Comparative trends in hospital expenses, finances, utilization, and inputs, 1970-81

The annual surveys of the American Hospital Association historically have been the only national source of statistics on hospital structure and performance. Although valuable, this source has not provided the policy or research community with hospital-specific information on revenues, assets, and financial status. Data on these and other variables from heretofore unpublished Medicare cost report data are presented in this article. Hospital expenses, revenues, profits, indebtedness, utilization, investments, and employees are trended over the 1970-81 period by urban-rural location, teaching status, and ownership. It is indicated in these data that a major transformation in the hospital industry has occurred in response to cost-based Medicare-Medicaid and other factors that made acute care essentially unaffordable to the average citizen. The health maintenance organization movement and Medicare's prospective payment system are seen as logical reactions to this transformation.