Assessing Changes in High-Volume Hospital Use

Hospitals, Payers, and Aggregate Volume Trends

This article assesses changes in high-volume hospital use between 1995 and 2002. Although the relationship between positive medical outcomes and high-volume hospitals has garnered significant policy interest, little is known about whether trends of hospital use have changed as a result.

The author based his analysis on 3.4 million hospital admissions in Arizona, Florida, New Jersey and Wisconsin in 1995-1996 and 2001-2002.

Key Findings:

  • There were only limited changes to hospital usage between 1995 and 2002. For a number of services fewer than half of patients received care at high-volume hospitals.
  • For several services the percentage of patients treated in high-volume facilities dropped between 1995 and 2002.
  • Trends at high-volume hospitals were associated with overall trends of utilization.

These findings suggest that although significant research exists on the relationship between hospital quality and volume, this research is not directly influencing hospital utilization patterns.