Prevalence and cost of hospital medical errors in the general and elderly United States populations

Figures & data

Table 1. Prevalence rate of medical errors, 2009.

	Count of medical injuries* (n)	Count of medical errors** (n)	Count of inpatient visits (n)	Prevalence rate/1000 visits
Overall	660,688	170,200	3,466,596	49
≥Age 65	330,247	96,756	1,230,836	79

*Medical injuries are determined by ICD-9 codes that indicate a medical injury during the hospital visit. Appendix A lists all ICD-9 codes used to identify a medical injury.

**Medical errors are as sub-set of medical injury. See Appendix B.

Table 2. Top 10 general population medical errors ranked by prevalence, 2009.

General population	Count of medical errors (n)	US extrapolated count of medical errors (n)	Prevalence rate/1000 visits	Median cost of medical error	Total cost of medical error (1000s)
Pressure Ulcer (Medicare Never Event)	63,335	470,447	18.3	$1017	$478,501
Post-operative infection	20,524	145,736	5.9	$3906	$569,286
Hypotension—iatrogenic	8913	64,370	2.6	$1223	$78,737
Substances causing adverse effects in therapeutic use	7587	55,250	2.2	$764	$42,191
Infection due to central venous catheter	7174	50,213	2.1	$10,394	$521,932
Accidental puncture or laceration during a procedure, NEC	6637	46,087	1.9	$1974	$90,990
Catheter-associated urinary tract infection (Medicare Never Event)	6089	43,540	1.8	$2171	$94,545
Hematoma complicating a procedure	5979	41,229	1.7	$3083	$127,088
Hemorrhage complicating a procedure	5822	41,096	1.7	$2912	$119,670
Abnormal reaction due to surgery without mentioning of misadventure	4028	28,960	1.2	$1450	$41,982

NEC, not elsewhere classified.

Table 3. Top 10 elderly population medical errors ranked by prevalence, 2009.

	Count of medical errors (n)	US extrapolated count of medical errors (n)	Prevalence rate/1000 visits	Median cost of medical error	Total cost of medical error (1000s)
Pressure Ulcer (Medicare Never Event)	46,004	346,691	37.4	$1001	$347,166
Post-operative infection	7717	56,679	6.3	$3819	$216,464
Hypotension—iatrogenic	5269	38,708	4.3	$1273	$49,284
Catheter-associated urinary tract infection (Medicare Never Event)	4268	30,751	3.5	$2408	$74,050
Substances causing adverse effects in therapeutic use	4267	31,537	3.5	$860	$27,127
Hematoma complicating a procedure	3091	21,544	2.5	$3298	$71,055
Hemorrhage complicating a procedure	2869	20,322	2.3	$3419	$69,489
Accidental puncture or laceration during a procedure, NEC	2769	19,183	2.2	$2717	$52,119
Infection due to central venous catheter	2547	18,412	2.1	$10795	$198,749
Pneumothorax	1935	13,754	1.6	$2925	$40,235

NEC, not elsewhere classified.

Table A1. ICD-9 codes for injuries associated with an error.

