116,873,717
$8,284,626
$1,691,292
Total $
$816,660
Clinical Chapters
$0
$0
$0
$2,707
$2,516
$2,354
$5,743
$2,383
$15,603
$4,978
$4,668
$6,370
$5,986
$2,668
$4,709
$11,776
$9,257
$4,650
$3,443
$5,887
$10,833
$5,475
$25,793
$3,059
Unit $
$2,704
0
0
0
1,846
3,061
214
9,024
2,733
19,808
5,964
9,963
7,362
14,430
2,006
3,660
10,518
12,162
4,232
1,575
3,403
4,508
7,236
27,961
3,386
SD
2,870
0
0
0
87
851
18
766
2,502
601
1,232
6,101
1,814
1,152
670
2,592
586
145
1,962
1,400
208
335
10,864
236
102
Number
117
$0
$0
$0
$235,509
$2,141,116
$42,372
$4,399,138
$5,962,266
$9,377,403
$6,132,896
$28,480,736
$11,555,180
$6,895,872
$1,787,560
$12,205,728
$6,900,736
$1,342,265
$9,123,300
$4,820,200
$1,224,496
$3,629,055
$59,484,392
$6,087,148
$312,018
Total $
$316,368
$3,350
$3,827
$2,922
$3,203
$0
$0
$4,438
$2,427
$13,774
$3,401
$3,526
$6,825
$5,726
$4,303
$5,174
$15,681
$14,820
$4,370
$3,383
$7,551
$10,739
$6,388
$36,979
$7,027
Unit $
$3,496
1,496
1,813
2,825
1,138
0
0
5,898
1,977
16,409
3,810
4,178
6,376
11,074
4,277
3,342
12,060
23,827
4,635
1,566
2,926
4,590
10,014
36,885
20,303
SD
6,217
9,428
1,322
2,508
3,809
0
0
2,317
2,473
403
3,327
32,947
1,024
800
772
2,037
555
496
1,954
874
180
273
8,965
67
189
Number
143
$31,583,800
$5,059,294
$7,328,376
$12,200,227
$0
$0
$10,282,846
$6,001,971
$5,550,922
$11,315,127
$116,177,248
$6,988,800
$4,580,800
$3,321,916
$10,539,438
$8,702,955
$7,350,720
$8,538,980
$2,956,742
$1,359,180
$2,931,747
$57,271,278
$2,477,593
$1,328,103
Total $
$499,928
98
$3,652
$2,732
$3,146
$1,709
$3,045
$2,709
$1,985
$3,493
$8,635
$12,708
$13,390
$3,293
$2,631
$6,706
$2,517
$4,396
$3,580
$2,818
$4,613
Chapter XV—Pregnancy, childbirth and the
puerperium
Medical abortion
Complications predominantly related to the
puerperium
Chapter XVII—Congenital malformations,
deformations and chromosomal abnormalities
Unit $
9,563
4,038
3,857
8,464
3,492
28,172
2,178
8,959
17,691
18,743
13,554
5,015
961
1,888
2,749
2,119
2,552
2,425
3,452
SD
4,754
1,408
405
1,902
11,617
1,315
4,451
26,581
482
134
1,953
2,029
23,883
157,322
108,265
12,085
1,429
313,946
7,107
Number
$21,930,202
$3,967,744
$1,449,900
$8,361,192
$29,239,989
$8,818,390
$11,710,581
$87,531,384
$6,453,980
$1,702,872
$16,863,804
$7,087,297
$47,407,755
$426,185,298
$329,666,925
$20,653,265
$4,495,634
$857,748,277
$25,954,764
Total $
Other noninflammatory disorders of female
genital tract
Clinical Chapters
$4,485
$2,939
$3,290
$4,595
$2,335
$2,790
$2,685
$3,107
$12,088
$8,680
$8,285
$0
$0
$0
$0
$0
$0
$0
$0
Unit $
0
0
0
0
0
0
0
0
6,762
5,180
3,871
7,420
3,835
2,709
2,155
4,901
9,174
5,468
9,140
SD
2,262
691
168
662
3,101
697
2,766
10,651
230
56
952
0
0
0
0
0
0
0
0
Number
$10,145,070
$2,030,849
$552,720
$3,041,890
$7,240,835
$1,944,630
$7,426,710
$33,092,083
$2,780,240
$486,080
$7,887,707
$0
$0
$0
$0
$0
$0
$0
$0
Total $
$4,721
$2,680
$3,836
$4,302
$2,576
$10,068
$2,532
$3,368
$14,669
$15,393
$9,023
$3,493
$1,985
$2,709
$3,045
$1,709
$3,146
$2,732
$3,652
Unit $
11,414
2,115
3,883
8,931
3,374
38,072
2,221
10,800
23,174
23,515
16,697
5,015
961
1,888
2,749
2,119
2,552
2,425
3,452
SD
2,492
717
237
1,240
8,515
618
1,685
15,929
252
78
1,000
2,029
23,883
157,322
108,265
12,085
1,429
313,946
7,107
Number
$11,764,732
$1,921,560
$909,132
$5,334,480
$21,934,640
$6,222,024
$4,266,420
$53,655,015
$3,696,588
$1,200,654
$9,022,955
$7,087,297
$47,407,755
$426,185,298
$329,666,925
$20,653,265
$4,495,634
$857,748,277
$25,954,764
Total $
Appendices
99
$7,300
$19,831
$6,050
$13,983
$8,835
$9,333
$6,108
$4,477
$4,381
$3,778
$12,112
$5,083
$5,147
$4,460
$5,285
$10,637
$2,763
$3,574
$21,174
$21,122
$3,996
$5,223
Intracranial injury
Fracture of forearm
Fracture of femur
Injuries to unspecified parts of trunk, limb or
body region
Effects of foreign body entering through
natural orifice
Frostbite
as to source
Unit $
7,027
7,824
32,041
61,263
7,769
2,483
17,693
6,352
8,323
6,474
8,375
17,630
4,502
6,551
8,933
9,052
22,026
16,072
34,768
11,441
36,748
18,121
SD
810
7,209
91
855
345
128
347
1,399
1,806
8,924
528
1,292
2,631
564
3,103
2,005
4,395
2,645
1,311
5,201
3,017
58,940
Number
$4,230,630
$28,807,164
$1,922,102
$18,103,770
$1,233,030
$353,664
$3,691,039
$7,393,715
$8,054,760
$45,931,828
$2,683,824
$15,648,704
$9,939,918
$2,470,884
$13,892,131
$12,246,540
$41,018,535
$23,368,575
$18,331,713
$31,466,050
$59,830,127
$430,275,866
Total $
Clinical Chapters
$6,099
$4,558
$18,558
$21,536
$2,860
$3,501
$12,884
$5,330
$4,700
$5,113
$5,238
$11,909
$3,761
$4,473
$4,672
$6,032
$9,886
$8,158
$14,422
$5,938
$20,041
$7,716
Unit $
7,957
9,377
30,749
65,442
7,829
2,440
19,845
6,225
9,230
6,227
9,035
18,723
4,422
6,913
8,854
9,470
24,436
13,229
36,957
11,436
36,983
19,261
SD
499
2,749
73
691
232
77
231
1,114
1,358
6,081
414
988
2,143
452
2,147
1,493
3,080
2,124
911
4,309
2,331
37,957
Number
$3,043,401
$12,529,942
$1,354,734
$14,881,376
$663,520
$269,577
$2,976,204
$5,937,620
$6,382,600
$31,092,153
$2,168,532
$11,766,092
$8,059,823
$2,021,796
$10,030,784
$9,005,776
$30,448,880
$17,327,592
$13,138,442
$25,586,842
$46,715,571
$292,860,868
Total $
$3,755
$3,586
$41,637
$18,825
$4,888
$2,025
$4,047
$5,144
$3,606
$5,222
$4,283
$12,647
$3,847
$3,708
$4,047
$6,375
$7,815
$12,201
$12,670
$6,786
$19,124
$6,519
Unit $
4,845
6,436
46,477
18,960
7,598
2,474
4,300
6,771
3,458
6,990
3,459
14,426
4,834
2,777
9,110
7,464
13,260
25,794
27,371
11,484
36,054
15,448
SD
311
4,460
18
164
113
51
116
285
448
2,843
114
304
488
112
956
512
1,315
521
400
892
686
20,980
Number
$1,167,805
$15,993,560
$749,466
$3,087,300
$552,344
$103,275
$469,452
$1,466,040
$1,615,488
$14,846,146
$488,262
$3,844,688
$1,877,336
$415,296
$3,868,932
$3,264,000
$10,276,725
$6,356,721
$5,068,000
$6,053,112
$13,119,064
$136,764,573
Total $
100
$7,636
$5,742
$5,500
$1,392
$1,913
$4,791
$6,940
$1,775
$7,906
$4,782
for examination and investigation
other circumstances
12,904
41,503
2,930
33,367
7,342
3,476
1,407
25,459
4,876
17,003
17,841
SD
$5,795,098
$252,050
$78,005,600
$18,751,974
$1,497,879
$587,424
$108,167,219
$470,844
$72,442,732
$2,570,321
Total $
710,252 $3,396,307,083
733
142
11,240
3,914
783
422
19,667
82
9,487
227
Number
$6,996
$17,197
$2,122
$9,210
$4,953
$2,393
$1,732
$7,755
$7,047
$8,278
$10,024
Unit $
18,117
65,451
4,663
33,085
7,154
4,710
1,561
26,310
4,928
16,488
13,457
SD
$3,559,779
$140,052
$44,456,670
$9,232,392
$959,593
$290,976
$58,665,664
$415,773
$32,491,150
$1,824,368
Total $
183,225 $1,281,826,990
207
66
4,827
1,864
401
168
7,565
59
3,925
182
Number
-: Data not published due to small cell size.
Notes:
$11,323
Unit $
Certain early complications of trauma,
Clinical Chapters
$3,999
$1,801
$1,563
$5,217
$4,611
$1,501
$1,127
$3,971
$1,825
$7,129
$20,631
Unit $
10,500
2,864
1,098
33,509
7,547
1,782
1,228
24,750
1,556
17,389
37,555
SD
$947,326
$118,788
$33,440,970
$9,452,550
$573,382
$286,258
$48,047,016
$41,975
$39,630,111
$928,395
Total $
527,011 $2,107,582,308
526
76
6,410
2,050
382
254
12,099
23
5,559
45
Number
Appendices
101
$15,778
$7,118
$3,682
$17,415
$24,856
$12,623
$8,002
$16,690
$18,917
$12,049
$10,101
$15,799
$11,963
$11,857
$24,428
$5,336
$18,502
$4,797
$7,037
$9,506
$6,766
$6,109
infectious origin
Tuberculosis
Septicemia
Viral infections characterized by skin and
mucous membrane
Hepatitis
Unit $
9,015
2,773
14,153
6,932
4,692
61,331
4,844
43,067
31,112
13,298
21,292
19,910
23,488
35,311
30,394
14,329
21,756
42,469
23,478
4,673
17,663
31,390
SD
1,391
3,793
1,054
2,038
5,439
512
408
119
4,180
4,757
975
55,720
1,114
415
256
238
160
2,246
200
297
1,403
6,329
Number
$8,497,619
$25,663,438
$10,019,324
$14,341,406
$26,090,883
$9,473,024
$2,177,088
$2,906,932
$49,562,260
$56,907,991
$15,404,025
$562,823,751
$13,422,586
$7,850,555
$4,272,640
$1,904,476
$2,019,680
$55,826,576
$3,483,000
$1,093,554
$9,986,554
$99,859,621
Total $
Clinical Chapters
$6,567
$6,766
$0
$0
$3,638
$20,753
$5,836
$27,280
$12,991
$11,705
$15,343
$12,268
$11,266
$18,312
$20,096
$7,077
$15,022
$22,929
$17,118
$3,961
$8,765
$16,215
Unit $
9,809
2,773
0
0
1,968
80,825
5,186
54,695
41,300
10,379
18,603
25,305
19,845
38,046
37,095
7,472
26,277
40,541
25,009
6,278
24,854
31,730
SD
1,084
3,793
0
0
29
272
242
61
2,209
2,865
722
22,983
613
334
159
114
75
1,222
139
116
545
3,317
Number
$7,118,628
$25,663,438
$0
$0
$105,502
$5,644,816
$1,412,312
$1,664,080
$28,697,119
$33,534,825
$11,077,646
$281,960,724
$6,906,058
$6,116,208
$3,195,264
$806,778
$1,126,650
$28,019,238
$2,379,402
$459,476
$4,776,925
$53,785,999
Total $
$4,713
$0
$9,506
$7,037
$4,802
$15,682
$4,675
$21,772
$10,594
$12,360
$17,212
$8,575
$13,238
$21,391
$12,022
$9,236
$8,945
$27,075
$18,350
$3,522
$5,733
$15,218
Unit $
5,797
0
14,153
6,932
4,700
17,579
4,296
29,150
12,054
16,842
28,097
14,472
28,202
21,169
17,123
20,412
11,864
44,599
18,664
3,578
7,295
30,964
SD
307
0
1,054
2,038
5,410
240
166
58
1,971
1,892
253
32,737
501
81
97
124
85
1,024
61
181
858
3,012
Number
$1,446,891
$0
$10,019,324
$14,341,406
$25,978,820
$3,763,680
$776,050
$1,262,776
$20,880,774
$23,385,120
$4,354,636
$280,730,993
$6,632,238
$1,732,671
$1,166,134
$1,145,264
$760,325
$27,724,800
$1,119,350
$637,482
$4,918,914
$45,837,178
Total $
Standard Deviation and Number of Stays, Age Group 45 to 64, by Selected Clinical Chapters or Medical
102
$13,312
$4,916
$23,124
$12,553
$4,774
$6,431
$4,165
$9,545
$6,614
$5,930
$7,395
$6,023
$14,774
$12,297
$8,643
$3,865
$10,928
$18,340
$4,972
$5,577
$8,846
$15,438
endocrine glands
and related tissue
Carcinoma in situ
Leiomyoma of uterus
Other benign neoplasms and neoplasms of
uncertain or unknown behaviour
immune mechanism
Anemias
Agranulocytosis
diseases
Diabetes mellitus
Malnutrition
Dementia
Unit $
16,317
12,788
10,744
4,420
22,362
18,361
2,797
16,307
15,170
40,538
11,172
12,424
9,356
13,856
30,017
1,714
3,531
3,214
15,592
27,622
7,553
15,041
SD
203
33,081
2,979
696
94
8,150
1,645
14,384
114
167
1,866
556
1,965
4,668
5,799
5,716
520
958
11,902
3,553
1,376
1,230
Number
$3,133,914
$292,649,541
$16,613,883
$3,460,512
$1,723,960
$89,063,200
$6,357,925
$124,323,056
$1,401,858
$2,467,258
$11,238,918
$4,111,620
$11,652,450
$30,872,104
$55,351,455
$23,807,140
$3,344,120
$4,573,492
$149,405,806
$82,159,572
$6,764,416
$16,373,760
Total $
Clinical Chapters
$18,586
$8,869
$6,134
$6,772
$12,357
$11,169
$4,590
$9,921
$13,749
$23,118
$6,170
$6,330
$7,394
$7,650
$12,157
$0
$6,683
$5,651
$12,948
$23,447
$6,287
$12,385
Unit $
