Transcript TABLE OF CONTENTS CHAPTER 6.0: The Economic Contribution of Hospitals Chart 6.1: National Health Expenditures as a Percentage of Gross Domestic Product and Breakdown of.

TABLE OF CONTENTS
CHAPTER 6.0:
The Economic Contribution of Hospitals
Chart 6.1:
National Health Expenditures as a Percentage of Gross Domestic Product
and Breakdown of National Health Expenditures, 2007
Chart 6.2:
Number of Full-time and Part-time Hospital Employees, 1993 – 2007
Chart 6.3:
Impact of Community Hospitals on U.S. Economy (in $ billions), 2007
Chart 6.4:
Hospital Employment vs. Employment in Other Industries, 2008
Chart 6.5:
Average Weekly Earnings of Workers, Hospitals vs.
All Service-providing Industries, 1990 – 2007
Chart 6.6:
Hospital Employment by Occupation Type, 2007
Chart 6.7:
Percent Change in Employment, Seasonally-adjusted: Hospital vs.
All Industries (Total Non-farm), 2006 – 2008
Chart 6.8:
Percent of Total Regional Employment by Hospitals, 2007
Chart 6.9:
Impact of Community Hospitals on U.S. Jobs (in millions), 2007
Chart 6.10:
Percent of Hospital Costs by Type of Expense, 2Q08
Chart 6.11:
Hospital Impact on Sectors of the U.S. Economy (in $ billions), 2007
Chart 6.12:
Impact of Community Hospitals on U.S. Economy, All States, DC and Total U.S., 2007
Chart 6.1: National Health Expenditures as a Percentage of Gross
Domestic Product and Breakdown of National Health Expenditures, 2007
U.S. GDP 2007
$2.24 Trillion
Other, 32%
Nursing Home Care, 6%
Other
Sectors,
84.8%
Health Care
Expenditures,
16.2%
Prescription Drugs, 10%
Physician Services, 21%
Hospital Care, 31%
Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released January 6, 2009.
Millions
Chart 6.2: Number of Full-time and Part-time Hospital Employees,
1993 – 2007
5.3
5.2
5.1
5.0
4.9
4.8
4.7
4.6
4.5
4.4
4.3
4.2
4.1
4.0
93
94
95
96
97
98
99
00
01
02
03
04
05
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.
06
07
Chart 6.3: Impact of Community Hospitals on U.S. Economy
(in $ billions), 2007
Direct Effect
Ripple Effect
Total Contribution
$299
Impact on Wages &
Salaries
$419
$718
$603
Impact on Economy
$1,381
$1,984
Source: Avalere Health, using BEA RIMS-II (1997/2006) multipliers applied to 2007 American Hospital Association Annual
Survey data.
Chart 6.4: Hospital Employment vs. Employment in Other
Industries, 2008(1)
Thousands of Employees
6,000
4,500
3,000
1,500
0
Full-service
Restaurants
General
Medical &
Surgical
Hospitals
Limitedservice Eating
Places
Employment
Services
Grocery
Stores
Offices of
Physicians
Building
Equipment
Contractors
Department
Stores
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
2008 figures reflect annual projections.
Chart 6.5: Average Weekly Earnings of Workers, Hospitals(1) vs.
All Service-providing Industries, 1990 – 2007
$900
Average Weekly Earnings
$800
Hospitals
$700
$600
$500
$400
All Service-providing Industries
$300
$200
$100
$0
90
91
92
93
94 95
96
97
98
99
00
01
02
03 04
05
06
07
Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics (CES) Survey, customized tables. Data released 2009.
Link: http://www.bls.gov/ces.
(1)
Includes physicians employed by hospitals.
Chart 6.6: Hospital Employment by Occupation Type, 2007
Health Care Practitioner and Technical
2,814.2
Office and Administrative Support
798.7
706.6
Health Care Support
Other Occupations
267.8
Building and Grounds Cleaning and Maintenance
196.1
Management
184.6
Food Preparation and Serving
154.0
Community and Social Services
132.6
Business and Financial Operations
96.3
59.1
Installation, Maintenance, and Repair
0
500
1,000
1,500
2,000
Number of Employees (Thousands)
2,500
Source: Department of Labor, Bureau of Labor Statistics, 2007 National Industry-specific Occupational Employment and
Wage. Data released February 2009. Link: http://www.bls.gov/oes/current/naics3_622000.htm.
3,000
Chart 6.7: Percent Change in Employment, Seasonally-adjusted: Hospital
vs. All Industries (Total Non-farm), 2006 – 2008
Hospitals
All Industries (Total Non-farm)
Quarterly (3-Month) Percent Change
1.2%
0.8%
0.5%
0.6%
0.4%
0.4%
0.7%
0.6%
0.6%
0.5%
0.4%
0.4% 0.4%
0.3%
0.2%
0.8%
0.7%
0.6%
0.8%
0.7%
0.4%
0.2%
0.0%
0.0%
-0.2%
-0.4%
-0.3%
-0.5%
-0.8%
-1.2%
-1.2%
-1.6%
Qtr 1
Qtr 2
Qtr 3
2006
Qtr 4
Qtr 1
Qtr 2
Qtr 3
Qtr 4
2007
Source: Department of Labor, Bureau of Labor Statistics. Link: http://www.bls.gov/bls/employment.htm.