Injury type	ICD-9 code list
Abnormal reaction due to other procedures without mentioning of misadventure	E879.0, E879.1, E879.2, E879.3, E879.4, E879.5, E879.6, E879.7, E879.8, E879.9
Abnormal reaction due to surgery without mentioning of misadventure	E878.0, E878.1, E878.2, E878.3, E878.4, E878.5, E878.6, E878.8, E878.9
Accidental cut, puncture, perforation, or hemorrhage	E870.1, E870.3, E870.4, E870.5, E870.6, E870.8, E870.9
Accidental puncture or laceration during a procedure, NEC	998.2
Acute reaction to foreign substance accidentally left in during procedure	998.7
Air Embolism (Medicare Never Event)	999.1
Amputation stump complication	997.60, 997.69
Blind loop syndrome	579.2
Blood-Type Incompatibility (Medicare Never Event)	999.6, 999.7, E876.0
Cataract fragments in eye following cataract surgery	998.82
Catheter-associated urinary tract infection (Medicare Never Event)	996.64
Colostomy and enterostomy complications	569.60, 569.69
Colostomy and enterostomy complications–Infection	569.61
Complication of prosthetic joint	996.41, 996.42, 996.43, 996.44, 996.47
Complications affecting other specified body systems, not elsewhere classified	997.91
Complications affecting specified body systems, not elsewhere classified	997.00, 997.01, 997.09, 997.1, 997.2, 997.39, 997.4, 997.5, 997.99
Complications of labor and delivery	669.40, 669.41, 669.42, 669.43, 669.44
Complications of medical care, not elsewhere classified	999.2, 999.9
Complications of re-attached extremity or body part	996.90, 996.91, 996.92, 996.93, 996.94, 996.95, 996.96, 996.99
Complications of the administration of anesthetic or other sedation in labor and delivery	668.00, 668.01, 668.02, 668.03, 668.04, 668.10, 668.11, 668.12, 668.13, 668.14, 668.20, 668.21, 668.22, 668.23, 668.24, 668.80, 668.81, 668.82, 668.83, 668.84, 668.90, 668.91, 668.92, 668.93, 668.94
Complications of the Puerperium (670–677)	674.10, 674.12, 674.14, 674.20, 674.22, 674.24, 674.30, 674.32, 674.34
Complications of transplanted organ	996.80, 996.81, 996.82, 996.83, 996.84, 996.85, 996.86, 996.87, 996.89
Complications peculiar to certain specified procedures	996.45, 996.46
Contact dermatitis and other eczema	692.3
Contaminated transfusion, injection, drug	E875.0, E875.1, E875.2, E875.8, E875.9
Dermatitis due to substances taken internally	693.0
Disorders of the pituitary gland and its hypothalamic control	253.7
Disruption of operation wound	998.3, 998.30, 998.31, 998.32, 998.33
Dosage failure in shock therapy	E873.4
Emphysema (subcutaneous) (surgical) resulting from procedure	998.81
Encephalitis, myelitis, and encephalomyelitis	323.5, 323.51, 323.52
Failure in suture and ligature during surgical operation	E876.2
Failure of sterile precautions during procedure	E872.0, E872.1, E872.3, E872.4, E872.6, E872.8, E872.9
Failure to introduce or remove other tube or instrument	E876.4
Gastrostomy complications	536.40, 536.49
Gastrostomy complications—Infection	536.41
Gastrostomy complications—Mechanical	536.42
Generalized vaccinia as a complication of medical care	999.0
Hematoma complicating a procedure	998.12
Hemorrhage complicating a procedure	998.11
Hypotension—Iatrogenic	458.2, 458.21, 458.29
Iatrogenic cerebrovascular infarction or hemorrhage	997.02