19,496
14,741
13,221
3,786
14,972
19,603
4,935
20,383
17,746
61,384
11,355
9,101
12,615
17,771
44,162
0
3,527
4,188
16,275
29,007
10,755
13,371
SD
116
15,747
1,313
97
38
4,922
293
7,021
57
77
639
280
873
1,926
1,761
0
272
111
6,370
2,109
353
730
Number
$2,155,976
$139,655,536
$8,053,942
$656,884
$469,566
$54,973,818
$1,344,870
$69,654,164
$783,693
$1,780,086
$3,942,630
$1,772,400
$6,454,962
$14,733,771
$21,408,477
$0
$1,817,776
$627,261
$82,478,760
$49,449,723
$2,219,311
$9,041,050
Total $
$14,179
$8,859
$5,052
$4,845
$26,118
$10,533
$3,665
$7,435
$11,249
$8,516
$5,949
$8,429
$4,716
$5,902
$8,383
$4,165
$6,113
$4,663
$12,085
$22,649
$4,407
$14,661
Unit $
15,235
11,013
7,699
4,452
28,296
16,129
1,769
11,211
13,449
6,542
11,097
14,958
5,034
10,385
20,763
1,714
3,554
3,063
14,733
25,467
5,878
17,131
SD
87
17,334
1,666
599
56
3,228
1,352
7,363
57
90
1,227
276
1,092
2,742
4,038
5,716
248
847
5,532
1,444
1,023
500
Number
$1,233,573
$153,559,899
$8,416,632
$2,902,155
$1,462,608
$34,000,524
$4,955,080
$54,741,707
$641,193
$766,440
$7,299,423
$2,326,404
$5,149,872
$16,183,332
$33,850,554
$23,807,140
$1,516,024
$3,949,561
$66,854,220
$32,705,156
$4,508,361
$7,330,500
Total $
Appendices
103
$6,417
$5,484
$12,003
$9,459
$4,385
$4,887
$12,256
$10,279
$27,476
$10,093
$16,133
$29,131
$9,139
$7,924
$2,872
$15,739
$16,288
$7,417
$11,193
$2,734
$2,613
$5,552
$2,630
$2,438
Multiple sclerosis
Epilepsy
related syndromes
Cataract
Unit $
977
1,033
6,656
1,425
2,067
26,285
9,874
38,164
56,618
2,593
9,558
12,071
38,852
23,680
10,748
48,301
26,727
25,886
13,685
6,385
10,448
14,584
7,585
12,438
SD
1,481
52
116
173
2,357
3,140
197
162
338
1,443
1,795
574
90
365
219
387
8,710
973
793
3,619
14,000
7,148
1,172
5,173
Number
$3,610,678
$136,760
$644,032
$452,049
$6,443,739
$35,146,020
$1,461,149
$2,638,656
$5,319,782
$4,144,296
$14,223,580
$5,245,786
$2,621,790
$5,888,545
$2,210,367
$10,633,212
$89,533,183
$11,925,088
$3,875,391
$15,869,315
$132,426,000
$85,797,444
$6,427,248
$33,195,141
Total $
Clinical Chapters
$2,444
$2,294
$4,105
$2,720
$2,634
$12,515
$5,486
$12,524
$18,285
$2,784
$7,543
$10,477
$17,396
$14,920
$12,507
$33,277
$10,706
$13,326
$7,063
$4,344
$9,564
$11,907
$4,357
$6,845
Unit $
996
939
4,776
1,716
1,820
30,768
8,039
19,103
77,808
2,261
9,508
15,263
412
13,567
12,353
61,034
31,815
32,977
22,168
4,947
11,293
16,497
4,568
13,828
SD
938
26
61
62
1,408
1,724
111
91
216
833
1,081
220
44
195
130
194
4,839
518
277
1,432
5,597
3,391
689
3,727
Number
$2,292,472
$59,644
$250,405
$168,640
$3,708,024
$21,575,860
$608,946
$1,139,684
$3,949,560
$2,319,072
$8,153,983
$2,304,940
$765,424
$2,909,400
$1,625,910
$6,455,738
$51,808,517
$6,902,868
$1,956,451
$6,220,608
$53,529,708
$40,376,637
$3,001,973
$25,511,315
Total $
$2,429
$3,017
$7,083
$2,555
$2,852
$9,484
$9,699
$19,148
$13,128
$2,983
$8,383
$8,077
$32,064
$17,530
$5,668
$19,639
$9,465
$11,356
$3,800
$4,412
$9,395
$12,079
$6,856
$5,471
Unit $
943
1,019
8,027
1,273
2,393
18,892
11,636
48,112
18,756
2,970
9,628
8,721
43,452
31,715
4,329
19,297
18,888
17,970
5,846
7,190
9,904
12,892
9,962
8,556
SD
543
26
55
111
949
1,416
86
71
122
610
714
354
46
170
89
193
3,871
455
516
2,187
8,403
3,757
483
1,446
Number
$1,318,947
$78,442
$389,565
$283,605
$2,706,281
$13,429,344
$834,114
$1,359,508
$1,601,616
$1,819,630
$5,985,462
$2,859,258
$1,474,944
$2,980,100
$504,452
$3,790,327
$36,638,755
$5,166,980
$1,960,800
$9,649,044
$78,946,185
$45,380,803
$3,311,448
$7,911,066
Total $
104
$2,522
$2,543
$2,985
$3,156
$4,678
$4,247
$2,633
$3,145
$2,239
$21,406
$11,934
$11,105
$32,936
$10,907
$5,811
$10,271
$11,911
$7,674
$19,117
$23,080
$5,103
$11,601
$10,616
$16,560
$11,967
Chapter VIII—Diseases of the ear and
mastoid process
Angina pectoris
AMI (heart attack)
Pulmonary HD
Cardiomyopathy
Atrial fibrillation
Heart failure
Atherosclerosis
Unit $
13,322
26,362
14,748
21,232
8,891
44,128
25,294
14,018
13,249
13,038
9,764
18,010
55,281
19,446
14,019
14,473
1,418
2,758
1,074
7,509
6,434
2,178
1,210
2,364
1,734
SD
1,100
7,460
3,746
5,619
4,786
819
2,479
1,858
19,929
15,146
11,111
1,820
448
82,901
73
103
866
398
94
1,534
57
54
38
211
86
Number
$13,163,700
$123,537,600
$39,767,536
$65,186,019
$24,422,958
$18,902,520
$47,391,043
$14,258,292
$237,374,319
$155,564,566
$64,566,021
$19,850,740
$14,755,328
$920,595,887
$871,182
$2,204,818
$1,938,974
$1,251,710
$247,502
$6,514,186
$266,646
$170,424
$113,430
$536,573
$216,892
Total $
Glaucoma
Clinical Chapters
$12,863
$14,385
$13,330
$12,243
$5,203
$22,740
$18,354
$7,539
$12,060
$10,212
$6,034
$9,749
$37,941
$11,113
$7,887
$21,527
$2,214
$3,264
$2,414
$3,889
$2,463
$2,589
$3,314
$2,935
$2,360
Unit $
15,456
24,787
16,787
22,886
9,422
35,559
18,625
14,935
12,071
11,613
11,016
15,306
68,423
17,754
11,897
15,172
1,361
2,287
1,152
6,267
1,603
1,445
1,058
2,938
1,300
SD
747
4,471
2,127
3,625
3,206
597
1,731
963
15,873
11,674
7,515
948
208
57,770
27
41
382
209
41
700
36
36
25
130
46
Number
$9,608,661
$64,315,335
$28,352,910
$44,380,875
$16,680,818
$13,575,780
$31,770,774
$7,260,057
$191,428,380
$119,214,888
$45,345,510
$9,242,052
$7,891,728
$641,989,928
$212,949
$882,607
$845,748
$682,176
$98,974
$2,722,454
$88,668
$93,204
$82,850
$381,550
$108,560
Total $
$10,353
$19,518
$7,708
$10,314
$4,897
$23,904
$20,990
$7,814
$11,223
$10,494
$5,229
$12,746
$29,091
$11,129
$15,048
$21,321
$2,262
$2,979
$3,146
$4,603
$6,893
$4,176
$2,409
$1,989
$2,696
Unit $
8,041
28,100
11,486
17,413
7,698
60,388
36,862
13,028
17,695
17,426
5,216
21,558
42,464
23,219
15,119
14,795
1,480
3,331
773
8,620
8,616
3,007
1,366
883
2,147
SD
353
2,989
1,619
1,994
1,580
222
748
895
4,056
3,472
3,596
872
240
25,130
46
62
484
189
53
834
21
18
13
81
40
Number
$3,654,609
$58,339,302
$12,479,252
$20,566,116
$7,737,260
$5,306,688
$15,700,520
$6,993,530
$45,520,488
$36,435,168
$18,803,484
$11,114,512
$6,981,840
$279,666,881
$692,208
$1,321,902
$1,094,808
$563,031
$166,738
$3,838,687
$144,753
$75,168
$31,317
$161,109
$107,840
Total $
Appendices
105
$7,759
$11,448
$4,595
$9,412
$3,860
$1,972
$3,036
$8,563
$3,688
$94,817
$23,013
$6,835
$4,160
$5,054
$5,939
$6,393
$6,425
$4,129
$2,945
$5,432
$9,939
$4,132
$6,146
Pneumonia
Asthma
Peptic ulcer
and duodenum
Inguinal hernia
Paralytic ileus and intestinal obstruction
without hernia
Unit $
12,701
5,161
11,899
9,461
2,469
3,517
13,863
15,665
10,642
7,241
3,584
19,153
52,627
101,728
8,294
23,740
4,825
1,266
6,939
22,535
8,897
36,819
22,034
SD
6,272
2,921
2,278
5,604
4,522
4,460
2,027
2,191
2,157
502
712
68,267
6,050
256
2,265
10,239
1,712
110
764
7,814
1,029
30,239
463
Number
$38,547,712
$12,069,572
$22,641,042
$30,440,928
$13,317,290
$18,415,340
$13,023,475
$14,007,063
$12,810,423
$2,537,108
$2,961,920
$466,586,700
$139,228,650
$24,273,152
$8,353,320
$87,676,557
$5,197,632
$216,920
$2,949,040
$73,545,368
$4,728,255
$346,168,894
$3,592,417
Total $
Clinical Chapters
6,214
31,087
3,758
1,823
9,233
23,988
10,965
40,962
3,631
SD
$5,907
$4,159
$9,830
$5,241
$2,902
$4,250
$4,778
$5,998
$5,310
$6,557
$3,421
$6,839
$23,782
15,103
5,049
9,714
5,713
2,469
4,000
5,677
11,391
9,154
9,154
2,746
20,051
55,141
$100,159 107,973
$3,679
$9,701
$2,737
$2,585
$5,463
$9,286
$5,154
$12,524
$3,558
Unit $
2,883
1,104
1,077
2,619
4,299
2,190
1,018
1,469
1,135
262
255
35,733
3,360
118
610
4,707
1,027
38
315
4,141
464
14,780
177
Number
$17,029,881
$4,591,536
$10,586,910
$13,726,179
$12,475,698
$9,307,500
$4,864,004
$8,811,062
$6,026,850
$1,717,934
$872,355
$244,384,373
$79,907,520
$11,818,762
$2,244,190
$45,662,607
$2,810,899
$98,230
$1,720,845
$38,453,326
$2,391,456
$185,107,835
$629,766
Total $
$6,360
$4,108
$10,052
$5,608
$3,549
$4,005
$7,776
$7,259
$6,850
$3,156
$4,494
$6,804
$22,009
$88,139
$3,692
$7,560
$3,459
$1,767
$2,068
$9,569
$4,017
$10,359
$15,812
Unit $
10,091
5,279
13,831
11,910
2,470
2,940
17,902
22,372
12,461
2,578
3,863
18,088
49,169
94,846
9,034
14,397
6,006
1,160
1,529
20,588
6,106
31,734
36,773
SD
3,389
1,817
1,201
2,985
223
2,270
1,009
722
1,022
240
457
32,534
2,690
138
1,655
5,532
685
72
449
3,673
565
15,459
286
Number
$21,554,040
$7,464,236
$12,072,452
$16,739,880
$791,427
$9,091,350
$7,845,984
$5,240,998
$7,000,700
$757,440
$2,053,758
$221,376,047
$59,204,210
$12,163,182
$6,110,260
$41,821,920
$2,369,415
$127,224
$928,532
$35,146,937
$2,269,605
$160,141,285
$4,522,232
Total $
106
$5,296
$4,452
$13,283
$15,271
$22,475
$4,529
$6,474
$8,593
$7,723
$7,266
$5,373
$4,324
$5,300
$36,270
$7,887
$9,876
$8,161
$2,906
$5,919
$20,482
$10,814
$6,109
$4,269
$5,452
Cholelithiasis
subcutaneous tissue
Decubitus ulcers
Coxarthrosis
Gonarthrosis
Other arthropathies
Dorsalgia
Unit $
12,548
3,593
5,293
14,282
36,048
7,266
1,606
3,051
3,961
10,918
41,146
7,569
3,923
6,398
16,042
15,079
26,841
10,389
12,210
50,250
30,809
24,830
9,047
5,899
SD
3,997
1,700
3,954
2,915
592
5,033
434
8,574
5,294
35,398
321
176
262
4,474
5,787
5,330
5,115
2,348
8,595
2,171
2,219
2,323
1,772
4,748
Number
$21,791,644
$7,257,300
$24,154,986
$31,522,810
$12,125,344
$29,790,327
$1,261,204
$69,972,414
$52,283,544
$279,174,713
$11,642,670
$932,800
$1,132,888
$24,038,802
$42,050,732
$41,163,590
$43,953,195
$15,200,952
$38,926,755
$48,793,225
$33,886,349
$30,856,409
$7,888,944
$25,145,408
Total $
Clinical Chapters
$4,644
$4,377
$5,942
$10,708
$30,776
$6,264
$3,146
$7,958
$9,963
$7,834
$38,110
$6,393
$4,217
$5,156
$7,322
$7,154
$9,917
$7,443
$4,219
$22,008
$15,286
$15,315
$3,354
$5,329
Unit $
9,147
4,212
5,055
17,151
56,706
6,707
1,333
3,120
4,902
12,724
42,608
9,608
3,189
6,349
17,072
14,855
32,791
12,095
3,317
48,452
27,906
27,199
5,405
5,596
SD
2,395
816
2,202
1,575
188
2,076
241
3,420
2,664
17,127
205
69
116
2,626
3,273
2,919
2,961
1,124
3,262
1,286
1,548
917
1,091
2,314
Number
$11,122,380
$3,571,632
$13,084,284
$16,865,100
$5,785,888
$13,004,064
$758,186
$27,216,360
$26,541,432
$134,180,926
$7,812,550
$441,117
$489,172
$13,539,656
$23,966,210
$20,882,526
$29,364,237
$8,365,932
$13,762,378
$28,302,288
$23,662,728
$14,043,855
$3,659,214
$12,331,306
Total $
$6,518
$4,162
$6,327
$10,954
$16,021
$5,700
$2,619
$8,292
$9,783
$7,927
$32,592
$4,353
$4,392
$5,734
$7,279
$8,363
$6,538
$5,345
$4,747
$23,218
$15,235
$11,985
$6,205
$5,264
Unit $
15,913
2,865
5,589
9,228
20,483
7,596
1,867
3,000
2,609
8,877
38,729
5,396
4,398
6,475
14,323
15,318
12,806
7,833
15,703
53,093
37,134
23,147
12,707
6,177
SD
1,602
884
1,752
1,340
404
2,957
193
5,154
2,630
