Profile of Insurance Coverage in a National Inpatient Sample

To identify the hospitals most strongly impacted by health insurance trends, this study investigated the relationships between hospital characteristics and patterns of insurance coverage in a national inpatient sample. Data from the 2007 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project were used to examine hospital characteristics, aggregated patient characteristics, and payer mix (defined as rates of Medicare, Medicaid, private insurance, and uninsured). Medicare was expected to cover nearly half of all inpatient admissions; however, hospitals showed a wide range of percentages for all payers, and some facilities reported up to 61.5% of visits from uninsured patients. Significant multivariate differences in insurance coverage resulted from bed size, location, region, and patient age, gender, racial, and socioeconomic distributions. Results suggest that reimbursement policy changes may disproportionally impact certain hospitals based on their characteristics and/or patient distribution and may be particularly informative in the current era of potential system-wide reform.