UTILIZATION INDICATORS Calendar Year 2015

ABOUT THIS REPORT The charts and tables in this publication are intended to provide aggregate and comparative data on healthcare facility utilization in the District of Columbia. The source of the data is the District of Columbia Hospital Association’s (DCHA) Monthly Utilization Survey and Quarterly Bed Capacity and Census Survey (self-reported by individual facilities). Data for 2014 may vary slightly from earlier publications due to clarification of data definitions and revisions of data by facilities.

ISSUED / APRIL / 2016 EMERGENCY Emergency Department visits have increased steadily in the District of AMBULATORY Ambulatory Surgeries Columbia. In 2015, there were 18,350 (6.6%) more visits than in 2014. The DEPARTMENT 2015 number of Emergency Department visits was 7% greater than 5 years SURGERIES 2014 2015 % Change VISITS ago and 31% greater than 10 years ago. ACUTE CARE ------Children’s National Medical Center 11,743 11,901 1.35 EMERGENCY Emergency Department Visits ------DEPARTMENT VISITS George Washington University Hospital 15,146 15,797 4.30 2014 2015 % Change ------Howard University Hospital 6,504 6,488 -0.25 ACUTE CARE ------MedStar Georgetown University Hospital 8,114 8,306 2.37 Children's National Medical Center* 82,680 92,304 11.64 ------George Washington University Hospital 75,482 77,390 2.53 MedStar Washington Hospital Center 11,085 11,207 1.10 ------Howard University Hospital 52,949 49,790 -5.97 Providence Hospital 7,911 7,967 0.71 ------MedStar Georgetown University Hospital 34,612 34,280 -0.96 Sibley Memorial Hospital 6,913 7,354 6.38 ------MedStar Washington Hospital Center** 87,610 86,913 -0.80 ------United Medical Center 964 921 -4.46 Providence Hospital 43,167 52,469 21.55 ------ACUTE TOTAL 68,380 69,941 2.28 Sibley Memorial Hospital 35,636 35,741 0.29 ------United Medical Center 63,503 63,266 -0.37 ------ACUTE TOTAL 508,944 527,294 3.61 FEDERAL ------Veterans Affairs Medical Center 3,725 3,726 0.03 ------FEDERAL ------Veterans Affairs Medical Center 24,005 24,313 1.28 ------

GRAND TOTAL 72,105 73,667 2.17 ------GRAND TOTAL 532,949 551,607 3.50

*Includes 33,305 United Medical Center visits in 2014 and 35,141 in 2015. **Does not include MedSTAR trauma visits. Note: Hospital averages are rounded; therefore, their sums may not match totals. Hospital figures are self-reported.

Emergency AMBULATORY SURGERIES Department Visits EMERGENCY DEPARTMENT VISITS Ambulatory Surgeries 600,000 527,294 493,036 505,936 495,353 502,265 453,411 452,436 67,034 68,823 69,126 69,695 69,941 450,000 70,000 63,222 63,980 63,195 65,103 403,892 407,719 417,842 58,967 60,000 50,000 300,000 40,000 30,000 20,000 150,000 10,000 0 Year 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Note: Calculations are based on reported utilization figures for the District of Columbia acute non-federal hospitals. Note: Calculations are based on reported utilization figures for the District of Columbia acute non-federal hospitals.

UTILIZATION INDICATORS / PAGE 2 UTILIZATION INDICATORS / PAGE 3 The number of inpatient admissions has declined over the last five years, with INPATIENT a decrease of almost half a percent in 2015 compared to 2014. As evident in PSYCH Yearly Utilization Report 2015 ADMISSIONS the overall increase in ambulatory surgeries, the hospitals continue to provide ADMISSIONS 2014 2015 % Change more and more care on an outpatient basis. and ACUTE ------Children’s National Medical Center 1,062 1,163 9.51 PATIENT ------George Washington University Hospital 1,125 962 -14.49 DAYS ------Howard University Hospital 580 570 -1.72 ------MedStar Georgetown University Hospital 465 415 -10.75 ------MedStar Washington Hospital Center 1,720 1,665 -3.20 ------Providence Hospital 1,568 1,706 8.80 ------Sibley Memorial Hospital 618 744 20.39 ------TOTAL Yearly Utilization Report 2015 United Medical Center 1,217 1,252 2.88 ------ADMISSIONS 2014 2015 % Change ACUTE TOTAL 8,355 8,477 1.46 ------