18,271
116
107
146
1,848
2,514
2,411
2,154
1,224
5,333
885
671
1,406
681
2,434
Number
$10,441,836
$3,679,208
$11,084,904
$14,678,360
$6,472,484
$16,854,900
$505,467
$42,736,968
$25,729,290
$144,837,762
$3,780,672
$465,771
$641,232
$10,596,432
$18,300,130
$20,163,193
$14,082,852
$6,542,280
$25,315,751
$20,547,930
$10,222,685
$16,850,910
$4,225,605
$12,812,576
Total $
Appendices
107
$9,988
$4,643
$5,165
$15,201
$2,967
$4,887
$2,955
$6,605
$3,303
$3,847
$3,848
$3,465
$4,352
$5,601
$3,300
$1,648
$3,727
$3,905
$12,349
$14,569
$18,111
Renal failure
Urolithiasis
Disorders of breast
genital conditions
genital tract
Chapter XV—Pregnancy, childbirth and the
puerperium
Unit $
25,327
19,997
19,713
4,491
2,744
2,339
3,416
14,657
2,967
1,802
2,138
3,389
1,528
17,823
1,288
10,218
2,431
28,804
7,494
10,577
17,537
SD
333
80
884
145
200
76
450
980
3,271
4,769
5,267
770
1,970
896
2,420
5,960
5,961
2,094
3,509
37,867
2,905
Number
$6,030,963
$1,165,520
$10,916,863
$566,225
$745,400
$125,248
$1,484,903
$5,488,980
$14,235,392
$16,524,585
$20,267,416
$2,962,190
$6,506,910
$5,918,080
$7,151,100
$29,126,520
$17,686,287
$31,830,894
$18,123,985
$175,822,339
$29,015,140
Total $
Clinical Chapters
$17,256
$12,029
$11,371
$0
$0
$0
$0
$7,477
$0
$0
$0
$0
$2,092
$6,605
$2,955
$5,790
$2,841
$16,225
$5,466
$5,266
$10,472
Unit $
21,096
13,749
16,743
0
0
0
0
21,097
0
0
0
0
747
17,823
1,288
15,154
2,346
34,108
7,644
16,129
19,520
SD
166
27
395
0
0
0
0
158
0
0
0
0
38
896
2,420
1,849
4,099
1,168
1,684
12,312
1,550
Number
$2,864,496
$324,783
$4,491,397
$0
$0
$0
$0
$1,181,366
$0
$0
$0
$0
$79,496
$5,918,080
$7,151,100
$10,705,710
$11,645,259
$18,950,800
$9,204,744
$64,836,555
$16,231,600
Total $
$19,015
$16,328
$12,823
$3,905
$3,727
$1,648
$3,300
$5,274
$4,352
$3,465
$3,848
$3,847
$3,331
$0
$0
$4,292
$3,266
$13,829
$4,890
$4,313
$9,339
Unit $
29,278
23,473
22,067
4,491
2,744
2,339
3,416
13,289
2,967
1,802
2,138
3,389
1,530
0
0
4,599
2,600
19,557
7,356
6,376
14,469
SD
167
53
488
145
200
76
450
822
3,271
4,769
5,267
770
1,932
0
0
4,111
1,862
926
1,825
25,555
1,355
Number
$3,175,505
$865,384
$6,257,750
$566,225
$745,400
$125,248
$1,484,903
$4,335,228
$14,235,392
$16,524,585
$20,267,416
$2,962,190
$6,435,492
$0
$0
$17,644,412
$6,081,292
$12,805,654
$8,924,250
$110,215,911
$12,654,345
Total $
108
$12,544
$10,236
$9,152
$3,895
$2,708
$5,969
$3,209
$4,735
$3,120
$4,507
$3,442
$5,956
$3,942
$9,370
$20,764
$8,517
$18,352
$8,533
$12,934
$7,143
Congenital malformations and deformations of
the musculoskeletal system
Other symptoms and signs involving the digestive
system and abdomen
Intracranial injury
Unit $
14,559
45,130
16,476
37,670
19,646
34,885
21,476
4,736
13,827
2,683
5,686
3,197
7,857
3,752
16,945
2,164
8,954
9,229
8,296
12,972
SD
1,880
2,153
1,956
633
1,539
1,563
41,994
906
6,635
57
1,791
932
2,393
6,235
2,752
14,755
36,456
101
116
70
Number
$13,428,840
$27,846,902
$16,690,548
$11,616,816
$13,107,663
$32,454,132
$393,463,874
$3,571,452
$39,518,060
$196,194
$8,072,037
$2,907,840
$11,330,855
$20,008,115
$16,426,688
$39,956,540
$141,987,781
$924,352
$1,187,376
$878,080
Total $
Other congenital malformations of the
digestive system
Clinical Chapters
$6,483
$14,154
$8,007
$19,475
$9,087
$22,149
$10,061
$4,289
$6,211
$4,888
$4,951
$2,768
$5,690
$2,953
$5,789
$2,602
$3,939
$5,246
$12,318
$4,153
Unit $
8,079
52,694
14,233
42,136
20,908
35,754
23,037
5,796
14,641
2,794
6,773
2,986
10,209
3,288
19,372
2,170
10,014
3,272
10,035
1,299
SD
1,025
1,359
1,421
457
1,125
1,113
23,097
422
3,582
27
888
657
1,003
2,287
1,471
7,977
18,314
32
52
33
Number
$6,645,075
$19,235,286
$11,377,947
$8,900,075
$10,222,875
$24,651,837
$232,375,746
$1,809,958
$22,247,802
$131,976
$4,396,488
$1,818,576
$5,707,070
$6,753,511
$8,515,619
$20,756,154
$72,137,154
$167,872
$640,536
$137,049
Total $
$8,069
$10,173
$10,020
$14,797
$6,757
$16,675
$8,435
$3,612
$5,637
$2,639
$4,002
$3,991
$3,968
$3,366
$6,184
$2,838
$3,842
$11,555
$7,461
$16,274
Unit $
20,460
18,976
21,619
17,063
15,089
31,980
19,157
3,440
12,749
2,371
4,093
3,548
5,148
4,007
13,528
2,150
7,623
10,818
4,053
14,103
SD
855
794
535
176
414
450
18,897
484
3,053
30
903
275
1,389
3,948
1,281
6,778
18,141
69
64
37
Number
$6,898,995
$8,077,362
$5,360,700
$2,604,272
$2,797,398
$7,503,750
$159,394,356
$1,748,208
$17,209,761
$79,170
$3,613,806
$1,097,525
$5,511,552
$13,288,968
$7,921,704
$19,235,964
$69,706,658
$797,295
$477,504
$602,138
Total $
Appendices
109
$4,066
$7,618
$5,146
$11,971
$3,569
$5,974
$3,896
$5,973
$7,358
$2,360
$23,148
$6,598
$9,621
$9,989
$11,030
$2,652
$6,073
$1,786
$2,509
$7,314
$5,344
Fracture of forearm
Fracture of femur
as to source
Certain early complications of trauma,
Medical observation and evaluation for
suspected diseases and conditions
Unit $
17,520
12,277
3,766
1,941
15,456
1,351
22,839
18,376
21,284
13,924
40,048
2,901
6,786
6,458
5,349
8,630
2,485
13,230
7,834
15,917
4,409
SD
16,672
9,516
684
377
28,005
52
13,076
103
505
2,884
457
348
139
740
695
6,273
462
2,397
905
172
2,536
Number
$89,095,168
$69,600,024
$1,716,156
$673,322
$170,068,954
$137,904
$144,228,280
$1,028,867
$4,858,605
$19,028,632
$10,578,636
$821,280
$1,022,762
$4,420,020
$2,707,720
$37,474,902
$1,648,878
$28,694,487
$4,657,130
$1,310,296
$10,311,376
Total $
Clinical Chapters
$5,471
$7,120
$2,669
$1,731
$6,091
$3,604
$11,232
$5,822
$8,834
$7,762
$23,205
$2,676
$8,414
$6,246
$3,830
$6,470
$3,468
$13,227
$4,823
$7,833
$4,747
Unit $
20,564
12,629
4,481
1,833
17,516
1,307
20,268
5,572
24,221
18,310
43,485
3,307
7,737
6,620
5,623
10,257
2,428
15,823
6,488
18,080
6,164
SD
8,560
4,771
393
193
14,342
29
6,584
70
304
1,164
358
226
80
531
461
2,980
371
1,244
693
112
1,068
Number
$46,831,760
$33,969,520
$1,048,917
$334,083
$87,355,528
$104,516
$73,951,488
$407,540
$2,685,536
$9,034,968
$8,307,390
$604,776
$673,120
$3,316,626
$1,765,630
$19,280,600
$1,286,628
$16,454,388
$3,342,339
$877,296
$5,069,796
Total $
$5,207
$7,530
$2,264
$1,841
$6,059
$1,700
$10,809
$17,907
$10,904
$5,766
$22,963
$1,600
$5,395
$4,912
$4,061
$5,505
$4,316
$10,496
$5,950
$7,117
$3,585
Unit $
13,547
11,875
2,296
2,063
12,831
148
25,366
29,617
15,699
9,598
27,125
1,294
4,299
5,743
4,648
6,711
2,878
9,110
10,492
10,037
2,408
SD
8,112
4,745
291
184
13,663
23
6,492
33
201
1,720
99
122
59
209
234
3,293
91
1,153
212
60
1,468
Number
$42,239,184
$35,729,850
$658,824
$338,744
$82,784,368
$39,100
$70,172,028
$590,931
$2,191,704
$9,917,520
$2,273,337
$195,200
$318,305
$1,026,608
$950,274
$18,127,965
$392,756
$12,101,888
$1,261,400
$427,020
$5,262,780
Total $
110
$8,406
19,357
21,541
SD
$8,379,462
Total $
495,034 $4,161,344,395
618
Number
$9,051
$13,656
Unit $
21,388
19,226
SD
$4,916,160
Total $
255,085 $2,308,858,415
360
Number
Notes:
$13,559
Unit $
Persons encountering health services
in other circumstances
Clinical Chapters
$7,703
$13,427
Unit $
16,782
25,789
SD
$3,464,166
Total $
239,946 $1,848,402,883
258
Number
Appendices
111
$15,818
$7,021
$7,273
$16,613
$21,086
$14,690
$15,194
$11,105
$18,507
$13,853
$11,252
$7,442
$14,130
$4,516
$6,920
$9,716
$6,416
$6,474
$14,484
$4,923
infectious origin
Tuberculosis
Septicemia
mucous membrane
Hepatitis
Malignant neoplasms of eye, brain and
other parts of central nervous system
Malignant neoplasms of thyroid and
other endocrine glands
Unit $
5,068
16,589
9,708
4,120
8,162
6,432
3,607
24,639
11,302
13,102
17,053
23,221
15,646
23,134
23,920
29,576
17,061
9,790
10,941
25,652
SD
319
558
2,042
2,965
471
927
2,356
362
284
4,514
4,613
522
34,338
53
194
1,911
86
207
972
4,025
Number
$1,570,437
$8,082,072
$13,219,908
$19,023,440
$4,576,236
$6,414,840
$10,639,696
$5,115,060
$2,113,528
$50,791,528
$63,903,889
$9,660,654
$381,318,575
$805,282
$2,849,860
$40,295,346
$1,428,718
$1,505,511
$6,824,412
$63,666,255
Total $
Clinical Chapters
$6,414
$15,173
$6,868
$6,416
$0
$0
$2,514
$15,527
$7,414
$11,594
$14,186
$18,209
$11,802
$9,646
$14,622
$20,927
$8,336
$7,495
$6,091
$15,486
Unit $
7,616
18,923
10,287
4,120
0
0
0
28,706
8,410
14,339
18,123
23,975
17,097
4,819
26,035
30,452
4,210
10,991
9,258
24,580
SD
93
340
1,637
2,965
0
0
23
232
163
2,566
2,783
337
18,782
27
84
1,088
54
83
410
2,072
Number
$596,502
$5,158,820
$11,242,916
$19,023,440
$0
$0
$57,822
$3,602,264
$1,208,482
$29,750,204
$39,479,638
$6,136,433
$221,659,791
$260,442
$1,228,248
$22,768,576
$450,144
$622,085
$2,497,310
$32,087,048
Total $
$4,431
$13,540
$5,049
$0
$9,716
$6,920
$4,521
$11,947
$7,488
$10,823
$13,335
$19,121
$10,270
$21,851
$14,780
$21,331
$30,063
$7,029
$8,015
$16,088
Unit $
3,815
12,785
7,093
0
8,162
6,432
3,610
16,438
14,997
11,359
15,254
21,736
13,531
34,719
21,670
28,302
20,889
8,867
12,482
26,967
SD
226
218
405
0
471
927
2,333
130
121
1,948
1,830
185
15,556
26
110
823
32
124
562
1,953
Number
$1,001,406
$2,951,720
$2,044,845
$0
$4,576,236
$6,414,840
$10,547,493
$1,553,110
$906,048
$21,083,204
$24,403,050
$3,537,385
$159,757,149
$568,126
$1,625,800
$17,555,413
$962,016
$871,596
$4,504,430
$31,420,316
Total $
112
$20,277
$12,452
$5,869
$7,181
$5,676
$6,510
$5,009
$8,342
$5,848
$10,774
$4,381
$13,988
$13,641
$17,957
$12,868
$4,076
$15,554
$13,491
$7,272
$10,427
$28,460
$27,035
Carcinoma in situ
Leiomyoma of uterus
immune mechanism
Anemias
Coagulation defects, purpura and
other hemorrhagic conditions
Agranulocytosis
Chapter IV—Endocrine, nutritional
and metabolic diseases
Diabetes mellitus
Dementia
Unit $
60,260
35,580
22,240
9,629
14,533
17,860
2,910
18,043
19,293
17,244
22,135
3,202
18,253
7,482
10,356
7,037
30,328
2,353
7,259
6,534
15,215
27,334
SD
178
114
5,140
714
2,734
1,023
130
1,091
738
7,269
5,103
456
8,734
1,065
414
1,934
3,505
119
496
441
8,549
2,289
Number
$4,812,230
$3,244,440
$53,595,498
$5,192,208
$36,884,394
$15,911,742
$529,880
$14,038,988
$13,252,266
$99,158,938
$71,380,764
$1,997,736
$94,101,227
$6,228,120
$3,453,588
$9,687,406
$22,819,058
$675,444
$3,561,776
$2,588,229
$106,452,148
$46,414,053
Total $
Clinical Chapters
$37,993
$39,075
$11,011
$7,571
$12,837
$13,179
$3,950
$13,830
$20,273
$14,373
$14,125
$4,976
$11,663
$7,099
$8,660
$4,014
$5,666
$0
$7,130
$11,819
$12,655
$20,828
Unit $
73,933
40,300
23,636
8,881
15,770
15,074
2,469
19,978
22,803
20,247
21,177
5,670
18,886
9,299
12,379
3,755
8,414
0
8,137
11,016
16,326
29,265
SD
101
60
2,837
239
1,011
329
53
786
433
3,308
2,890
102
4,335
535
210
888
1,670
0
289
119
4,872
1,345
Number
$3,837,293
$2,344,500
$31,238,582