Inappropriate temperature in local application and packing	E873.5
Incorrect amount or dilution of fluid during transfusion or infusion	E873.0
Infection and inflammatory reaction due to internal prosthetic device, implant, and graft	996.60, 996.61, 996.62, 996.63, 996.65, 996.66, 996.67, 996.68, 996.69
Infection due to central venous catheter	999.31
Infection following other infusion, injection, transfusion, or vaccination	999.39
Infection of amputation stump	997.62
Infusion or transfusion reaction	999.8, 999.81, 999.82, 999.88, 999.89
Late effects of other and unspecified external causes	909.0, 909.2, 909.3, 909.5
Malignant Hyperthermia	995.86
Mechanical complication of cardiac device, implant, and graft	996.00, 996.01, 996.02, 996.03, 996.04, 996.09
Mechanical complication of device, implant, or graft	996.1, 996.2, 996.40, 996.49
Mechanical complication of genitourinary device, implant, and graft	996.30, 996.31, 996.32, 996.39
Mechanical complication of other specified prosthetic device, implant, and graft	996.51, 996.52, 996.53, 996.54, 996.55, 996.56, 996.57, 996.59
Mechanical failure of instrument or apparatus	E874.0, E874.1, E874.4, E874.5, E874.8, E874.9
Neuroma of amputation stump	997.61
Non-administration of necessary drug or medicinal substance	E873.6
Non-healing surgical wound	998.83
Non-infectious disorders of lymphatic channels	457.0
Noxious influences affecting fetus or newborn via placenta or breast milk	760.72, 760.76
Noxious influences affecting fetus or newborn via placenta or breast milk—anti-infectives	760.74
Object left in body (Medicare Never Event)	998.4, E871.0, E871.1, E871.2, E871.3, E871.5, E871.6, E871.7, E871.8, E871.9
Other and unspecified disorders of the nervous system	349.0, 349.1
Other and unspecified extrapyramidal diseases and abnormal movement disorders	333.92
Other and unspecified non-infectious gastroenteritis and colitis	558.1
Other complications of internal (biological) (synthetic) prosthetic device, implant, and graft	996.70, 996.71, 996.72, 996.73, 996.74, 996.75, 996.76, 996.77, 996.78, 996.79
Other complications or adverse effects not elsewhere classified	995.89, 998.89, 998.9
Other failure in dosage	E873.8, E873.9
Other specified types of cystitis	595.82
Overdose or inadvertent exposure to radiation	E873.2, E873.3
Persistent post-operative fistula, NEC	998.6
Pneumothorax	512.1
Poisoning	960.0, 960.1, 960.2, 960.3, 960.4, 960.5, 960.6, 960.7, 960.8, 960.9, 961.0, 961.1, 961.2, 961.3, 961.4, 961.5, 961.6, 961.7, 961.8, 961.9, 962.0, 962.1, 962.2, 962.3, 962.4, 962.5, 962.6, 962.7, 962.8, 962.9, 963.0, 963.1, 963.2, 963.3, 963.4, 963.5, 963.8, 963.9, 964.0, 964.1, 964.2, 964.3, 964.4, 964.5, 964.6, 964.7, 964.8, 964.9, 965.00, 965.02, 965.09, 965.1, 965.4, 965.5, 965.61, 965.69, 965.7, 965.8, 965.9, 966.0, 966.1, 966.2, 966.3, 966.4, 967.0, 967.1, 967.2, 967.3, 967.4, 967.5, 967.6, 967.8, 967.9, 968.0, 968.1, 969.0, 969.1, 969.2, 969.3, 969.4, 969.5, 969.7, 969.8, 969.9, 970.0, 970.1, 970.8, 970.9, 971.0, 971.1, 971.2, 971.3, 971.9, 972.0, 972.1, 972.2, 972.3, 972.4, 972.5, 972.6, 972.7, 972.8, 972.9, 973.0, 973.1, 973.2, 973.3, 973.4, 973.5, 973.6, 973.8, 973.9, 974.0, 974.1, 974.2, 974.3, 974.4, 974.5, 974.6, 974.7, 975.0, 975.1, 975.2, 975.3, 975.4, 975.5, 975.6, 975.7, 975.8, 976.0, 