Qtr 1
Qtr 2
Qtr 3
2008
Qtr 4
Chart 6.8: Percent of Total Regional Employment(1) by Hospitals, 2007
4.7%
Mountain
West North Central
East North
Central
4.5%
New
England
4.3%
4.3%
3.2%
Pacific
2.9%
Mid-Atlantic
4.6%
3.5%
3.4%
South
Atlantic
West South
Central
East
South
Central
Source: Avalere Health analysis of American Hospital Association 2007 Annual Survey data and 2007 total non-farm
employment data from the Bureau of Labor Statistics.
(1)
Does not include farm employment.
Chart 6.9: Impact of Community Hospitals on U.S. Jobs (in millions), 2007
Direct Jobs
Ripple Effect
5.3
9.5
Total Jobs
Source: Avalere Health, using BEA RIMS-II (1997/2006) multipliers applied to 2007 American Hospital Association Annual
Survey data.
14.8
Chart 6.10: Percent of Hospital Costs(1) by Type of Expense, 2Q08
Other Products
Prescription Drugs,
6.4%
(e.g., Food,
Medical
Instruments),
14.8%
Professional Fees, 5.4%
Utilities, 1.4%
Professional Liability Insurance, 2.0%
Other Services,
19.4%
All Other: Labor Intensive, 4.0%
Wages and Benefits,
59.5%
(2)
All Other: Non-labor Intensive, 6.6%
Source: AHA analysis of Centers for Medicare and Medicaid Services data, using base year 2002 weights.
(1)
Does not include capital.
(2)
Includes postage and telephone expenses.
Chart 6.11: Hospital Impact on Sectors of the U.S. Economy
(in $ billions), 2007
Industry
Health care and social assistance
Economic Impact
$697.9
Manufacturing
297.2
Real estate and rental and leasing
187.9
Finance and insurance
126.8
Professional, scientific and technical services
82.4
Retail trade
81.1
Wholesale trade
65.0
Information
64.9
Transportation and warehousing
61.8
Administrative and waste management services
61.5
Accommodation and food services
51.0
Other services
49.7
Management of companies and enterprises
39.9
Utilities
35.3
Agriculture, forestry, fishing and hunting
29.1
Educational services
16.0
Arts, entertainment, and recreation
14.2
Mining
12.5
Construction
Total
9.8
$1,984.0
Source: Avalere Health, using BEA RIMS-II (1997/2006) multipliers applied to 2007 American Hospital
Association Annual Survey data.
Chart 6.12: Impact of Community Hospitals on U.S. Economy; All States, DC
and Total U.S., 2007
State Name
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
U.S.
Number of
Hospital Jobs
(FT and PT)
84,372
10,373
81,851
48,358
488,413
64,565
64,512
18,192
25,453
274,075
142,804
17,231
23,081
238,827
121,943
69,362
50,930
79,408
83,035
34,068
88,988
170,921
202,310
109,745
57,797
128,399
21,189
41,535
24,104
29,170
145,810
23,920
410,448
160,251
19,702
255,472
55,856
55,836
280,451
21,269
70,611
20,689
135,462
322,603
39,172
12,997
107,870
94,091
42,024
108,969
8,989
5,287,503
Multiplier for
Employment
2.0128
1.8931
2.1321
1.9434
2.2751
2.2728
1.9089
1.9083
1.5648
2.0425
2.1991
2.1522
2.0753
2.2421
2.0684
1.9678
1.9810
2.0151
1.9761
2.0994
2.0835
2.0772
2.0864
2.2509
1.9358
2.1314
2.0277
2.0012
1.9473
2.0164
2.1713
2.0834
1.8941
2.1746
1.8906
2.1845
2.0911
2.2135
2.1859
1.9944
2.1289
1.8942
2.1825
2.3308
2.2587
2.0105
1.9699
2.2047
1.9048
2.0666
1.7451
2.8048
Effect of Hospital
Jobs on Total Jobs
in State Economy
169,824
19,637
174,515
93,979
1,111,188
146,743
123,147
34,716
39,829
559,798
314,040
37,085
47,900
535,474
252,227
136,491
100,892
160,015
164,085
71,522
185,406
355,037
422,100
247,025
111,883
273,670
42,965
83,120
46,938
58,818
316,597
49,835
777,430
348,482
37,249
558,079
116,800
123,593
613,038
42,419
150,324
39,189
295,646
751,923