$1,809,469
$12,978,207
$4,335,891
$209,350
$10,870,380
$8,778,209
$47,544,717
$40,821,250
$507,552
$50,557,022
$3,797,965
$1,818,600
$3,564,432
$9,461,908
$0
$2,060,570
$1,406,461
$61,655,160
$28,013,660
Total $
$8,107
$19,613
$9,695
$7,087
$13,868
$16,416
$4,178
$10,923
$14,237
$12,921
$13,798
$4,192
$9,984
$4,695
$8,100
$5,976
$7,406
$5,676
$7,275
$4,168
$12,162
$19,379
Unit $
5,955
29,261
20,194
10,164
13,791
18,754
3,345
13,289
10,912
14,370
23,422
1,839
17,553
5,044
8,635
9,076
41,071
2,353
5,374
2,779
13,478
23,890
SD
77
54
2,303
475
1,723
694
77
305
305
3,961
2,213
354
4,399
530
204
1,046
1,835
119
207
322
3,677
944
Number
$624,239
$1,059,102
$22,328,131
$3,366,325
$23,894,564
$11,392,704
$321,706
$3,331,515
$4,342,285
$51,179,821
$30,534,974
$1,483,968
$43,917,658
$2,488,350
$1,652,400
$6,250,896
$13,589,646
$675,444
$1,505,925
$1,342,096
$44,719,674
$18,293,776
Total $
Appendices
113
$14,716
$15,534
$17,986
$7,126
$3,288
$25,166
$13,432
$11,750
$10,906
$2,796
$4,891
$2,403
$2,450
$2,522
$2,816
$3,922
$3,439
$2,501
$12,122
$33,078
$13,432
$5,590
$12,519
$14,141
$10,860
Multiple sclerosis
Epilepsy
Transient cerebral ischemic attacks
and related syndromes
Cataract
Glaucoma
Angina pectoris
AMI (heart attack)
Pulmonary HD
Unit $
24,112
16,326
17,451
7,241
23,999
40,181
19,918
1,615
2,089
7,432
1,878
1,631
1,047
1,006
7,177
1,884
14,700
11,923
15,959
49,428
4,329
8,124
43,631
17,113
19,233
SD
1,254
13,882
10,169
8,273
1,324
384
70,564
551
125
760
142
83
719
69
94
1,303
1,107
100
84
157
1,679
577
101
506
537
Number
$13,618,440
$196,305,362
$127,305,711
$46,246,070
$17,783,968
$12,701,952
$855,365,284
$1,378,051
$429,875
$2,980,904
$399,872
$209,326
$1,761,550
$165,807
$459,754
$3,642,847
$12,072,942
$1,175,000
$1,128,288
$3,951,062
$5,520,552
$4,111,702
$1,816,586
$7,860,204
$7,902,492
Total $
Clinical Chapters
$12,257
$14,503
$12,734
$5,853
$13,582
$36,485
$12,520
$2,213
$3,631
$3,490
$2,586
$2,507
$2,454
$2,315
$5,051
$2,716
$10,405
$9,520
$13,361
$15,346
$2,778
$8,218
$33,446
$16,818
$15,835
Unit $
31,748
16,890
18,575
8,057
22,046
33,199
20,690
1,481
2,664
8,314
1,477
1,878
1,048
1,189
8,267
1,778
12,823
8,183
14,788
21,355
2,574
10,025
71,004
21,319
21,482
SD
632
9,934
6,621
5,114
540
151
44,079
204
59
302
67
26
394
33
44
666
609
66
49
96
916
316
40
241
343
Number
$7,746,424
$144,072,802
$84,311,814
$29,932,242
$7,334,280
$5,509,235
$551,858,009
$451,452
$214,229
$1,054,071
$173,262
$65,182
$966,876
$76,395
$222,244
$1,808,703
$6,336,645
$628,320
$654,689
$1,473,216
$2,544,648
$2,596,888
$1,337,840
$4,053,138
$5,431,405
Total $
$9,571
$13,147
$12,091
$5,145
$13,281
$31,020
$11,406
$2,716
$3,229
$4,386
$3,040
$2,531
$2,446
$2,458
$4,749
$2,881
$11,582
$15,095
$13,563
$42,351
$4,005
$5,851
$8,711
$14,151
$12,584
Unit $
13,705
14,625
14,979
5,571
25,996
43,900
18,365
1,698
1,300
6,605
2,194
1,507
1,048
903
6,570
1,993
16,955
16,978
19,212
75,783
5,920
4,893
9,811
11,219
14,037
SD
622
3,948
3,548
3,159
784
233
26,485
347
66
458
75
57
325
36
50
637
498
34
35
61
763
261
61
265
194
Number
$5,953,162
$51,904,356
$42,898,868
$16,253,055
$10,412,304
$7,227,660
$302,097,820
$942,452
$213,114
$2,008,882
$228,000
$144,267
$794,950
$88,488
$237,450
$1,835,102
$5,767,836
$513,230
$474,705
$2,583,411
$3,055,815
$1,527,111
$531,371
$3,750,015
$2,441,296
Total $
114
$24,091
$19,959
$5,958
$11,032
$13,541
$13,060
$15,462
$6,281
$10,959
$5,826
$8,658
$4,387
$3,925
$7,953
$3,431
$98,906
$7,838
$3,342
$6,340
$5,909
$8,928
$6,890
$5,767
$3,079
$7,201
Atrial fibrillation
Heart failure
Atherosclerosis
Pneumonia
Asthma
Peptic ulcer
and duodenum
Inguinal hernia
Unit $
16,262
2,243
11,978
10,681
21,935
9,127
9,391
2,781
18,837
101,096
2,880
17,357
5,536
5,147
19,617
11,842
32,994
11,237
22,326
20,908
15,613
21,040
9,813
31,793
34,037
SD
2,590
2,466
836
1,045
1,585
1,190
186
141
34,210
158
755
15,238
434
616
6,576
533
29,287
172
1,165
8,305
3,799
8,994
5,093
374
2,064
Number
$18,650,590
$7,592,814
$4,821,212
$7,200,050
$14,150,880
$7,031,710
$1,179,240
$471,222
$268,145,180
$15,627,148
$2,590,405
$121,187,814
$1,703,450
$2,702,392
$56,935,008
$3,105,258
$320,966,634
$1,080,332
$18,013,230
$108,463,300
$51,442,259
$99,221,808
$30,344,094
$7,464,666
$49,723,824
Total $
Cardiomyopathy
Clinical Chapters
3,241
15,861
3,008
4,773
19,410
3,744
33,052
3,255
25,683
19,182
17,057
24,077
5,743
38,882
37,409
SD
$8,361
$3,052
$5,041
$6,241
$9,564
$5,479
$7,083
$3,505
$7,797
20,843
2,170
3,170
8,947
23,334
6,403
11,896
3,893
18,838
$107,793 111,446
$3,755
$8,120
$2,824
$4,837
$8,835
$3,156
$11,511
$3,915
$16,598
$11,845
$15,022
$11,756
$5,467
$23,712
$24,373
Unit $
1,184
2,286
416
535
978
649
85
71
18,176
94
237
7,811
263
262
3,671
237
15,460
65
754
4,902
2,301
5,245
2,748
238
1,311
Number
$9,899,424
$6,976,872
$2,097,056
$3,338,935
$9,353,592
$3,555,871
$602,055
$248,855
$141,710,607
$10,132,542
$889,935
$63,425,320
$742,712
$1,267,294
$32,433,285
$747,972
$177,964,978
$254,475
$12,514,892
$58,064,190
$34,565,622
$61,660,220
$15,023,316
$5,643,456
$31,953,003
Total $
$6,116
$3,293
$6,346
$7,602
$7,668
$6,601
$5,596
$3,203
$7,883
$87,406
$3,295
$7,788
$5,668
$4,136
$8,409
$9,052
$10,375
$7,142
$13,092
$14,865
$11,097
$9,876
$6,559
$14,668
$23,610
Unit $
10,203
2,796
15,827
12,358
18,896
12,328
6,208
1,331
18,839
87,815
2,725
18,722
7,769
5,397
19,928
16,683
32,917
13,043
12,665
23,129
12,523
14,921
13,175
16,558
27,429
SD
1,406
180
420
510
607
541
101
70
16,034
64
518
7,427
171
354
2,905
296
13,827
107
411
3,403
1,498
3,749
2,345
136
753
Number
$8,599,096
$592,740
$2,665,320
$3,877,020
$4,654,476
$3,571,141
$565,196
$224,210
$126,402,692
$5,593,984
$1,706,810
$57,841,476
$969,228
$1,464,144
$24,428,145
$2,679,392
$143,456,572
$764,194
$5,380,812
$50,585,595
$16,623,306
$37,025,124
$15,380,855
$1,994,848
$17,778,330
Total $
Appendices
115
$8,920
$4,940
$7,357
$8,465
$6,147
$16,789
$12,253
$14,062
$5,821
$6,418
$11,980
$8,639
$9,143
$7,505
$6,103
$5,801
$29,179
$10,945
$9,004
$9,411
$8,392
$3,936
$7,964
$24,565
$12,007
without hernia
Cholelithiasis
subcutaneous tissue
Decubitus ulcers
Coxarthrosis
Gonarthrosis
Other arthropathies
Unit $
13,970
68,342
9,016
3,697
2,725
4,394
11,272
17,185
33,936
7,026
8,872
9,044
15,099
17,747
35,917
7,415
8,688
25,784
13,617
34,935
9,068
18,076
16,500
7,103
10,879
SD
1,999
294
2,678
50
9,578
5,258
24,566
282
154
62
145
2,030
2,694
3,929
1,720
1,373
3,977
989
595
1,709
797
2,400
4,211
1,907
564
Number
$24,001,993
$7,222,110
$21,327,592
$196,800
$80,378,576
$49,483,038
$221,192,819
$3,086,490
$4,493,566
$359,662
$884,935
$15,235,150
$24,631,213
$33,942,631
$20,605,600
$8,811,914
$23,150,117
$13,907,318
$7,290,535
$28,692,401
$4,899,159
$20,316,000
$30,980,327
$9,420,580
$5,030,880
Total $
Clinical Chapters
$12,595
$12,760
$9,197
$1,826
$8,342
$9,306
$9,046
$11,002
$30,562
$4,843
$4,503
$6,737
$8,627
$8,475
$13,917
$6,913
$6,236
$14,487
$11,994
$18,259
$6,469
$8,085
$6,562
$5,571
$8,504
Unit $
16,394
19,290
11,163
965
2,846
3,135
10,015
16,291
36,255
479
4,114
6,406
14,788
18,255
42,288
8,507
8,761
22,609
14,537
31,315
11,243
15,078
13,158
8,365
5,779
SD
983
79
1,089
25
4,047
2,243
10,672
142
85
26
69
1,089
1,423
2,206
947
790
1,882
483
433
763
447
947
2,120
726
228
Number
$12,380,885
$1,008,040
$10,015,533
$45,650
$33,760,074
$20,873,358
$96,534,342
$1,562,284
$2,597,770
$125,918
$310,707
$7,336,593
$12,276,304
$18,695,850
$13,179,399
$5,461,270
$11,736,152
$6,997,221
$5,193,402
$13,931,617
$2,891,643
$7,656,495
$13,911,440
$4,044,546
$1,938,912
Total $
$11,358
$29,669
$6,960
$5,202
$8,427
$9,497
$8,935
$10,862
$27,670
$6,184
$6,850
$8,454
$9,706
$8,847
$9,544
$5,650
$5,423
$13,557
$13,021
$15,691
$5,756
$8,806
$8,299
$4,488
$9,230
Unit $
10,668
80,612
6,628
4,241
2,639
5,209
12,208
18,801
32,902
8,561
10,428
11,458
15,489
17,114
25,712
5,242
8,616
29,221
10,614
37,467
5,450
20,434
19,727
6,041
13,532
SD
1,016
215
1,589
25
5,531
3,015
13,894
140
69
36
76
941
1,271
1,723
773
583
2,095
506
162
946
350
1,453
2,091
1,181
336
Number
$11,539,728
$6,378,835
$11,059,440
$130,050
$46,609,737
$28,633,455
$124,138,810
$1,520,680
$1,909,230
$222,624
$520,600
$7,955,214
$12,336,095
$15,243,381
$7,377,512
$3,293,950
$11,361,185
$6,859,842
$2,109,402
$14,843,686
$2,014,600
$12,795,118
$17,353,209
$5,300,328
$3,101,280
Total $
116
$8,281
$5,399
$6,226
$11,745
$5,947
$6,301
$15,527
$3,227
$5,314
$3,246
$8,065
$3,173
$4,986
$4,012
$3,958
$4,831
$7,305
$16,874
$16,604
$5,214
$3,095
$6,161
Dorsalgia
Renal failure
Urolithiasis
Disorders of breast
genital conditions
genital tract
Unit $
8,572
2,573
9,461
17,389
20,905
14,731
3,412
2,724
1,661
6,136
2,062
28,440
1,763
6,881
2,347
35,098
8,572
15,677
16,830
13,721
7,353
8,093
SD
2,525
6,824
22,056
95
189
713
466
140
2,636
73
185
472
4,305
3,736
1,722
2,361
1,630
18,439
1,427
1,595
721
966
Number
$15,556,525
$21,120,280
$115,003,101
$1,577,380
$3,189,221
$5,208,465
$2,251,246
$554,120
$10,575,632
$363,978
$587,005
$3,806,680
$13,974,030
$19,853,104
$5,556,894
$36,659,247
$10,270,630
$109,661,031
$16,760,115
$9,930,470
$3,892,679
$7,999,446
Total $
Clinical Chapters
$5,765
$3,164
$5,341
$16,674
$14,702
$12,251
$0
$0
$0
$0
$1,973
$8,065
$3,246
$4,915
$3,364
$14,017
$6,263
$5,616
$14,082
$5,252
$5,879
$8,882
Unit $
8,608
2,980
10,823
10,403
19,707
24,426
0
0
0
0
0
28,440
1,763
6,577
2,482
20,876
10,004
12,061
21,953
8,069
5,924
9,671
SD
1,360
3,191
11,350
41
86
175
0
0
0
0
9
472
4,305
1,848
1,232
1,359
889
10,289
554
852
310
490
Number
$7,840,400
$10,096,324
$60,622,260
$683,634
$1,264,372
$2,143,925
$0
$0
$0
$0
$17,757
$3,806,680
$13,974,030
$9,082,920
$4,144,448
$19,049,103
$5,567,807
$57,786,670
$7,801,428
$4,474,704
$1,822,490
$4,352,180
Total $
$6,700
$3,041
$5,078
$16,534
$14,495
$5,979
$4,831
$3,958
$4,012
$4,986
$3,223
$0
$0
$5,704
$2,866
$17,751
$6,350
$6,404
$9,681
$7,527
$5,125
$7,641
Unit $
8,522
2,201
7,631
22,620
22,387
10,535
3,412
2,724
1,661
6,136
2,090
0
0
7,153
1,914
49,035
6,242
19,172
10,012
18,749
8,111
5,958
SD
1,165
3,633
10,706
54
103
538
466
140
2,636
73
176
0
0
1,888
490
1,002
741
8,150
873
743
411
476
Number
$7,805,500
$11,047,953
$54,363,939
$892,836
$1,492,939
$3,216,702
$2,251,246
$554,120
$10,575,632
$363,978
$567,248
$0
$0
$10,769,152
$1,404,340
$17,786,502
$4,705,350
$52,194,270
$8,451,513
$5,592,561
$2,106,375
$3,637,116
Total $
Appendices
117
$4,027
$6,167