976.1, 976.2, 976.3, 976.4, 976.5, 976.6, 976.7, 976.8, 976.9, 977.0, 977.1, 977.2, 977.3, 977.4, 977.8, 977.9, 978.0, 978.1, 978.2, 978.3, 978.4, 978.5, 978.6, 978.8, 978.9, 979.0, 979.1, 979.2, 979.3, 979.4, 979.5, 979.6, 979.7, 979.9, E850.1, E850.2, E850.3, E850.4, E850.6, E850.7, E850.8, E850.9, E851, E852.2, E852.4, E852.8, E852.9, E853.0, E853.1, E853.2, E853.8, E853.9, E854.0, E854.2, E854.3, E854.8, E855.0, E855.1, E855.2, E855.3, E855.4, E855.5, E855.6, E855.8, E855.9, E856, E857, E858.0, E858.1, E858.2, E858.3, E858.4, E858.5, E858.6, E858.7, E858.8, E858.9, E950.0, E950.1, E950.2, E950.3, E950.4, E950.5, E962.0, E980.0, E980.1, E980.2, E980.3, E980.4, E980.5
Poisoning—Anesthetics	968.2, 968.3, 968.4, 968.5, 968.6, 968.7, 968.9
Post-cholecystectomy syndrome	576.0
Post-gastric surgery syndrome	564.2
Post-laminectomy syndrome	722.80, 722.81, 722.82, 722.83
Post-operative infection	998.51, 998.59
Post-operative Shock	998.0
Pressure Ulcer (Medicare Never Event)	707.0, 707.00, 707.01, 707.02, 707.03, 707.04, 707.05, 707.06, 707.07, 707.09, 707.20, 707.22, 707.23, 707.24
Radiation Kyphosis or scoliosis	737.11, 737.33
Respiratory conditions due to other and unspecified external agents	508.0, 508.1
Seroma complicating a procedure	998.13
Serum reaction	999.4, 999.5
Shock due to anesthesia	995.4
Substances causing adverse effects in therapeutic use	357.6, E930.0, E930.1, E930.2, E930.3, E930.4, E930.5, E930.6, E930.7, E930.8, E930.9, E931.0, E931.1, E931.2, E931.3, E931.4, E931.5, E931.6, E931.7, E931.8, E931.9, E932.0, E932.1, E932.2, E932.3, E932.4, E932.5, E932.6, E932.7, E932.8, E932.9, E933.0, E933.1, E933.2, E933.3, E933.4, E933.5, E933.6, E933.7, E933.8, E933.9, E934.0, E934.1, E934.2, E934.3, E934.4, E934.5, E934.6, E934.7, E934.8, E934.9, E935.1, E935.2, E935.3, E935.4, E935.5, E935.6, E935.7, E935.8, E935.9, E936.0, E936.1, E936.2, E936.3, E936.4, E937.0, E937.1, E937.2, E937.4, E937.6, E937.8, E937.9, E938.0, E938.1, E938.2, E938.3, E938.4, E938.5, E938.6, E938.7, E938.9, E939.0, E939.1, E939.2, E939.3, E939.4, E939.5, E939.7, E939.8, E939.9, E940.1, E940.8, E940.9, E941.0, E941.1, E941.2, E941.3, E941.9, E942.0, E942.1, E942.2, E942.3, E942.4, E942.5, E942.6, E942.7, E942.8, E942.9, E943.0, E943.1, E943.2, E943.3, E943.4, E943.5, E943.6, E943.8, E943.9, E944.0, E944.1, E944.2, E944.3, E944.4, E944.5, E944.6, E944.7, E945.0, E945.1, E945.2, E945.3, E945.4, E945.5, E945.6, E945.7, E945.8, E946.0, E946.1, E946.2, E946.3, E946.4, E946.5, E946.6, E946.7, E946.8, E946.9, E947.0, E947.1, E947.2, E947.3, E947.4, E947.8, E947.9, E948.0, E948.1, E948.3, E948.4, E948.5, E948.6, E948.8, E948.9, E949.0, E949.1, E949.3, E949.4, E949.5, E949.6, E949.7, E949.9
Surgery on the wrong limb/person (Medicare Never Event)	E876.5
Surgical complication of the respiratory system	997.3
Thyroiditis	245.4
Tracheostomy complications	519.00, 519.02, 519.09
Tracheostomy complications—Infection	519.01
Unspecified adverse effect of drug medicinal and biological substance not elsewhere classified	995.2, 995.20, 995.21, 995.22, 995.23, 995.24, 995.27, 995.29
Urethral stricture	598.2
Ventilator associated pneumonia	997.31
Ventral hernia without mention of obstruction or gangrene	553.21
Wrong fluid in transfusion	E876.1