88,478
26,130
212,493
207,442
80,047
225,195
15,687
14,830,388
Percent of Total
(Non-farm)
Employment
Supported by
Hospital Employment
8.46%
6.18%
6.55%
7.81%
7.33%
6.30%
7.25%
7.95%
5.73%
6.96%
7.57%
5.95%
7.31%
8.95%
8.44%
9.00%
7.32%
8.56%
8.54%
11.58%
7.10%
10.83%
9.90%
8.92%
9.71%
9.79%
9.70%
8.63%
3.63%
9.06%
7.77%
5.91%
8.90%
8.41%
10.41%
10.29%
7.46%
7.14%
10.58%
8.60%
7.71%
9.64%
10.57%
7.26%
7.07%
8.49%
5.65%
7.08%
10.58%
7.81%
5.44%
10.80%
Hospital Payroll
and Benefits
($ millions)
Multiplier for
Earnings
$3,935
$754
$4,812
$2,271
$29,662
$4,019
$4,040
$1,119
$1,729
$15,482
$7,460
$1,099
$1,143
$13,321
$6,511
$3,185
$2,535
$4,084
$4,060
$1,745
$5,215
$9,860
$11,498
$6,370
$2,908
$6,510
$1,030
$2,098
$1,755
$1,770
$8,816
$1,561
$27,886
$8,674
$948
$13,913
$2,728
$3,511
$14,380
$1,443
$3,667
$977
$6,734
$17,986
$1,871
$875
$6,129
$6,183
$2,036
$5,971
$465
$298,734
1.7382
1.5342
1.7511
1.6528
1.9677
1.9439
1.7029
1.6208
1.3668
1.7860
1.9466
1.6993
1.6781
2.0074
1.7652
1.6683
1.6851
1.7246
1.6890
1.6934
1.7969
1.8276
1.7892
1.8750
1.6342
1.8270
1.6295
1.7151
1.6078
1.7655
1.8966
1.6371
1.6807
1.8509
1.5824
1.8463
1.7621
1.7507
1.9220
1.6867
1.7830
1.5882
1.8680
1.9591
1.9017
1.5910
1.7659
1.8049
1.5673
1.7664
1.4443
2.4031
Effect of Hospital
Payroll and Benefits
on Total Labor Income
($ millions)
$6,840
$1,157
$8,426
$3,754
$58,366
$7,813
$6,880
$1,814
$2,363
$27,651
$14,522
$1,868
$1,918
$26,741
$11,493
$5,314
$4,272
$7,043
$6,857
$2,955
$9,371
$18,020
$20,572
$11,944
$4,752
$11,894
$1,678
$3,598
$2,822
$3,125
$16,720
$2,556
$46,868
$16,055
$1,500
$25,688
$4,807
$6,147
$27,638
$2,434
$6,538
$1,552
$12,579
$35,236
$3,558
$1,392
$10,823
$11,160
$3,191
$10,547
$672
$717,888
Source: Avalere Health, using BEA RIMS-II (1997/2006) multipliers for hospital NAICS Code 622, released 2008, applied to
American Hospital Association Annual Survey data for 2007. Hospital jobs are total part time and full time jobs. Hospital
labor income is defined as payroll plus benefits. The percent of total employment supported by direct and indirect hospital
employment is based on 2007 BLS data.
*Expenditures are defined as net patient revenue + other operating revenue.
Hospital
Expenditures*
($ millions)
Multiplier
for Output
$7,995
$1,513
$10,066
$4,733
$59,590
$8,610
$7,351
$2,086
$3,268
$33,100
$15,247
$2,118
$2,426
$27,543
$13,585
$6,273
$4,789
$8,892
$8,179
$3,367
$10,882
$20,146
$22,483
$12,054
$5,538
$14,782
$2,023
$4,373
$3,672
$3,320
$16,115
$2,905
$49,651
$17,497
$1,741
$28,050
$6,082
$6,847
$30,846
$2,526
$8,461
$1,972
$13,950
$37,777
$4,145
$1,480
$13,420
$11,832
$4,193
$12,720
$908
$603,122
2.1741
1.8427
2.1596
2.0373
2.5265
2.4720
2.1058
1.9746
1.3866
2.2052
2.4931
2.0783
2.0419
2.6107
2.2423
2.0566
2.1205
2.1535
2.0450
2.0724
2.2440
2.2898
2.2250
2.3801
2.0111
2.3078
1.9804
2.1184
1.9425
2.1038
2.4450
1.9595
2.1262
2.3573
1.8921
2.3406
2.1927
2.1740
2.4662
2.0518
2.2809
1.9210
2.4045
2.5537
2.4405
1.8782
2.2555
2.2829
1.8522
2.2070
1.6980
3.2896
Effect of Hospital
Expenditures on
Total Output in
State Economy
($ millions)
$17,382
$2,788
$21,739
$9,643
$150,554
$21,284
$15,480
$4,119
$4,531
$72,992
$38,012
$4,402
$4,954
$71,907
$30,462
$12,901
$10,155
$19,149
$16,726
$6,978
$24,419
$46,130
$50,025
$28,690
$11,137
$34,114
$4,006
$9,264
$7,133
$6,985
$39,401
$5,692
$105,568
$41,246
$3,294
$65,654
$13,336
$14,885
$76,072
$5,183
$19,299
$3,788
$33,543
$96,471
$10,116
$2,780
$30,269
$27,011
$7,766
$28,073
$1,542
$1,984,030