$3,050
$6,518
$3,908
$7,817
$11,833
$18,991
$9,472
$29,230
$13,455
$9,427
$8,149
$4,255
$9,922
$13,608
$5,890
$7,464
$5,528
$5,454
$39,111
$5,620
$35,161
Intracranial injury
Fracture of femur
Effects of foreign body entering through
natural orifice
Unit $
47,651
7,198
82,819
3,890
4,614
8,811
7,333
14,923
20,968
4,597
8,975
13,314
23,357
55,340
13,284
33,739
25,341
14,079
2,679
10,726
3,341
10,601
10,039
SD
103
179
76
167
210
1,900
286
3,343
212
931
966
992
924
258
420
765
20,852
5,155
48
1,593
1,258
1,338
2,644
Number
$3,621,583
$1,005,980
$2,972,436
$910,818
$1,160,880
$14,181,600
$1,684,540
$45,491,544
$2,103,464
$3,961,405
$7,871,934
$9,351,584
$12,432,420
$7,541,340
$3,978,240
$14,528,115
$246,741,402
$40,296,635
$187,584
$10,383,174
$3,836,900
$8,251,446
$10,647,388
Total $
Clinical Chapters
3,142
5,132
11,774
4,472
15,238
27,730
6,810
8,239
7,570
23,294
49,318
13,763
36,371
29,113
15,679
2,656
12,343
3,404
12,018
15,879
SD
$31,156
$7,085
45,782
8,439
$110,192 156,322
$5,084
$5,806
$8,205
$4,742
$14,901
$12,748
$5,026
$8,194
$8,222
$12,531
$25,666
$9,655
$19,928
$13,118
$8,031
$4,084
$6,988
$3,037
$6,594
$4,548
Unit $
72
111
40
84
89
576
165
1,135
149
180
297
445
553
173
243
495
9,852
2,794
24
800
1,109
595
1,140
Number
$2,243,232
$786,435
$4,407,680
$427,056
$516,734
$4,726,080
$782,430
$16,912,635
$1,899,452
$904,680
$2,433,618
$3,658,790
$6,929,643
$4,440,218
$2,346,165
$9,864,360
$129,240,318
$22,438,614
$98,016
$5,590,400
$3,368,033
$3,923,430
$5,184,720
Total $
$41,168
$3,302
$10,679
$5,825
$5,210
$7,104
$7,531
$12,944
$6,342
$3,998
$8,125
$10,597
$14,710
$34,850
$8,967
$16,718
$10,893
$7,520
$3,556
$5,953
$3,160
$5,739
$3,720
Unit $
52,878
3,841
16,803
4,621
4,110
6,935
10,019
14,732
4,661
3,571
9,399
17,128
23,591
64,322
12,241
26,430
21,023
11,509
3,782
8,424
2,828
9,012
3,537
SD
31
68
36
83
121
1,324
121
2,208
63
751
669
547
371
85
177
270
11,000
2,361
24
793
149
743
1,504
Number
$1,276,208
$224,536
$384,444
$483,475
$630,410
$9,405,696
$911,251
$28,580,352
$399,546
$3,002,498
$5,435,625
$5,796,559
$5,457,410
$2,962,250
$1,587,159
$4,513,860
$119,819,161
$17,754,720
$85,344
$4,720,729
$470,840
$4,264,077
$5,594,880
Total $
118
$52,032
$12,722
$6,201
$1,561
$2,080
$8,738
$4,790
$9,592
$8,187
$9,785
as to source
Medical observation and evaluation for
suspected diseases and conditions
other circumstances
19,847
10,964
18,033
11,460
15,329
2,173
1,422
13,154
25,939
171,142
7,240
SD
$5,894,640
$345,312
$53,590,520
$57,836,822
$794,560
$309,078
$118,828,787
$103,277,196
$4,734,912
$3,838,540
Total $
307,098 $3,005,007,974
720
36
11,188
6,619
382
198
19,164
8,118
91
590
Number
8,880
SD
$10,148
$8,530
$1,502
$4,341
$7,563
$1,905
$1,441
$5,543
$12,550
20,289
8,982
1,202
10,559
11,676
1,440
1,326
10,932
26,426
$99,092 240,747
$7,564
Unit $
$3,403,470
$27,036
$26,085,069
$27,778,899
$426,720
$167,156
$57,888,350
$57,052,300
$5,549,152
$2,004,460
Total $
165,805 $1,682,558,052
399
18
6,009
3,673
224
116
10,444
4,546
56
265
Number
Notes:
$6,506
Unit $
Clinical Chapters
$9,374
$7,930
$21,726
$5,549
$10,164
$2,338
$1,696
$7,130
$12,937
$4,973
$5,808
Unit $
19,257
12,637
27,598
12,812
18,740
2,969
1,539
15,751
25,333
6,933
5,926
SD
$2,545,530
$391,068
$28,738,271
$29,943,144
$369,404
$139,072
$62,170,569
$46,210,964
$174,055
$1,887,600
Total $
141,293 $1,324,509,572
321
18
5,179
2,946
158
82
8,720
3,572
35
325
Number
Appendices
119
$12,535
$9,597
$7,202
$12,093
$16,982
$5,162
$11,318
$19,972
$13,549
$11,959
$15,438
$10,043
$13,317
$4,477
$8,669
$12,301
$6,898
$6,081
$13,858
$11,250
infectious origin
Tuberculosis
Septicemia
mucous membrane
Malignant neoplasms of eye, brain and
other parts of central nervous system
Malignant neoplasms of thyroid and
other endocrine glands
Unit $
28,250
18,523
9,840
8,449
12,224
7,552
3,583
13,661
14,194
9,123
11,887
15,726
23,152
14,686
4,193
27,242
11,724
9,254
17,790
22,072
SD
151
414
2,356
1,792
393
569
1,935
303
347
48
3,370
4,667
319
28,735
278
2,422
76
277
1,451
5,135
Number
$1,698,750
$5,737,212
$14,326,836
$12,361,216
$4,834,293
$4,932,661
$8,662,995
$4,035,051
$3,484,921
$741,024
$40,301,830
$63,233,183
$6,371,068
$325,219,810
$1,435,036
$41,130,404
$919,068
$1,994,954
$13,925,247
$64,365,961
Total $
Clinical Chapters
$4,772
$14,729
$6,029
$6,898
$0
$0
$4,424
$11,825
$7,021
$20,056
$12,308
$15,106
$18,377
$11,850
$5,314
$14,916
$12,916
$7,780
$13,728
$13,095
Unit $
4,876
22,596
9,820
8,449
0
0
1,277
12,270
8,833
7,110
12,573
19,540
25,591
16,303
2,755
22,660
12,402
10,114
26,005
21,412
SD
44
204
1,810
1,792
0
0
20
176
202
22
1,959
2,400
168
14,802
92
1,257
42
94
510
2,277
Number
$209,968
$3,004,716
$10,912,490
$12,361,216
$0
$0
$88,480
$2,081,200
$1,418,242
$441,232
$24,111,372
$36,254,400
$3,087,336
$175,407,352
$488,888
$18,749,412
$542,472
$731,320
$7,001,280
$29,816,404
Total $
$13,707
$12,972
$6,291
$0
$12,301
$8,669
$4,477
$15,498
$16,207
$12,140
$11,401
$11,878
$21,206
$10,755
$5,056
$18,867
$10,283
$6,872
$6,953
$11,787
Unit $
32,860
13,314
9,967
0
12,224
7,552
3,607
15,368
20,093
9,352
10,697
9,892
21,240
12,753
5,067
30,774
11,156
8,967
8,423
22,621
SD
107
210
546
0
393
569
1,915
127
145
26
1,411
2,267
151
13,933
186
1,165
34
183
941
2,858
Number
$1,466,649
$2,724,120
$3,434,886
$0
$4,834,293
$4,932,661
$8,573,455
$1,968,246
$2,350,015
$315,640
$16,086,811
$26,927,426
$3,202,106
$149,849,876
$940,416
$21,980,055
$349,622
$1,257,576
$6,542,773
$33,688,485
Total $
120
$14,979
$13,347
$4,924
$11,091
$4,917
$6,626
$6,440
$6,292
$7,711
$8,201
$10,103
$5,637
$14,259
$16,102
$15,782
$18,789
$14,123
$5,775
$12,738
$15,967
$5,296
$10,954
$27,955
Carcinoma in situ
Leiomyoma of uterus
immune mechanism
Anemias
Agranulocytosis
metabolic diseases
Diabetes mellitus
Malnutrition
Dementia
Unit $
37,520
19,962
6,081
16,285
12,317
3,672
16,893
17,913
17,041
18,738
23,612
4,759
17,779
8,958
13,283
7,441
10,928
10,950
3,433
12,776
6,677
14,772
18,909
SD
72
7,319
682
2,025
561
101
449
2,354
7,819
79
4,760
226
9,636
51
483
468
3,065
4,102
30
421
330
7,265
2,096
Number
$2,012,760
$80,169,923
$3,611,872
$32,333,175
$7,146,018
$583,275
$6,341,227
$44,229,306
$123,402,048
$1,272,058
$67,872,840
$1,273,962
$97,357,259
$418,251
$3,724,413
$2,944,656
$19,738,600
$27,177,880
$147,510
$4,669,311
$1,624,920
$96,965,955
$31,395,984
Total $
Clinical Chapters
$28,587
$10,928
$5,088
$15,053
$12,247
$6,079
$16,359
$18,786
$16,803
$13,843
$15,443
$4,633
$11,676
$9,462
$6,356
$6,641
$6,877
$6,780
$0
$12,962
$6,690
$13,867
$14,696
Unit $
32,791
22,365
7,679
15,393
8,632
4,384
18,357
20,523
19,058
11,337
25,343
2,404
20,740
11,678
6,041
9,104
14,438
11,843
0
12,636
11,328
16,309
17,591
SD
33
3,555
200
726
152
35
350
1,072
3,282
33
2,402
60
4,143
22
238
245
1,251
1,767
0
211
119
3,751
1,087
Number
$943,371
$38,849,290
$1,017,600
$10,928,478
$1,861,544
$212,765
$5,725,650
$20,138,592
$55,148,854
$456,819
$37,094,086
$277,980
$48,374,269
$208,164
$1,512,728
$1,627,045
$8,603,127
$11,981,138
$0
$2,734,982
$796,110
$52,015,117
$15,974,552
Total $
$27,128
$10,902
$5,423
$16,577
$12,917
$5,648
$6,899
$18,791
$15,062
$17,232
$12,928
$6,010
$8,872
$6,940
$9,390
$5,847
$6,101
$6,498
$4,917
$8,099
$4,092
$12,784
$15,340
Unit $
44,351
17,463
5,028
16,878
13,475
3,545
7,347
15,559
15,314
22,486
21,461
5,359
15,040
6,012
18,678
4,603
7,126
10,074
3,433
12,697
2,149
12,889
20,519
SD
39
3,764
482
1,299
409
66
99
1,282
4,537
46
2,358
166
5,493
29
245
223
1,814
2,335
30
210
211
3,514
1,009
Number
$1,057,992
$41,034,132
$2,613,886
$21,533,523
$5,283,053
$372,768
$683,001
$24,090,062
$68,337,645
$792,672
$30,484,224
$997,660
$48,736,480
$201,260
$2,300,550
$1,303,881
$11,067,214
$15,172,833
$147,510
$1,700,790
$863,412
$44,922,976
$15,478,060
Total $
Appendix D-7. Estimation of Total Acute Care Inpatient Costs, With Average Cost per Stay (Unit $), Standard Deviation and Number of Stays, Age Group 7
Appendices
121
$19,533
$14,840
$19,733
$5,960
$3,866
$23,622
$14,548
$11,015
$2,858
$2,506
$3,210
$2,605
$2,587
$4,119
$3,295
$4,155
$5,947
$2,890
$11,611
$43,501
$11,796
$5,898
$12,124
$14,271
Epilepsy
related syndromes
Cataract
Glaucoma
Angina pectoris
AMI (heart attack)
Unit $
15,467
14,220
7,198
16,608
56,234
17,819
1,997
5,300
7,479
3,963
6,128
1,299
976
3,397
2,417
2,697
20,186
22,233
42,184
4,523
7,149
20,627
17,029
30,538
SD
8,982
12,295
8,457
1,757
335
82,663
742
68
870
144
90
471
113
89
84
1,148
120
118
116
2,731
542
1,593
869
136
Number
$128,182,122
$149,064,580
$49,879,386
$20,725,572
$14,572,835
$959,840,868
$2,144,380
$404,396
$3,614,907
$474,480
$370,710
$1,218,477
$294,365
$285,690
$210,504
$3,281,484
$1,321,800
$1,716,664
$2,740,152
$10,558,046
$3,230,320
$31,434,669
$12,895,960
$2,656,488
Total $
Clinical Chapters
$14,695
$12,220
$5,945
$13,770
$47,635
$12,243
$3,130
$9,104
$4,995
$3,798
$5,156
$2,644
$2,387
$3,934
$2,134
$3,045
$6,137
$19,189
$28,775
$3,578
$5,229
$18,458
$15,039
$22,387
Unit $
15,463
13,676
6,914
17,676
61,962
19,202
2,405
4,358
7,546
5,061
8,283
1,260
969
4,936
2,162
3,131
6,626
29,579
51,455
4,090
7,097
15,322
11,991
38,721
SD
5,659
6,582
4,216
595
157
42,472
244
24
297
70
33
228
48
38
31
512
59
44
72
1,257
290
724
494
76
Number
$83,159,005
$80,432,040
$25,064,120
$8,193,150
$7,478,695
$520,002,563
$763,720
$218,496
$1,483,558
$265,860
$170,148
$602,832
$114,576
$149,492
$66,154
$1,558,850
$362,083
$844,316
$2,071,800
$4,497,546
$1,516,410
$13,363,592
$7,429,266
$1,701,412
Total $
$13,450
$12,011
$5,840
$9,796
$39,718
$10,853
$2,763
$5,245
$3,782
$2,765
$3,341
$2,535
$2,813
$2,708
$2,959
$2,719
$15,081
$9,063
$13,889
$4,104
$6,864
$20,668
$14,583
$15,727
Unit $
15,450
14,839
7,537
15,282
50,662
15,931
1,767
5,421
7,514
2,258
3,954
1,336
955
1,788
2,752
2,240
27,077
4,651
9,673
4,849
7,198
23,806
22,068
14,675
SD
3,323
5,713
4,241
1,162
178
40,191
498
44
573
74
57
243
65
51
53
636
61
74
44
1,474
252
869
375
60
Number
$44,694,350
$68,618,843
$24,767,440
$11,382,952
$7,069,804
$436,182,981
$1,375,974
$230,780
$2,167,336
$204,610
$190,437
$616,005
$182,845
$138,108
$156,827
$1,729,367
$919,941
$670,662
$611,116
$6,049,296
$1,729,728
$17,960,492
$5,468,625
$943,620
Total $
122
$9,067
$23,905
$18,422
$6,271
$8,996
$12,869
$13,560
$14,922
$8,978
$10,488
$6,820
$8,547
$3,034
$6,131
$7,753
$4,209
$64,751
$8,076
$3,056
$5,197
$9,953
$8,658
$5,998
$7,603
$3,135
$6,957
Cardiomyopathy