NEC, not elsewhere classified.

Table A2. Percentage of occurrences with error.

Error type	Percentage of occurrences with error	Mid-point for frequency calculation
Abnormal reaction due to other procedures without mentioning of misadventure	<10	0.05
Abnormal reaction due to surgery without mentioning of misadventure	<10	0.05
Accidental cut, puncture, perforation, or hemorrhage	>90	0.95
Accidental puncture or laceration during a procedure, NEC	>90	0.95
Acute reaction to foreign substance accidentally left in during procedure	>90	0.95
Air Embolism (Medicare Never Event)	>90	0.95
Amputation stump complication	<10	0.05
Blind loop syndrome	<10	0.05
Blood-Type Incompatibility (Medicare Never Event)	>90	0.95
Cataract fragments in eye following cataract surgery	>90	0.95
Catheter-associated urinary tract infection (Medicare Never Event)	>90	0.95
Colostomy and enterostomy complications	<10	0.05
Colostomy and enterostomy complications—Infection	>90	0.95
Complication of prosthetic joint	10–35	0.225
Complications affecting other specified body systems, not elsewhere classified	<10	0.05
Complications affecting specified body systems, not elsewhere classified	<10	0.05
Complications of labor and delivery	<10	0.05
Complications of medical care, not elsewhere classified	<10	0.05
Complications of reattached extremity or body part	<10	0.05
Complications of the administration of anesthetic or other sedation in labor and delivery	<10	0.05
Complications of the Puerperium (670–677)	<10	0.05
Complications of transplanted organ	<10	0.05
Complications peculiar to certain specified procedures	<10	0.05
Contact dermatitis and other eczema	<10	0.05
Contaminated transfusion, injection, drug	>90	0.95
Dermatitis due to substances taken internally	<10	0.05
Disorders of the pituitary gland and its hypothalamic control	65–90	0.775
Disruption of operation wound	10–35	0.225
Dosage failure in shock therapy	>90	0.95
Emphysema (subcutaneous) (surgical) resulting from procedure	10–35	0.225
Encephalitis, myelitis, and encephalomyelitis	<10	0.05
Failure in suture and ligature during surgical operation	>90	0.95
Failure of sterile precautions during procedure	>90	0.95
Failure to introduce or remove other tube or instrument	>90	0.95
Gastrostomy complications	<10	0.05
Gastrostomy complications—Infection	>90	0.95
Gastrostomy complications—Mechanical	10–35	0.225
Generalized vaccinia as a complication of medical care	10–35	0.225
Hematoma complicating a procedure	35–65	0.5
Hemorrhage complicating a procedure	35–65	0.5
Hypotension—Iatrogenic	35–65	0.5
Iatrogenic cerebrovascular infarction or hemorrhage	>90	0.95
Inappropriate temperature in local application and packing	>90	0.95
Incorrect amount or dilution of fluid during transfusion or infusion	>90	0.95
Infection and inflammatory reaction due to internal prosthetic device, implant, and graft	<10	0.05
Infection due to central venous catheter	>90	0.95
Infection following other infusion, injection, transfusion, or vaccination	>90	0.95
Infection of amputation stump	>90	0.95
Infusion or transfusion reaction	10–35	0.225
Late effects of other and unspecified external causes	<10	0.05
Malignant Hyperthermia	<10	0.05
Mechanical complication of cardiac device, implant, and graft	10–35	0.225
Mechanical complication of device, implant, or graft	10–35	0.225
Mechanical complication of genitourinary device, implant, and graft	10–35	0.225
Mechanical complication of other specified prosthetic device, implant, and graft	<10	0.05
Mechanical failure of instrument or apparatus	>90	0.95
Neuroma of amputation stump	10–35	0.225
Non-administration of necessary drug or medicinal substance	>90	0.95
Non-healing surgical wound	<10	0.05
Non-infectious disorders of lymphatic channels	<10	0.05
Noxious influences affecting fetus or newborn via placenta or breast milk	10–35	0.225
Noxious influences affecting fetus or newborn via placenta or breast milk—anti-infectives	<10	0.05
Object left in body (Medicare Never Event)	>90	0.95
Other and unspecified disorders of the nervous system	<10	0.05
Other and unspecified extrapyramidal diseases and abnormal movement disorders	<10	0.05
Other and unspecified non-infectious gastroenteritis and colitis	<10	0.05
Other complications of internal (biological) (synthetic) prosthetic device, implant, and graft	<10	0.05
Other complications or adverse effects not elsewhere classified	<10	0.05
Other failure in dosage	>90	0.95
Other specified types of cystitis	<10	0.05
Overdose or inadvertent exposure to radiation	>90	0.95
Persistent post-operative fistula, NEC	<10	0.05
Pneumothorax	35–65	0.5
Poisoning	<10	0.05
Poisoning—Anesthetics	10–35	0.225
Post-cholecystectomy syndrome	10–35	0.225
Post-gastric surgery syndrome	10–35	0.225
Post-laminectomy syndrome	10–35	0.225
Post-operative infection	>90	0.95
Post-operative Shock	10–35	0.225
Pressure Ulcer (Medicare Never Event)	>90	0.95
Radiation Kyphosis or scoliosis	<10	0.05
Respiratory conditions due to other and unspecified external agents	<10	0.05
Seroma complicating a procedure	10–35	0.225
Serum reaction	10–35	0.225
Shock due to anesthesia	10–35	0.225
Substances causing adverse effects in therapeutic use	<10	0.05
Surgery on the wrong limb/person (Medicare Never Event)	>90	0.95
Surgical complication of the respiratory system	10–35	0.225
Thyroiditis	10–35	0.225
Tracheostomy complications	<10	0.05
Tracheostomy complications—Infection	10–35	0.225
Unspecified adverse effect of drug medicinal and biological substance not elsewhere classified	<10	0.05
Urethral stricture	10–35	0.225
Ventilator associated pneumonia	>90	0.95
Ventral hernia without mention of obstruction or gangrene	10–35	0.225
Wrong fluid in transfusion	>90	0.95

NEC, not elsewhere classified.

Table A3. Injury and no injury population prior to propensity matching.