ACUTE ------SPECIALTY ------Children’s National Medical Center 14,054 14,381 2.33 ------Psychiatric Institute of Washington 4,438 4,247 -4.30 ------George Washington University Hospital 18,733 19,141 2.18 ------Saint Elizabeths Hospital 463 434 -6.26 Howard University Hospital 8,589 9,141 6.43 ------MedStar Georgetown University Hospital 15,756 15,458 -1.89 ------FEDERAL MedStar Washington Hospital Center 35,471 34,015 -4.10 ------Veterans Affairs Medical Center 684 611 -10.67 Providence Hospital 11,249 11,848 5.32 ------Sibley Memorial Hospital 11,405 11,365 -0.35 ------GRAND TOTAL 13,940 13,769 -1.23 United Medical Center 5,691 5,734 0.76 ------ACUTE TOTAL 120,948 121,083 0.11 ------

------SPECIALTY ------BridgePoint Hospital Capitol Hill 444 658 48.20 ------BridgePoint Hospital Hadley 533 748 40.34 ------Yearly Utilization Report 2015 MedStar National Rehabilitation Hospital 2,168 2,047 -5.58 REHAB ------2014 2015 % Change Psychiatric Institute of Washington 4,438 4,247 -4.30 ADMISSIONS ------Saint Elizabeths Hospital 463 434 -6.26 ------ACUTE ------

------George Washington University Hospital 279 306 9.68 FEDERAL ------Veterans Affairs Medical Center 7,488 6,816 -8.97 ------SPECIALTY ------

------MedStar National Rehabilitation Hospital 2,168 2,047 -5.58 ------GRAND TOTAL 136,482 136,033 -0.33

------FEDERAL ------Veterans Affairs Medical Center 99 92 -7.07 ------

------GRAND TOTAL 2,546 2,445 -3.97

Note: Hospital averages are rounded; therefore, their sums may not match totals. Hospital figures are self-reported.

UTILIZATION INDICATORS / PAGE 4 UTILIZATION INDICATORS / PAGE 5 SNF Yearly Utilization Report 2015 TOTAL Yearly Utilization Report 2015 ADMISSIONS 2014 2015 % Change PATIENT DAYS 2014 2015 % Change

ACUTE ACUTE ------Providence Hospital 554 608 9.75 Children’s National Medical Center 71,559 75,502 5.51 ------Sibley Memorial Hospital 915 925 1.09 George Washington University Hospital 94,679 101,947 7.68 ------United Medical Center 75 91 21.33 Howard University Hospital 41,066 38,137 -7.13 ------ACUTE TOTAL 1,544 1,624 5.18 MedStar Georgetown University Hospital 109,421 109,352 -0.06 ------MedStar Washington Hospital Center 223,116 218,941 -1.87 ------SPECIALTY Providence Hospital 129,063 139,115 7.79 ------BridgePoint Hospital Capitol Hill 131 126 -3.82 Sibley Memorial Hospital 56,762 55,506 -2.21 ------BridgePoint Hospital Hadley 90 123 36.67 United Medical Center 31,311 30,475 -2.67 ------ACUTE TOTAL 756,977 768,975 1.58 ------

FEDERAL ------Veterans Affairs Medical Center 96 85 SPECIALTY -11.46 ------BridgePoint Hospital Capitol Hill 50,378 56,188 11.53 ------BridgePoint Hospital Hadley 33,626 39,111 16.31 GRAND TOTAL 1,861 1,958 5.21 ------MedStar National Rehabilitation Hospital 37,463 36,271 -3.18 ------Psychiatric Institute of Washington 32,682 32,741 0.18 ------Saint Elizabeths Hospital 97,583 99,114 1.57 NEONATAL Yearly Utilization Report 2015 ------ADMISSIONS 2014 2015 % Change ------FEDERAL ------Veterans Affairs Medical Center 85,306 82,904 -2.82 Children's National Medical Center 869 797 -8.29 ------George Washington University Hospital 368 339 -7.88 ------Howard University Hospital 166 150 -9.64 GRAND TOTAL 1,094,015 1,115,304 1.95 ------MedStar Georgetown University Hospital 365 352 -3.56 ------MedStar Washington Hospital Center 1,532 1,434 -6.40 ------Providence Hospital 188 212 12.77 ------Note: Hospital averages are rounded; therefore, their sums may not match totals. Hospital figures are self-reported.