Atrial fibrillation
Heart failure
Atherosclerosis
Pneumonia
Asthma
Peptic ulcer
and duodenum
Inguinal hernia
Unit $
7,427
3,834
8,344
8,179
15,298
23,402
6,332
4,190
15,414
75,744
4,812
13,382
11,800
2,096
15,943
12,956
29,825
11,889
13,702
19,212
13,488
11,412
6,762
24,168
21,438
14,326
SD
1,826
2,272
440
1,203
2,035
1,230
147
116
35,397
117
649
19,959
224
911
11,375
839
40,363
163
1,238
12,011
5,341
16,718
6,386
261
1,786
1,235
Number
$12,703,482
$7,122,720
$3,345,320
$7,215,594
$17,619,030
$12,242,190
$763,959
$354,496
$285,871,206
$7,575,867
$2,731,641
$154,742,127
$1,373,344
$2,763,974
$97,222,125
$5,721,980
$423,313,442
$1,463,414
$18,473,436
$162,869,160
$68,733,329
$150,395,128
$40,046,606
$4,808,142
$42,694,330
$11,197,745
Total $
Pulmonary HD
Clinical Chapters
$7,402
$3,083
$9,084
$6,581
$8,384
$11,910
$3,947
$2,243
$8,289
$69,696
$3,026
$7,976
$3,360
$3,376
$8,672
$8,720
$10,720
$6,455
$14,419
$13,347
$14,119
$9,238
$6,838
$20,121
$23,555
$9,340
Unit $
8,282
3,966
10,915
9,736
13,354
29,626
3,297
1,294
16,418
79,971
3,271
12,876
6,124
2,387
16,322
16,845
30,038
9,916
13,368
20,441
14,191
11,966
7,820
28,203
20,226
15,483
SD
682
2,000
205
498
976
593
57
67
16,421
76
159
10,912
117
394
5,956
357
21,385
60
672
5,836
2,830
8,306
2,586
153
984
514
Number
$5,048,164
$6,166,000
$1,862,220
$3,277,338
$8,182,784
$7,062,630
$224,979
$150,281
$136,112,923
$5,296,896
$481,134
$87,034,112
$393,120
$1,330,144
$51,650,432
$3,113,040
$229,241,102
$387,300
$9,689,568
$77,893,092
$39,956,770
$76,730,828
$17,683,068
$3,078,513
$23,178,120
$4,800,760
Total $
$6,664
$3,657
$6,513
$5,597
$8,940
$7,378
$6,183
$3,981
$7,868
$52,387
$4,581
$7,508
$9,631
$2,772
$8,406
$4,550
$10,222
$10,584
$15,501
$13,778
$11,156
$8,749
$5,914
$15,752
$24,447
$8,854
Unit $
6,814
2,103
5,641
6,961
17,106
10,288
7,912
5,894
14,432
69,086
5,164
13,916
15,875
1,844
15,517
4,792
29,582
13,154
14,154
17,873
12,266
10,818
5,982
16,198
23,230
13,402
SD
1,144
272
235
705
1,059
637
90
49
18,976
41
490
9,047
107
517
5,419
482
18,978
103
566
6,175
2,511
8,412
3,800
108
802
721
Number
$7,623,616
$994,704
$1,530,555
$3,945,885
$9,467,460
$4,699,786
$556,470
$195,069
$149,305,957
$2,147,867
$2,244,690
$67,924,876
$1,030,517
$1,433,124
$45,552,114
$2,193,100
$193,996,920
$1,090,152
$8,773,566
$85,079,150
$28,012,716
$73,596,588
$22,473,200
$1,701,216
$19,606,494
$6,383,734
Total $
Appendices
123
$19,872
$5,320
$8,427
$9,171
$4,888
$13,846
$15,697
$10,884
$6,655
$7,529
$10,103
$8,169
$9,268
$8,400
$7,091
$3,877
$20,235
$10,265
$10,192
$8,895
$9,708
$10,680
$12,835
$11,030
$8,906
without hernia
Cholelithiasis
subcutaneous tissue
Decubitus ulcers
Coxarthrosis
Gonarthrosis
Other arthropathies
Dorsalgia
Unit $
10,294
11,366
18,365
17,964
20,268
4,035
5,413
11,890
20,574
2,090
6,965
11,162
12,666
15,316
15,744
9,482
8,509
19,172
20,271
25,962
5,120
14,497
15,343
7,386
37,325
SD
1,065
705
1,876
334
2,545
7,143
4,428
21,318
156
43
121
2,320
2,953
4,905
1,570
1,267
3,566
710
207
2,377
1,034
2,645
4,861
2,625
361
Number
$9,484,890
$7,776,150
$24,078,460
$3,567,120
$24,706,860
$63,536,985
$45,130,176
$218,839,063
$3,156,660
$166,711
$858,011
$19,488,000
$27,369,817
$40,068,945
$15,861,710
$9,539,243
$23,731,730
$7,727,640
$3,249,279
$32,911,942
$5,054,192
$24,257,295
$40,963,647
$13,965,000
$7,173,792
Total $
Clinical Chapters
$8,869
$8,871
$11,781
$9,230
$8,499
$8,998
$9,981
$9,731
$34,968
$2,915
$6,130
$8,546
$9,973
$8,500
$8,782
$8,464
$7,768
$10,604
$12,275
$16,172
$3,652
$9,678
$8,573
$5,619
$31,467
Unit $
10,147
7,292
12,198
8,963
9,373
5,462
4,507
8,484
29,298
1,635
2,826
12,871
13,278
15,048
12,091
11,477
10,595
17,664
13,541
28,266
4,639
14,916
16,616
7,643
52,693
SD
344
245
768
114
863
2,689
1,558
7,656
57
14
44
1,037
1,277
2,396
721
645
1,661
337
156
955
433
890
2,151
847
151
Number
$3,050,936
$2,173,395
$9,047,808
$1,052,220
$7,334,637
$24,195,622
$15,550,398
$74,498,130
$1,993,176
$40,810
$269,720
$8,862,202
$12,734,908
$20,366,000
$6,331,822
$5,459,280
$12,902,648
$3,573,548
$1,914,900
$15,444,260
$1,581,316
$8,613,420
$18,440,523
$4,759,293
$4,751,517
Total $
$8,925
$12,421
$13,599
$11,369
$10,353
$8,838
$10,311
$10,593
$17,473
$4,519
$8,435
$8,273
$9,097
$7,837
$11,185
$6,534
$5,659
$11,234
$30,853
$12,390
$5,632
$8,900
$8,305
$5,178
$10,424
Unit $
10,457
13,215
21,759
21,006
24,143
2,966
5,860
13,469
18,386
2,392
10,824
9,459
12,183
15,592
18,170
6,653
5,898
21,044
35,724
24,349
5,265
14,292
14,214
7,278
10,474
SD
721
460
1,108
220
1,682
4,454
2,870
13,662
99
29
77
1,283
1,676
2,509
849
622
1,905
373
51
1,422
601
1,755
2,710
1,778
210
Number
$6,434,925
$5,713,660
$15,067,692
$2,501,180
$17,413,746
$39,364,452
$29,592,570
$144,720,038
$1,729,827
$131,051
$649,495
$10,614,259
$15,246,076
$19,663,033
$9,496,065
$4,064,148
$10,780,395
$4,190,282
$1,573,503
$17,618,580
$3,384,832
$15,619,500
$22,506,550
$9,206,484
$2,189,040
Total $
124
$9,616
$6,676
$8,317
$12,372
$4,860
$6,130
$3,427
$5,191
$2,914
$6,696
$4,341
$2,926
$6,411
$7,018
$12,603
$20,344
$5,738
$3,481
$5,735
$3,907
$6,587
$3,583
Renal failure
Urolithiasis
Disorders of breast
genital conditions
genital tract
Unit $
4,151
10,473
4,113
8,110
3,360
8,457
19,029
16,042
14,610
5,760
1,937
2,422
4,514
1,050
9,833
2,222
8,512
9,898
16,057
12,436
10,592
14,114
SD
1,706
1,556
2,701
3,150
5,543
27,111
39
94
419
268
103
1,381
43
57
386
3,791
5,696
1,037
3,376
1,471
18,028
1,227
Number
$6,112,598
$10,249,372
$10,552,807
$18,065,250
$19,295,183
$155,570,663
$793,416
$1,184,692
$2,940,542
$1,718,148
$301,378
$5,994,921
$287,928
$166,098
$2,003,726
$12,991,757
$34,916,480
$5,039,820
$41,767,872
$12,234,307
$120,362,977
$11,798,832
Total $
Clinical Chapters
$3,419
$7,669
$3,404
$6,601
$3,076
$5,739
$24,082
$13,491
$10,619
$0
$0
$0
$0
$3,834
$5,191
$3,427
$6,088
$4,077
$13,245
$8,692
$6,431
$8,706
Unit $
4,197
13,156
3,141
8,529
2,138
8,600
22,941
18,375
23,048
0
0
0
0
0
9,833
2,222
9,996
7,495
17,432
13,897
11,398
13,001
SD
1,467
618
1,027
1,517
2,253
12,418
14
37
132
0
0
0
0
16
386
3,791
2,658
679
1,808
685
10,155
537
Number
$5,015,673
$4,739,442
$3,495,908
$10,013,717
$6,930,228
$71,269,830
$337,148
$499,156
$1,401,708
$0
$0
$0
$0
$61,344
$2,003,726
$12,991,757
$16,181,904
$2,768,283
$23,946,960
$5,954,020
$65,309,702
$4,675,122
Total $
$4,679
$5,560
$4,252
$4,910
$3,767
$5,719
$18,305
$10,341
$4,767
$6,411
$2,926
$4,341
$6,696
$2,454
$0
$0
$6,166
$6,217
$11,346
$8,034
$6,965
$10,480
Unit $
3,689
6,952
4,642
7,612
3,979
8,324
17,407
14,778
2,805
5,760
1,937
2,422
4,514
912
0
0
6,989
13,012
14,234
11,259
9,496
15,107
SD
239
938
1,674
1,633
3,290
14,693
25
57
287
268
103
1,381
43
41
0
0
3,038
358
1,568
786
7,873
690
Number
$1,118,281
$5,215,280
$7,117,848
$8,018,030
$12,393,430
$84,036,505
$457,625
$589,416
$1,368,129
$1,718,148
$301,378
$5,994,921
$287,928
$100,614
$0
$0
$18,732,308
$2,225,686
$17,790,528
$6,314,724
$54,834,364
$7,231,200
Total $
Appendices
125
$5,961
$5,607
$7,594
$8,639
$12,488
$15,977
$6,485
$26,117
$12,526
$13,295
$9,503
$4,935
$5,001
$13,918
$10,264
$8,763
$6,396
$7,934
$13,286
$3,902
$37,844
$6,225
$5,463
Intracranial injury
spine and pelvis
Fracture of femur
as to source
Unit $
5,196
9,580
39,611
4,668
22,246
6,557
5,477
8,818
20,390
12,417
4,396
4,518
13,250
32,965
18,487
56,866
9,317
25,080
21,606
9,367
11,099
4,006
7,401
SD
66
518
94
193
96
169
302
1,435
565
8,893
123
960
1,300
1,914
1,231
269
599
1,101
27,275
1,208
8,476
71
2,700
Number
$360,558
$3,224,550
$3,557,336
$753,086
$1,275,456
$1,340,846
$1,931,592
$12,574,905
$5,799,160
$123,772,774
$615,123
$4,737,600
$12,353,900
$25,446,630
$15,419,506
$7,025,473
$3,884,515
$17,590,677
$340,601,566
$10,435,912
$64,366,744
$398,097
$16,094,700
Total $
Clinical Chapters
$8,250
$5,362
$58,963
$2,189
$20,133
$8,421
$4,436
$10,847
$6,466
$15,692
$4,916
$5,446
$10,079
$20,010
$13,772
$32,098
$6,118
$17,427
$14,310
$8,329
$7,640
$4,074
$6,315
Unit $
4,807
5,440
51,423
1,054
32,915
7,443
3,410
12,126
4,321
17,112
4,913
4,811
12,458
57,948
20,758
71,811
7,743
29,453
30,257
8,309
10,944
2,526
8,682
SD
36
192
44
92
22
45
82
351
194
2,347
61
147
300
521
533
139
230
613
9,619
516
3,868
22
1,130
Number
$297,000
$1,029,504
$2,594,372
$201,388
$442,926
$378,945
$363,752
$3,807,297
$1,254,404
$36,829,124
$299,876
$800,562
$3,023,700
$10,425,210
$7,340,476
$4,461,622
$1,407,140
$10,682,751
$137,650,482
$4,297,764
$29,551,520
$89,628
$7,135,950
Total $
$1,284
$6,857
$28,244
$4,973
$7,809
$7,804
$7,498
$8,090
$12,105
$13,232
$5,122
$4,783
$9,363
$10,538
$11,471
$19,593
$6,815
$14,271
$11,468
$8,844
$7,552
$6,288
$5,698
Unit $
596
11,753
30,818
5,685
9,180
6,581
6,165
7,353
24,569
9,951
3,913
4,438
13,478
11,816
16,382
33,816
10,659
18,649
13,903
10,035
11,250
4,457
6,301
SD
30
326
50
101
74
124
220
1,084
371
6,546
62
813
1,000
1,393
698
130
369
488
17,656
692
4,608
49
1,570
Number
$38,520
$2,235,382
$1,412,200
$502,273
$577,866
$967,696
$1,649,560
$8,769,560
$4,490,955
$86,616,672
$317,564
$3,888,579
$9,363,000
$14,679,434
$8,006,758
$2,547,090
$2,514,735
$6,964,248
$202,470,949
$6,120,048
$34,799,616
$308,112
$8,945,860
Total $
126
$7,547
$2,069
$4,826
$9,277
$7,149
$4,530
$5,512
$10,009
other circumstances
18,250
6,086
4,818
16,275
13,596
7,254
2,203
15,049
26,361
SD
$8,499,504
$326,160
$100,715,112
$57,610,170
$1,476,756
$324,833
$168,976,167
$95,889,080
Total $
342,358 $3,426,519,733
1,542
72
14,088
6,210
306
157
22,389
7,105
Number
$10,362
$6,101
$4,573
$6,631
$8,443
$3,428
$2,012
$7,069
$14,430
Unit $
19,855
6,663
5,980
13,678
11,101
3,822
2,042
12,477
33,099
SD
$4,441,528
$105,179
$40,535,303
$27,515,737
$548,480
$164,984
$73,324,715
$50,822,460
Total $
162,449 $1,683,263,226
728
23
6,113
3,259
160
82
10,373
3,522
Number
Notes:
$13,496
Unit $
Clinical Chapters
$9,670
$5,097
$4,466
$7,713
$10,358
$7,114
$2,210
$8,127
$12,579
Unit $
16,527
5,815
4,618
18,694
16,222
10,564
2,731
17,571
17,339
SD
$4,148,958
$218,834
$61,511,175
$30,566,458
$1,038,644
$165,750
$97,649,819
$45,070,557
Total $
179,909 $1,739,749,179
814
49
7,975
2,951
146
75
12,016
3,583
Number
Appendices
127
$9,228
$7,945
$6,821
$10,344
$9,221
$10,881
$19,289
$16,252
$10,990
$6,399
$8,732
$10,971
$13,728
$7,830
$5,064
$25,263
$11,815
$12,192
$4,690
$6,526
infectious origin
Septicemia
mucous membrane
and related tissue
Carcinoma in situ
Unit $
4,420
3,434
13,541
10,576
22,101
5,827
9,352