	Overall					Elderly
Category	Injury		No injury		p-Value	Injury		No injury		p-Value
Patients	470,561		2,986,019			238,853		987014
Age group at diagnosis
<65	231,708	49.2%	1,999,005	66.9%		NA		NA
65+	238,853	50.8%	987,014	33.1%		238,853		987014
Gender					‡					‡
Male	214,221	45.5%	1,222,002	40.9%		106,976	44.8%	418,829	42.4%
Female	256,335	54.5%	1,763,890	59.1%		131,874	55.2%	568,178	57.6%
Unknown	5	0.0%	127	0.0%		3	0.0%	7	0.0%
Race					‡					‡
White	307,879	65.4%	1,784,609	59.8%		165,671	69.4%	683,743	69.3%
Black	64,400	13.7%	426,787	14.3%		24,131	10.1%	92,370	9.4%
Hispanic	21,594	4.6%	207,934	7.0%		9,119	3.8%	41,042	4.2%
Other/unknown	76,688	16.3%	566,689	19.0%		39,932	16.7%	169,859	17.2%
Insurance Product Type					‡					‡
Medicare	268,754	57.1%	1,086,592	36.4%		216,382	90.6%	888,687	90.0%
Medicaid	49,008	10.4%	616,243	20.6%		2,791	1.2%	11,900	1.2%
Commercial	117,724	25.0%	999,492	33.5%		14,351	6.0%	64,002	6.5%
Self-pay/Indigent	18,464	3.9%	167,297	5.6%		735	0.3%	3,837	0.4%
Any other payor	16,611	3.5%	116,395	3.9%		4,594	1.9%	18,588	1.9%
Admission Type					‡					‡
Emergency	272,400	57.9%	1,369,037	45.8%		143,826	60.2%	605,557	61.4%
Urgent	76,141	16.2%	491,731	16.5%		37,324	15.6%	150,577	15.3%
Elective	118,130	25.1%	758,995	25.4%		56,584	23.7%	224,307	22.7%
Trauma center	1,023	0.2%	10,614	0.4%		398	0.2%	2,417	0.2%
Other/unknown	2,867	0.6%	355,642	11.9%		721	0.3%	4,156	0.4%
APR-DRG Severity of Illness					‡					‡
1 = Minor	53,677	11.4%	1,155,065	38.7%		15,830	6.6%	165,720	16.8%
2 = Moderate	146,747	31.2%	1,082,007	36.2%		63,989	26.8%	396,476	40.2%
3 = Major	178,959	38.0%	600,333	20.1%		104,261	43.7%	335,793	34.0%
4 = Extreme	91,177	19.4%	148,489	5.0%		54,773	22.9%	89,023	9.0%
Unknown	1	0.0%	125	0.0%		0	0.0%	2	0.0%
APR-DRG Risk of Mortality					‡					‡
1 = Minor	142,851	30.4%	1,900,542	63.6%		33,827	14.2%	268,761	27.2%
2 = Moderate	132,597	28.2%	638,682	21.4%		72,965	30.5%	397,833	40.3%
3 = Major	130,349	27.7%	329,548	11.0%		85,190	35.7%	233,672	23.7%
4 = Extreme	64,763	13.8%	117,122	3.9%		46,871	19.6%	86,746	8.8%
Unknown	1	0.0%	125	0.0%		0	0.0%	2
Comorbidities
Depressive Disorders	75,869	16.1%	337,189	11.3%	‡	30,139	12.6%	115,520	11.7%	‡
Diverticulitis	4142	0.9%	25,925	0.9%	0.4095	2,319	1.0%	11,676	1.2%	‡
Asthma	35,390	7.5%	197,852	6.6%	‡	13,157	5.5%	55,162	5.6%	0.1245
Cardiac Dysrhythmias	119,761	25.5%	397,879	13.3%	‡	89,340	37.4%	294,903	29.9%	‡
Chronic Bronchitis	23,589	5.0%	107,133	3.6%	‡	16,051	6.7%	69,997	7.1%	‡
Colon Cancer	4822	1.0%	12,266	0.4%	‡	3,147	1.3%	7,620	0.8%	‡
COPD	69,844	14.8%	266,460	8.9%	‡	46,403	19.4%	172,543	17.5%	‡