------GRAND TOTAL 3,488 3,284 -5.85

NEWBORN Yearly Utilization Report 2015 ADMISSIONS 2014 2015 % Change

George Washington University Hospital 3,003 3,127 4.13 ------Howard University Hospital 819 844 3.05 ------MedStar Georgetown University Hospital 937 842 -10.14 ------MedStar Washington Hospital Center 3,336 3,394 1.74 ------Providence Hospital 1,850 1,971 6.54 ------Sibley Memorial Hospital 3,493 3,403 -2.58 ------United Medical Center 488 365 -25.21 ------

------GRAND TOTAL 13,926 13,946 0.14

UTILIZATION INDICATORS / PAGE 6 UTILIZATION INDICATORS / PAGE 7 PSYCH Yearly Utilization Report 2015 SNF Yearly Utilization Report 2015 PATIENT DAYS 2014 2015 % Change PATIENT DAYS 2014 2015 % Change

ACUTE ACUTE ------Children’s National Medical Center 6,924 7,262 4.88 Providence Hospital 87,784 87,698 -0.10 ------George Washington University Hospital 6,092 5,752 -5.58 Sibley Memorial Hospital 13,095 13,540 3.40 ------Howard University Hospital 2,423 2,273 -6.19 United Medical Center 38,746 39,599 2.20 ------MedStar Georgetown University Hospital 3,412 3,233 -5.25 ACUTE TOTAL 139,625 140,837 0.87 ------MedStar Washington Hospital Center 13,418 11,974 -10.76 ------Providence Hospital 8,611 8,989 4.39 SPECIALTY ------Sibley Memorial Hospital 6,570 6,191 -5.77 BridgePoint Hospital Capitol Hill 41,315 40,634 -1.65 ------United Medical Center 8,004 7,992 -0.15 BridgePoint Hospital Hadley 20,839 21,503 3.19 ------ACUTE TOTAL 55,454 53,666 -3.22 ------FEDERAL ------SPECIALTY Veterans Affairs Medical Center 17,694 17,927 1.32 ------Psychiatric Institute of Washington 32,682 32,741 0.18 ------Saint Elizabeths Hospital 97,583 99,114 1.57 ------GRAND TOTAL 219,473 220,901 0.65

------FEDERAL ------Veterans Affairs Medical Center 8,759 8,895 1.55 ------NEONATAL Yearly Utilization Report 2015 ------PATIENT DAYS 2014 2015 % Change GRAND TOTAL 194,478 194,416 -0.03 Children's National Medical Center 18,743 18,948 1.09 ------George Washington University Hospital 4,452 4,866 9.30 ------Howard University Hospital 3,559 3,149 -11.52 ------MedStar Georgetown University Hospital 6,819 6,967 2.17 ------Yearly Utilization Report 2015 MedStar Washington Hospital Center 10,107 10,239 1.31 REHAB ------Providence Hospital 1,181 1,316 11.43 PATIENT DAYS 2014 2015 % Change ------

ACUTE ------GRAND TOTAL 44,861 45,485 1.39 George Washington University Hospital 4,289 4,862 13.36 ------

------SPECIALTY Yearly Utilization Report 2015 ------NEWBORN MedStar National Rehabilitation Hospital 37,463 36,271 -3.18 ------PATIENT DAYS 2014 2015 % Change

