The average hospital bill rose 7.5 percent in 1985 despite a decline in the
average length of stay by patients, and one health official cites sicker patients and fixed costs as reasons why.
While the average stay dropped from 6.6 days to 6.4 days between 1984 and 1985, the typical patient charge for each stay increased from $3,571 to $3,840, said the study by Equicor, a joint venture of Hospital Corporation of America and the Equitable Group and Health Insurance Co.The figures were little surprise to Jack Owen, Washington representative of the American Hospital Association, who said shorter stays do not necessarily mean lower charges because "as you lower the length of stay the fixed costs don't change."
"In fact, the resources used in the shorter length of stay tend to be a little more because the patients are sicker during the time that they are in there," Mr. Owen said.
He said hospitals are treating a larger percentage of patients who need intensive care because many procedures once performed in hospitals are done in outpatient clinics.
The study said incentives to discharge patients after shorter stays were created three years ago by Medicare's new policy of paying hospitals set fees for treating specific illnesses.
But a study earlier this year by Richard Kusserow, inspector general of the Department of Health and Human Services, suggested that hospitals were making excessive profits under the new Medicare payment system and recommended that the formula for paying hospitals be adjusted to eliminate the profits.
The figures collected from 2,362 general hospitals in 1,989 cities showed wide swings in hospital costs. Charges increased 34 percent in Louisiana while they declined 26.8 percent in South Dakota.
The highest hospital charges were found in the nation's capital, where the average cost for a stay was $6,605. California was next with an average charge of $5,107 a stay.
Hospital stays declined in 37 states and the District of Columbia but increased in eight states: Vermont, Maine, Georgia, Oklahoma, Montana, Kansas, West Virginia and Louisiana. They remained unchanged in Idaho, Arkansas, New Hampshire, Connecticut and Rhode Island.
Stays ranged in length from an average of 8.5 days in Washington, D.C., to 4.1 days in Alaska. New York had the second-longest average stay, 8.3 days, followed by 7.9 days in Massachusetts and 7.6 days in Rhode Island.
The study showed no overall correlation between costs and length of stay, but some states had simultaneous declines or increases in both categories.
After Louisiana, the biggest increase in costs occurred in West Virginia where costs went up 27 percent to $3,141, followed by a 26.6 percent increase to $4,061 in Oregon, and Alaska's 25 percent boost to $3,747.
The average charge for a stay was calculated by multiplying all charges, including room, board, medication, and laboratory fees, by the average length of stays. The costs of private attending physicians were not included in the calculation.