Coronary Artery Disease	122,666	26.1%	507,125	17.0%	‡	88,774	37.2%	355,709	36.0%	‡
Crohn’s Disease	3281	0.7%	13,954	0.5%	‡	913	0.4%	3,262	0.3%	‡
Diabetes	145,039	30.8%	576,838	19.3%	‡	85,755	35.9%	313,726	31.8%	‡
Emphysema	4853	1.0%	18,295	0.6%	‡	3,233	1.4%	11,775	1.2%	‡
Gastric Ulcer	4815	1.0%	14,033	0.5%	‡	2,829	1.2%	7,903	0.8%	‡
Gastritis	13,833	2.9%	60,108	2.0%	‡	7,990	3.3%	28,798	2.9%	‡
Heart Failure	85,924	18.3%	315,509	10.6%	‡	64,882	27.2%	235,496	23.9%	‡
Hyperlipidemia	110,385	23.5%	511,634	17.1%	‡	71,957	30.1%	315,683	32.0%	‡
Hypertension	200,800	42.7%	988,436	33.1%	‡	122,329	51.2%	563,975	57.1%	‡
Hypothyroidism	59,703	12.7%	254,642	8.5%	‡	40,434	16.9%	164,005	16.6%	‡
Irritable Bowel Disease	4466	0.9%	23,531	0.8%	‡	1,934	0.8%	9,227	0.9%	‡
Lumbar Disk Disease	7416	1.6%	39,095	1.3%	‡	3,335	1.4%	14,170	1.4%	0.1454
Lung, Bronchus, or Trachea	11,456	2.4%	29,868	1.0%	‡	7,479	3.1%	19,394	2.0%	‡
MI (any)	46,294	9.8%	187,815	6.3%	‡	30,898	12.9%	120,786	12.2%	‡
Multiple Sclerosis	3,521	0.7%	9,252	0.3%	‡	916	0.4%	1,902	0.2%	‡
Neurotic Disorders	30,452	6.5%	153,791	5.2%	‡	11,961	5.0%	51,856	5.3%	‡
Osteoarthritis	52,888	11.2%	272,107	9.1%	‡	37,742	15.8%	180,317	18.3%	‡
Osteoporosis	23,377	5.0%	96,308	3.2%	‡	19,181	8.0%	82,302	8.3%	‡
Parkinson’s disease	6315	1.3%	23,111	0.8%	‡	5559	2.3%	20,558	2.1%	‡
Rheumatoid Arthritis	9546	2.0%	34,992	1.2%	‡	6001	2.5%	21,145	2.1%	‡
Skin Cancer	1082	0.2%	3,117	0.1%	‡	686	0.3%	2,099	0.2%	‡
Stroke	9860	2.1%	62,070	2.1%	0.4562	6411	2.7%	40,951	4.1%	‡
Ulcerative Colitis	1989	0.4%	7,717	0.3%	‡	858	0.4%	2,674	0.3%	‡
Provider Area					‡					‡
Northeast	87,279	18.5%	536,306	18.0%		46,692	19.5%	188,830	19.1%
Midwest	110,101	23.4%	660,583	22.1%		58,142	24.3%	228,933	23.2%
South	188,420	40.0%	1,236,972	41.4%		90,357	37.8%	399,064	40.4%
West	84,761	18.0%	552,158	18.5%		43,662	18.3%	170,187	17.2%
Population Served					‡					‡
Urban	413,107	87.8%	2,579,181	86.4%		208,833	87.4%	838,982	85.0%
Rural	57,454	12.2%	406,838	13.6%		30,020	12.6%	148,032	15.0%
Teaching Status					‡					‡
Teaching	182,639	38.8%	1,029,839	34.5%		86,931	36.4%	318,890	32.3%
Non-Teaching	287,922	61.2%	1,956,180	65.5%		151,922	63.6%	668,124	67.7%
Hospital Size					‡					‡
000–099	14,775	3.1%	118,146	4.0%		7,492	3.1%	36,133	3.7%
100–199	46,800	9.9%	328,159	11.0%		24,250	10.2%	113,605	11.5%
200–299	82,446	17.5%	539,254	18.1%		43,673	18.3%	191,326	19.4%
300–399	97,344	20.7%	666,974	22.3%		51,414	21.5%	210,137	21.3%
400–499	81,635	17.3%	525,638	17.6%		41,116	17.2%	174,090	17.6%
500+	147,561	31.4%	807,848	27.1%		70,908	29.7%	261,723	26.5%

‡p-Value < 0.0001.