7,663
10,447
7,959
5,021
8,310
15,647
20,040
12,858
9,108
11,338
6,437
11,395
10,927
SD
116
76
2,123
577
53
969
630
84
115
56
164
599
1,503
66
8,281
144
1,254
125
799
2,642
Number
$757,016
$356,440
$25,883,616
$6,817,255
$1,338,939
$4,907,016
$4,932,900
$1,153,152
$1,261,665
$488,992
$1,049,436
$6,583,010
$24,426,756
$1,273,074
$90,106,467
$1,327,824
$12,971,376
$852,625
$6,348,055
$24,380,067
Total $
Clinical Chapters
$6,070
$3,323
$13,034
$11,375
$27,664
$4,712
$7,830
$0
$0
$5,345
$7,808
$10,898
$21,320
$24,663
$11,380
$14,375
$12,210
$4,290
$10,062
$11,041
Unit $
3,859
1,452
16,944
11,040
6,291
5,284
9,352
0
0
4,254
5,543
8,537
20,530
26,689
14,493
10,875
13,724
2,079
16,713
13,156
SD
50
28
894
259
29
678
630
0
0
29
82
316
580
36
3,861
37
545
30
220
986
Number
$303,500
$93,044
$11,652,396
$2,946,125
$802,256
$3,194,736
$4,932,900
$0
$0
$155,005
$640,256
$3,443,768
$12,365,600
$887,868
$43,938,070
$531,875
$6,654,450
$128,700
$2,213,640
$10,886,425
Total $
$6,726
$4,963
$11,566
$12,360
$24,234
$6,216
$0
$13,728
$10,971
$14,659
$4,334
$11,098
$13,593
$15,569
$10,599
$5,213
$8,995
$8,629
$7,299
$8,147
Unit $
4,748
3,695
10,302
10,077
26,743
7,283
0
7,663
10,447
9,944
3,238
8,153
11,509
13,774
11,284
4,720
9,053
7,937
9,210
9,187
SD
66
48
1,229
318
24
291
0
84
115
27
82
283
923
30
4,420
107
709
95
579
1,656
Number
$443,916
$238,224
$14,214,614
$3,930,480
$581,616
$1,808,856
$0
$1,153,152
$1,261,665
$395,793
$355,388
$3,140,734
$12,546,339
$467,070
$46,849,018
$557,791
$6,377,455
$819,755
$4,226,121
$13,490,617
Total $
Standard Deviation and Number of Stays, Age Group 85+, by Selected Clinical Chapters or Medical
128
$6,517
$5,933
$10,780
$9,313
$13,555
$15,605
$16,237
$23,552
$14,611
$18,838
$6,619
$11,139
$16,252
$16,529
$9,715
$4,716
$3,188
$2,671
$2,438
$3,661
$3,588
$9,535
$8,265
Anemias
metabolic diseases
Diabetes mellitus
Dementia
Epilepsy
related syndromes
Cataract
Unit $
12,312
12,460
4,595
6,064
887
555
2,859
5,027
9,383
13,342
14,622
22,108
5,191
16,355
13,215
24,375
12,788
13,351
17,599
12,241
12,596
7,728
8,740
SD
835
38,259
327
352
82
57
343
1,444
171
1,047
278
3,319
249
522
146
56
1,866
4,051
1,529
4,529
217
1,902
2,183
Number
$6,901,275
$364,786,541
$1,173,276
$1,288,702
$199,916
$152,247
$1,093,611
$6,809,904
$1,661,265
$17,305,863
$4,518,056
$36,969,351
$1,648,131
$9,833,436
$2,133,206
$1,318,912
$30,298,242
$63,214,997
$20,725,595
$42,176,760
$2,339,260
$11,284,566
$14,226,694
Total $
immune mechanism
Clinical Chapters
$12,493
$10,252
$4,005
$4,068
$2,217
$2,682
$3,163
$4,524
$8,326
$16,883
$16,791
$10,905
$6,715
$19,979
$12,105
$24,301
$21,452
$18,290
$12,887
$9,931
$7,030
$6,083
$6,270
Unit $
19,684
13,657
5,543
7,716
976
569
3,136
5,089
8,978
14,959
15,603
13,034
6,999
21,629
13,038
31,857
16,512
14,692
17,347
12,665
5,171
7,478
7,305
SD
210
14,365
96
111
33
17
116
487
65
375
147
1,209
59
156
29
34
672
1,391
651
1,453
81
666
785
Number
$2,623,530
$147,267,153
$384,480
$451,572
$73,161
$45,594
$366,928
$2,203,188
$541,190
$6,331,125
$2,468,277
$13,183,702
$396,185
$3,116,724
$351,045
$826,234
$14,415,744
$25,441,591
$8,389,437
$14,430,413
$569,430
$4,051,278
$4,921,659
Total $
$6,644
$9,082
$3,301
$3,164
$2,588
$2,665
$3,101
$4,829
$10,548
$16,325
$13,941
$10,687
$6,571
$18,285
$17,534
$23,177
$14,034
$14,620
$13,892
$8,857
$12,655
$5,867
$6,658
Unit $
7,456
11,657
3,984
3,984
796
575
2,688
5,018
9,743
12,412
9,897
26,693
5,345
13,451
13,980
25,522
10,093
12,563
17,792
12,081
14,745
7,863
9,382
SD
625
23,893
231
241
49
40
227
957
106
672
131
2,110
190
366
117
22
1,194
2,660
878
3,076
136
1,236
1,398
Number
$4,152,500
$216,998,853
$762,531
$762,531
$126,812
$106,600
$703,978
$4,621,353
$1,118,088
$10,970,400
$1,826,271
$22,548,639
$1,248,490
$6,692,310
$2,051,478
$509,894
$16,756,596
$38,888,713
$12,197,176
$27,244,033
$1,721,080
$7,251,612
$9,308,346
Total $
85+, by Selected Clinical Chapters or Medical Conditions, DAD Reporting Jurisdictions, All Sexes, and Males and Females, 2004–2005 (cont’d)
Appendices
129
$4,882
$9,277
$13,617
$8,995
$19,382
$9,279
$7,300
$8,478
$10,777
$12,230
$15,150
$6,592
$9,084
$5,472
$8,013
$5,523
$8,064
$5,714
$54,237
$7,834
$6,826
$9,173
$5,270
$13,762
$4,248
$8,106
AMI (heart attack)
Pulmonary HD
Cardiomyopathy
Atrial fibrillation
Heart failure
Atherosclerosis
Pneumonia
Asthma
Peptic ulcer
Dyspepsia and other diseases of stomach and
duodenum
Inguinal hernia
Unit $
8,192
3,186
11,156
4,722
12,236
10,003
12,916
77,344
5,157
10,551
7,782
9,977
5,585
17,879
6,251
13,472
14,804
9,131
9,870
8,279
5,341
28,880
8,497
18,277
10,592
5,422
SD
484
662
113
540
855
572
15,798
51
217
7,809
573
8,749
598
21,319
103
440
6,291
2,398
11,462
2,852
70
407
420
1,317
6,389
3,198
Number
$3,923,304
$2,812,176
$1,555,106
$2,845,800
$7,842,915
$3,904,472
$123,765,215
$2,766,087
$1,239,938
$62,971,776
$3,164,679
$70,105,737
$3,272,256
$193,671,539
$678,976
$6,666,000
$76,938,930
$25,843,246
$97,174,836
$20,819,600
$649,530
$7,888,474
$3,777,900
$17,933,589
$59,270,753
$15,612,636
Total $
Angina pectoris
Clinical Chapters
$5,027
$4,263
$16,213
$5,502
$7,839
$4,815
$7,484
$88,364
$5,312
$7,870
$7,134
$8,110
$5,775
$9,662
$5,369
$11,014
$12,943
$11,554
$8,435
$7,619
$9,564
$21,892
$10,626
$15,123
$10,632
$5,136
Unit $
4,170
3,137
13,710
5,919
9,265
4,430
10,860
96,925
3,435
10,575
9,981
10,535
6,951
19,466
6,122
7,400
15,776
9,996
10,247
9,374
9,405
30,277
9,501
18,973
13,288
5,208
SD
147
534
50
163
318
216
5,638
20
44
3,943
190
3,609
186
9,511
34
211
2,236
1,047
4,112
810
34
182
138
630
2,626
1,214
Number
$738,969
$2,276,442
$810,650
$896,826
$2,492,802
$1,040,040
$42,194,536
$1,767,280
$233,728
$31,031,410
$1,355,460
$29,268,990
$1,074,150
$91,897,410
$182,546
$2,323,954
$28,940,548
$12,097,038
$34,684,720
$6,171,390
$325,176
$3,984,344
$1,466,388
$9,527,490
$27,919,632
$6,235,104
Total $
$9,001
$4,190
$12,383
$5,134
$10,100
$7,624
$7,974
$37,174
$5,795
$8,232
$3,611
$7,953
$5,303
$8,586
$7,640
$18,485
$11,818
$10,055
$8,499
$7,189
$9,109
$16,929
$8,311
$12,015
$8,396
$4,730
Unit $
8,851
3,463
9,646
3,948
13,895
11,421
13,912
65,803
5,489
10,537
3,139
9,621
4,741
16,596
6,615
16,175
14,209
8,210
9,678
7,875
2,366
27,565
7,999
17,433
8,278
5,552
SD
337
128
63
377
537
356
10,160
31
173
3,866
383
5,140
412
11,808
69
229
4,055
1,351
7,350
2,041
36
225
282
687
3,763
1,984
Number
$3,033,337
$536,320
$780,129
$1,935,518
$5,423,700
$2,714,144
$81,018,455
$1,152,394
$1,002,535
$31,824,912
$1,383,013
$40,878,420
$2,184,836
$101,383,589
$527,160
$4,233,065
$47,921,990
$13,584,305
$62,467,650
$14,672,749
$327,924
$3,809,025
$2,343,702
$8,254,305
$31,594,148
$9,384,320
Total $
130
$7,955
$5,650
$9,451
$7,833
$5,061
$9,597
$11,711
$9,006
$8,579
$6,341
$10,013
$9,050
$11,438
$12,352
$9,954
$8,795
$10,835
$13,753
$9,529
$8,483
$12,812
$7,481
$8,433
$9,616
$3,779
Cholelithiasis
subcutaneous tissue
Coxarthrosis
Gonarthrosis
Other arthropathies
Dorsalgia
Renal failure
Urolithiasis
Unit $
4,783
10,282
8,076
9,531
13,739
9,903
8,587
15,359
16,815
10,026
5,221
7,875
11,618
9,573
11,278
8,503
10,733
17,688
11,462
19,533
5,064
10,786
13,173
8,614
9,072
SD
207
1,811
466
7,491
471
661
245
481
109
1,030
826
772
5,742
1,404
1,808
598
513
1,200
141
1,279
621
1,179
2,470
1,527
102
Number
$782,253
$17,414,576
$3,929,778
$56,043,537
$6,034,452
$5,607,263
$2,334,605
$6,615,193
$1,181,015
$9,058,850
$8,222,004
$9,535,744
$65,675,730
$12,706,200
$18,102,982
$3,791,918
$4,401,027
$10,807,200
$1,651,251
$12,274,563
$3,142,881
$9,235,107
$23,343,970
$8,627,550
$811,410
Total $
Clinical Chapters
$3,969
$10,297
$9,357
$7,104
$10,904
$16,029
$7,917
$11,553
$9,284
$12,118
$10,894
$11,446
$11,890
$7,929
$7,397
$7,581
$7,559
$9,442
$9,819
$8,526
$4,013
$7,835
$10,077
$6,101
$3,744
Unit $
4,749
12,304
8,383
9,329
12,665
16,123
4,122
6,205
9,851
14,483
5,453
4,063
9,758
8,132
7,799
12,910
10,648
15,529
8,949
11,974
4,278
12,897
14,665
6,891
1,066
SD
134
825
201
3,427
152
166
65
145
27
307
273
227
1,571
442
559
194
232
456
61
414
161
325
869
402
39
Number
$531,846
$8,495,025
$1,880,757
$24,345,382
$1,657,408
$2,660,814
$514,605
$1,675,185
$250,668
$3,720,226
$2,974,062
$2,598,242
$18,679,914
$3,504,618
$4,134,818
$1,470,714
$1,753,688
$4,305,552
$598,959
$3,529,764
$646,093
$2,546,375
$8,756,913
$2,452,602
$146,016
Total $
$3,454
$8,945
$7,689
$7,768
$13,617
$6,654
$10,038
$14,568
$11,551
$7,641
$9,653
$12,687
$11,376
$9,564
$10,910
$5,765
$9,718
$8,718
$13,005
$9,988
$5,339
$7,833
$9,083
$5,489
$10,061
Unit $
5,002
7,782
7,840
9,700
14,223
6,810
9,612
17,564
19,540
7,673
5,130
8,871
12,156
10,145
12,391
5,440
10,829
19,052
12,975
21,679
5,246
9,892
12,236
9,171
10,614
SD
73
986
265
4,064
319
495
180
336
82
723
553
545
4,171
962
1,249
404
281
744
80
865
460
854
1,601
1,125
63
Number
$252,142
$8,819,770
$2,037,585
$31,567,512
$4,343,823
$3,293,730
$1,806,840
$4,894,848
$947,182
$5,524,443
$5,338,109
$6,914,415
$47,448,858
$9,200,568
$13,626,307
$2,329,060
$2,730,758
$6,486,192
$1,040,400
$8,639,620
$2,455,940
$6,689,382
$14,541,883
$6,175,125
$633,843
Total $
Appendices
131
$7,245
$4,535
$2,776
$5,342
$1,986
$7,222
$3,391
$7,024
$5,353
$5,883
$3,792
$8,836
$8,579
$12,815
$13,583
$7,904
$14,433
$10,913
$10,215
genital conditions
Intracranial injury
spine and pelvis
Unit $
10,331
16,495
15,063
8,197
16,429
13,109
9,118
20,309
4,053
6,142
4,985
9,064
3,067
10,380
1,112
2,224
1,706
4,716
8,664
SD
1,709
794
138
477
669
17,952
5,420
1,641
922
678
1,175
1,590
1,464
13,737
39
136
136
802
3,741
Number
$17,457,435
$8,664,922
$1,991,754
$3,770,208
$9,087,027
$230,050,191
$46,498,180
$14,499,876
$3,496,224
$3,988,674
$6,289,775
$11,168,160
$4,964,424
$99,210,326
$77,454
$726,512
$377,536
$3,637,070
$27,103,545
Total $
Clinical Chapters
$9,415
$9,626
$16,433
$11,593
$14,184
$13,589
$8,140
$12,180
$3,488
$6,813
$4,632
$7,552
$3,183
$7,119
$0
$0
$2,776
$4,535
$7,179
Unit $
8,818
8,657
18,374
11,947
19,642
14,672
8,956
35,454
4,111
6,590
4,783
11,339
2,395
12,574
0
0
1,706
4,716
9,339
SD
329
238
47
145
292
4,353
1,950
549
746
234
346
592
509
5,211
0
0
136
802
1,304
Number
$3,097,535
$2,290,988
$772,351
$1,680,985
$4,141,728
$59,153,391
$15,873,000
$6,686,820
$2,602,048
$1,594,242
$1,602,672
$4,470,784
$1,620,147
$37,095,480
$0
$0
$377,536
$3,637,070
$9,361,416
Total $
$10,413
$11,474
$13,576
$6,952
$12,905
$12,598
$8,831
$7,571
$5,387
$5,256
$5,610