------FEDERAL George Washington University Hospital 6,273 6,361 1.40 ------Veterans Affairs Medical Center 18,000 17,766 -1.30 Howard University Hospital 2,100 2,193 4.43 ------MedStar Georgetown University Hospital 1,927 2,068 7.32 ------55,463 55,727 0.48 MedStar Washington Hospital Center 15,619 15,823 1.31 GRAND TOTAL ------Providence Hospital 4,290 4,581 6.78 ------Sibley Memorial Hospital 9,845 9,708 -1.39 Note: Hospital averages are rounded; therefore, their sums may not match totals. Hospital figures are ------United Medical Center 1,313 964 -26.58 self-reported. ------

------GRAND TOTAL 41,367 41,698 0.80

UTILIZATION INDICATORS / PAGE 8 UTILIZATION INDICATORS / PAGE 9 Observation Patients Observation Patient Days Total Med/ OB/ Peds ICU NICU Psych Other Nursing Sub OBSERVATION Operating Surg GYN Home Acute Beds Beds Beds UTILIZATION DATA 2014 2015 % Change 2014 2015 % Change

ACUTE ACUTE ------Children’s National Medical Center 5,144 7,431 44.46 5,354 6,002 12.10 Children’s National Medical Center 313 0 0 163 70 54 26 0 0 ------George Washington University Hospital 3,657 3,548 -2.98 4,206 4,053 -3.64 George Washington University Hospital 343 202 45 48 12 20 16 16 ------Howard University Hospital 2,882 1,257 -56.38 3,086 1,505 -51.23 Howard University Hospital 241 173 13 0 28 9 18 0 0 ------MedStar Georgetown University Hospital 2,620 3,097 18.21 2,764 3,001 8.58 MedStar Georgetown University Hospital 399 224 33 36 57 36 13 0 0 ------MedStar Washington Hospital Center 5,425 6,569 21.09 6,713 9,084 35.32 MedStar Washington Hospital Center 820 643 33 0 66 32 46 0 0 ------Providence Hospital 2,077 2,326 11.99 2,740 3,221 17.56 Providence Hospital 197 107 31 0 12 9 38 0 192 60 ------Sibley Memorial Hospital 3,165 3,135 -0.95 2,317 3,163 36.51 Sibley Memorial Hospital 188 114 40 0 14 0 20 0 45 ------United Medical Center 2,494 2,264 -9.22 2,869 2,907 1.33 United Medical Center 210 145 15 0 16 0 34 0 120 ------ACUTE TOTAL 27,464 29,627 7.88 30,049 32,936 9.61 ACUTE TOTAL 2,711 1,608 210 199 311 152 215 16 357 60 ------

------FEDERAL PSYCHIATRIC AND OTHER SPECIALTY ------Veterans Affairs Medical Center 797 1,506 89.21 1,088 2,244 106.25 MedStar National Rehabilitation Hospital 137 0 0 0 0 0 0 137 0 ------Psychiatric Institute of Washington 124 0 0 0 0 0 124 0 0 ------GRAND TOTAL Saint Elizabeths Hospital 292 0 0 0 0 0 292 0 0 28,261 31,135 10.17 31,137 35,180 12.99 ------BridgePoint Hospital Capitol Hill 60 60 0 0 0 0 0 0 117 ------Between 2014 and 2015 there was significant variation between hospitals with large increases and decreases in the number of patients classified BridgePoint Hospital Hadley 82 82 0 0 0 0 0 0 62 as “observation patients”. Overall, there was a small increase in the total number of patients and a small decrease in the number of Observation ------patient days. ------FEDERAL ------Veterans Affairs Medical Center 149 99 0 0 22 0 27 0 120 26 ------

------GRAND TOTAL OCCUPANCY RATE 3,555 1,849 210 199 333 152 658 153 656 86 Percent Occupancy

90%

% 76 % % % % % 74 % 73 % % 73 73 73 % 72 72 71% 72 71% 71% 72 70% % % % % % 69 69 69 69 69 68%

60% 2011 2012 2013 2014 2015

Period Covered

UTILIZATION INDICATORS / PAGE 10 UTILIZATION INDICATORS / PAGE 11 1152 15th Street, NW Suite 900 Washington, DC 20005 Phone: 202.682.1581 Fax: 202.371.8151 www.dcha.org