The Pittsburgh Business Group on Health (PBGH) commissioned a study that compares, among other indicators, the number of hospitals, hospitalizations, and other hospital-related utilization metrics in the Pittsburgh Metropolitan Statistical Area (MSA) with that of the Cleveland, St. Louis, and Cincinnati MSAs. The study used the most recent data from the federal Bureau of Labor Statistics and IMS Health to compile MSA-level estimates of the supply of hospital beds, the frequency of hospitalizations and emergency department visits, and staffing. HCI3 used internally generated benchmarks to estimate the average cost of a bed day and the total costs per capita of hospitalizations in each MSA. In addition, data on 2007 inpatient days per Medicare enrollee from the Dartmouth Atlas were used to compare the Pittsburgh, Cleveland, Cincinnati, and St. Louis hospital referral centers.
The report’s authors examined the relationship between the supply of hospital beds and the frequency and length of hospital stays in Pittsburgh, Cleveland, Cincinnati and St. Louis. Pittsburgh and Cleveland had more beds per 1,000 residents, 4.2 and 4.3 respectively, than Cincinnati and St. Louis, 2.6 and 3.5 respectively. The researchers also found that Pittsburgh and Cleveland had higher hospital occupancy rates than Cincinnati and St. Louis, meaning that the regions with more beds filled those beds more often.
By taking the total number of days patients stay in the region’s hospitals each year and dividing by population, the researchers calculated a bed-days-per-patient ratio. Pittsburgh had the highest ratio, meaning patients here spend more time in the hospital than patients in Cleveland, Cincinnati and St. Louis. Using an average hospitalization cost, they determined how much extra money was spent on health care in Pittsburgh, Cleveland and St. Louis as compared to Cincinnati, which had the lowest number of beds and use of hospital services. Pittsburgh spends $187.3 million more than Cincinnati, while Cleveland and St. Louis spend $127.1 million and $74.4 million more, respectively. The study did not address whether patients in Pittsburgh receive higher-quality care or have better outcomes as a result of the additional spending. And because it used one estimated average hospitalization cost, the calculations might not accurately reflect health care spending in the regions studied.