$6,765
$3,513
$7,343
$1,986
$5,342
$0
$0
$7,278
Unit $
10,688
18,960
13,695
6,850
11,913
12,555
9,213
9,755
3,351
5,822
5,063
7,746
3,412
8,707
1,112
2,224
0
0
8,315
SD
1,380
556
91
332
377
13,599
3,470
1,092
176
444
829
998
955
8,526
39
136
0
0
2,437
Number
$14,369,940
$6,379,544
$1,235,416
$2,308,064
$4,865,185
$171,319,044
$30,643,570
$8,267,532
$948,112
$2,333,664
$4,650,690
$6,751,470
$3,354,915
$62,608,727
$77,454
$726,512
$0
$0
$17,736,486
Total $
132
$9,155
$14,861
$8,307
$11,670
$6,249
$3,862
$5,690
$10,853
$2,189
$1,875
$8,835
$11,802
$11,252
$9,724
Fracture of femur
substances
Persons encountering health services
in other circumstances
13,591
16,573
16,959
12,215
1,905
2,038
15,134
8,112
3,252
6,292
11,074
8,545
12,162
9,307
10,292
SD
$14,987,664
$80,536,848
$22,917,990
$191,250
$142,285
$119,255,123
$1,268,870
$463,440
$1,306,041
$5,811,660
$4,078,737
$135,680,930
$3,826,790
$7,825,752
Total $
158,812 $1,544,267,186
1,332
6,824
2,594
102
65
10,988
223
120
209
498
491
9,130
418
792
Number
$9,815
$7,321
$9,518
$9,285
$1,308
$3,230
$9,000
$7,710
$3,368
$5,606
$13,176
$10,048
$17,187
$7,414
$5,992
Unit $
14,321
6,259
14,750
12,580
477
3,403
13,653
12,927
2,340
1,843
7,438
12,875
13,974
8,648
4,435
SD
58,280
473
2,088
1,084
42
23
3,726
67
42
36
87
126
1,862
54
130
Number
$572,043,316
$3,462,833
$19,873,584
$10,064,940
$54,936
$74,290
$33,534,201
$516,570
$141,456
$201,816
$1,146,312
$1,266,048
$32,002,194
$400,356
$778,960
Total $
Notes:
$9,881
Unit $
Clinical Chapters
$9,690
$12,825
$13,507
$8,465
$2,329
$1,842
$12,169
$4,825
$4,042
$6,384
$11,387
$7,678
$14,320
$9,601
$10,281
Unit $
13,150
19,312
18,271
11,940
2,530
1,698
16,123
4,925
3,609
6,907
11,654
6,457
11,637
9,521
10,650
SD
100,531
859
4,736
1,510
60
42
7,262
156
78
173
411
365
7,268
364
662
Number
$974,140,630
$11,016,675
$63,969,152
$12,782,150
$139,740
$77,364
$88,369,008
$752,700
$315,276
$1,104,432
$4,680,057
$2,802,470
$104,077,760
$3,494,764
$6,806,022
Total $
Appendices
133
Appendix E. Share of Acute Care Inpatient Costs Due to the Treatment
or Presence of Complexities, All Age Groups, by Clinical Chapters or
Selected Medical Conditions, DAD Reporting Jurisdictions, All Sexes,
and Males and Females, 2004–2005
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
47.5%
46.8%
48.3%
30.2%
34.9%
25.2%
Diarrhea and gastroenteritis of presumed infectious origin
21.3%
21.9%
20.9%
Tuberculosis
40.6%
40.7%
40.4%
Septicemia
63.3%
63.4%
63.3%
40.0%
36.7%
43.1%
Viral infections characterized by skin and mucous membrane
35.9%
31.6%
39.8%
Hepatitis
54.0%
56.6%
49.9%
39.6%
36.8%
41.8%
33.5%
36.9%
30.0%
32.8%
29.6%
39.1%
33.8%
36.0%
30.9%
37.2%
41.1%
31.6%
37.4%
40.6%
30.1%
18.2%
14.7%
22.9%
37.4%
42.0%
30.6%
9.6%
0.0%
9.6%
17.4%
0.0%
17.4%
29.5%
0.0%
29.5%
9.6%
9.6%
0.0%
26.0%
26.1%
25.5%
Malignant neoplasms of eye, brain and other parts of central
nervous system
31.7%
30.5%
33.2%
Malignant neoplasms of thyroid and other endocrine glands
17.7%
21.4%
16.1%
Malignant neoplasms of lymphoid, hematopoietic and
related tissue
56.6%
56.9%
56.2%
35.2%
36.0%
34.2%
9.3%
26.1%
4.2%
22.3%
25.9%
16.8%
2.1%
0.0%
2.1%
28.1%
35.1%
23.1%
Clinical Chapters
Carcinoma in situ
Leiomyoma of uterus
Other benign neoplasms and neoplasms of uncertain or
unknown behaviour
134
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
Chapter III—Diseases of the blood and blood-forming organs and
certain disorders involving the immune mechanism
32.5%
34.1%
31.0%
Anemias
32.2%
37.6%
27.6%
Coagulation defects, purpura and other hemorrhagic conditions
32.5%
29.5%
35.1%
Agranulocytosis
28.8%
28.0%
29.5%
48.9%
39.5%
56.5%
33.4%
38.9%
30.1%
Chapter IV—Endocrine, nutritional and metabolic diseases
37.4%
40.0%
34.8%
10.8%
15.9%
9.4%
Diabetes mellitus
41.2%
41.6%
40.7%
Malnutrition
38.1%
29.5%
43.2%
10.3%
26.0%
7.0%
Cystic fibrosis
42.5%
47.0%
39.8%
33.3%
34.8%
32.1%
30.1%
39.4%
20.2%
27.6%
30.8%
24.1%
52.1%
51.9%
52.3%
Systemic atrophies primarily affecting the central nervous system
48.6%
50.7%
43.9%
29.1%
27.1%
32.2%
Multiple sclerosis
29.3%
28.3%
30.0%
Epilepsy
21.3%
23.3%
18.8%
Transient cerebral ischemic attacks and related syndromes
11.9%
9.1%
14.2%
Polyneuropathies and other disorders of the peripheral
nervous system
42.7%
42.5%
42.9%
49.3%
48.7%
49.8%
22.8%
21.5%
24.0%
37.7%
42.6%
31.4%
2.7%
1.7%
3.9%
3.6%
2.4%
4.9%
8.4%
4.2%
11.4%
Cataract
0.5%
0.4%
0.6%
0.8%
0.7%
1.0%
Glaucoma
6.4%
0.0%
11.9%
Clinical Chapters
Appendices
Appendix E. Share of Acute Care Inpatient Costs Due to the Treatment or Presence of Complexities,
All Age Groups, by Clinical Chapters or Selected Medical Conditions, DAD Reporting Jurisdictions,
All Sexes, and Males and Females, 2004–2005 (cont’d)
135
136
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
2.9%
3.9%
1.3%
9.0%
0.0%
14.0%
2.7%
4.4%
1.6%
1.4%
0.0%
2.2%
0.6%
0.6%
0.5%
3.4%
3.4%
3.3%
9.5%
8.0%
11.7%
5.8%
6.4%
4.9%
4.1%
2.8%
5.1%
0.3%
0.3%
0.3%
35.1%
34.4%
36.1%
67.3%
62.2%
70.7%
50.5%
54.1%
47.3%
45.4%
44.1%
46.9%
Angina pectoris
15.6%
16.1%
14.8%
AMI (heart attack)
30.3%
28.9%
33.0%
33.2%
33.1%
33.6%
Pulmonary HD
41.8%
43.5%
40.1%
Cardiomyopathy
43.8%
41.3%
48.0%
Atrial fibrillation
44.2%
43.5%
45.4%
23.0%
18.9%
27.0%
Heart failure
39.4%
41.0%
37.5%
22.9%
23.9%
21.3%
41.4%
40.8%
41.9%
Atherosclerosis
37.3%
37.9%
36.3%
39.1%
28.7%
43.5%
40.8%
41.4%
39.5%
45.5%
47.1%
43.7%
20.6%
22.7%
18.0%
Pneumonia
41.0%
43.4%
38.3%
22.2%
23.0%
21.1%
Clinical Chapters
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
1.4%
2.1%
0.5%
10.8%
9.3%
12.9%
40.8%
42.0%
39.6%
Asthma
11.8%
12.4%
11.3%
73.3%
73.2%
73.5%
59.2%
59.4%
59.0%
32.9%
34.1%
31.7%
2.3%
3.0%
1.9%
21.9%
21.7%
22.1%
26.5%
30.5%
21.2%
Peptic ulcer
38.6%
37.4%
40.4%
Dyspepsia and other diseases of stomach and duodenum
26.9%
22.9%
29.6%
9.5%
9.4%
9.6%
Inguinal hernia
6.8%
6.9%
5.6%
22.7%
26.3%
19.6%
29.3%
30.4%
28.1%
24.6%
19.6%
28.0%
30.4%
32.5%
28.7%
28.5%
27.4%
29.5%
19.9%
17.7%
21.7%
51.1%
52.5%
50.0%
55.9%
56.2%
55.4%
59.0%
58.6%
59.7%
Cholelithiasis
24.0%
26.0%
22.6%
30.4%
33.7%
26.1%
44.1%
49.2%
35.5%
39.3%
38.8%
39.7%
Chapter XII—Diseases of the skin and subcutaneous tissue
28.6%
28.3%
28.8%
24.8%
23.8%
25.7%
Bullous disorders
29.3%
31.9%
20.5%
17.2%
4.9%
23.9%
31.3%
23.1%
35.7%
Clinical Chapters
Appendices
137
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
Decubitus ulcers
42.0%
41.8%
42.3%
28.5%
28.9%
28.2%
15.2%
15.5%
15.1%
Coxarthrosis
7.5%
7.4%
7.6%
Gonarthrosis
6.4%
7.2%
5.9%
0.4%
0.3%
0.6%
Other arthropathies
15.1%
16.5%
14.1%
49.3%
48.8%
49.5%
21.5%
22.8%
20.3%
9.0%
8.9%
9.0%
Dorsalgia
16.4%
17.6%
15.6%
28.4%
27.3%
29.5%
23.7%
23.6%
23.7%
22.9%
29.7%
18.3%
24.9%
28.2%
21.9%
Renal failure
47.9%
48.5%
46.9%
8.0%
6.6%
10.3%
25.8%
27.1%
24.7%
7.3%
7.3%
0.0%
29.0%
29.0%
0.0%
Disorders of breast
2.3%
4.8%
2.3%
8.5%
0.0%
8.5%
2.6%
0.0%
2.6%
Menstrual, menopausal and other female genital conditions
1.6%
0.0%
1.6%
7.0%
0.0%
7.0%
28.0%
46.0%
18.8%
22.3%
16.6%
28.7%
23.9%
19.6%
27.6%
25.6%
18.1%
34.2%
48.9%
43.0%
53.1%
Clinical Chapters
Urolithiasis
138
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
0.8%
1.5%
0.0%
18.4%
16.8%
20.0%
15.3%
17.8%
9.5%
Congenital malformations and deformations of the
musculoskeletal system
10.4%
12.3%
7.8%
1.6%
1.3%
2.0%
28.2%
7.0%
43.4%
Chapter XVIII—Symptoms, signs and abnormal clinical
and laboratory findings, not elsewhere classified
21.2%
22.5%
20.1%
4.2%
4.4%
4.1%
31.4%
29.8%
32.9%
10.9%
14.3%
9.3%
Other symptoms and signs involving the digestive system
and abdomen
24.7%
28.9%
20.6%
12.2%
13.2%
9.0%
Symptoms and signs involving cognition, perception, emotional
state and behaviour
16.1%
18.9%
13.4%
15.6%
13.1%
17.0%
29.8%
30.8%
28.8%
Other symptoms, signs and abnormal clinical and
laboratory findings
21.2%
19.6%
22.2%
30.5%
32.5%
28.1%
Intracranial injury
49.9%
51.4%
45.9%
26.2%
26.1%
26.7%
46.2%
47.7%
42.6%
31.9%
31.6%
32.3%
Injuries to the abdomen, lower back, lumbar spine and pelvis
28.5%
30.4%
25.3%
17.1%
15.9%
18.2%
7.2%
9.5%
4.6%
Fracture of forearm
21.0%
23.7%
11.2%
10.0%
8.9%
13.0%
Fracture of femur
26.7%
29.5%
25.2%
Clinical Chapters
Appendices
139
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
19.9%
13.2%
27.6%
12.0%
12.8%
10.9%
13.6%
14.1%
12.3%
6.7%
6.9%
6.0%
36.6%
41.3%
18.8%
7.7%
1.6%
12.8%
13.9%
15.1%
12.2%
39.2%
41.0%
33.5%
Frostbite
21.3%
16.9%
45.5%
Poisoning by drugs, medicaments and biological substances
33.4%
34.8%
32.2%
Toxic effects of substances chiefly nonmedicinal as to source
53.0%
55.1%
46.6%
Certain early complications of trauma, not elsewhere classified
37.2%
31.8%
50.5%
Complications of surgical and medical care, not elsewhere
classified
35.0%
35.6%
34.5%
Sequelae of injuries, of poisoning and of other consequences
of external causes
10.7%
13.5%
0.0%
Other injuriy, poisoning and consequences of external causes
39.1%
42.2%
32.7%
Chapter XXI—Factors influencing health status and contact
with health services
21.1%
21.0%
21.0%
Medical observation and evaluation for suspected diseases
and conditions
1.9%
0.8%
3.2%
Other persons encountering health services for examination
and investigation
2.1%
0.7%
3.9%
2.3%
0.0%
2.3%
Other medical care (including radiotherapy and chemotherapy
sessions)
21.5%
21.1%
22.0%
Other persons encountering health services for specific
procedures
30.0%
31.7%
28.0%
3.2%
8.3%
0.0%
Clinical Chapters
Injuries to unspecified parts of trunk, limb or body region
140
Share of cost
attributed to
treatment or
presence of
complexities,
All sexes
Share of cost
attributed to
treatment or
presence of
complexities,
Males
Share of cost
attributed to
treatment or
presence of
complexities,
Females
Persons encountering health services in other circumstances
31.6%
22.2%
39.6%
27.3%
30.3%
24.4%
Clinical Chapters
Appendices
Notes:
The chapters or medical conditions not considered in the CMG/Plx methodology have been excluded in this table.
They are Chapters:
V. Mental and behavioral disorders;
XV. Pregnancy, childbirth and the puerperium;
XVI. Certain conditions originating in the perinatal period.
Otherwise, the others are true “0,” meaning no cost has been attributed to the treatment or presence of complexities for
the medical condition.
141
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The Cost of Acute Care Hospital Stays by Medical Condition

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