Health Care Indicators.

Health Care Indicators Carolyn S. Donham, Brenda T. Maple, and Arthur L. Sensenig

This regular feature of the journal changes, without interference introduced includes a discussion of each of the followingby seasonal fluctuations. four topics: community hospital statistics; In the national health accounts, indicators employment, hours, and earnings in the such as these play an important role in the private health sector; health care prices; estimation of the latest historical year of and national economic indicators. These health care expenditures. Information that is statistics are valuable in their own right formore comprehensive tends to lag behind the understanding the relationship between theclose of a calendar year by 9 to 12 months or health care sector and the overall economy.more. Therefore, we rely extensively on indiIn addition, they allow us to anticipate the cators such as these to anticipate and predict direction and magnitude of health care costchanges in health care sector expenditures changes prior to the availability of more for the most recent year. Other indicators help to identify specific reasons (e.g., comprehensive data. increases in price inflation or declines in utilization) for expenditure change. INTRODUCTION In the following sections, we will identify This article presents statistics on health important indicators of health care and care utilization, prices, expenses, employnational economic activity and their ment, and work hours, as well as on nationsources. We will then describe what these al economic activity. Some of these statistics indicators tell us about general economic are based on sample surveys conducted and health sector activity during the most monthly or quarterly by government agenrecent quarter. cies or private organizations, and are available 1 to 3 months after the completion of COMMUNITY HOSPITAL STATISTICS the period. They provide the first glimpse of Since 1963, the American Hospital Assocchanges occurring within the general econiation, in cooperation with member hospiomy and the health care sector. tals, has been collecting data on the operaThe accompanying tables report selecttion of community hospitals through its ed quarterly statistics for 1990 through the National Hospital Panel Survey. Community third quarter of 1993, and the calendar year hospitals, which comprised more than 80 aggregation of quarterly information in the percent of all hospital facilities in the United past 3 years. Additional tables show the change from the same period 1 year earlier. States in 1991, include all non-Federal, short-term general, and other special hospiFor quarterly information, this calculation tals open to the public. They exclude hospipermits analysis of quarterly data to focus tal units of institutions; psychiatric facilities; on the direction and magnitude of tuberculosis, other respiratory, and chronic disease hospitals; institutions for the menThe authors are with the Office of the Actuary, Health Care Financing Administration (HCFA). The opinions expressed are tally retarded; and alcohol and chemical those of the authors and do not necessarily reflect HCFA's views dependency hospitals. or policy positions. HEALTH CARE FINANCING REVIEW/Spring 1994/Volume 15, Number 3

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The survey samples approximately onethird of all U.S. community hospitals. The sample is designed to produce estimates of community hospital indicators by bed size and region (American Hospital Association, 1963-93). In Tables 1 and 2, statistics covering expenses, utilization, beds, and personnel depict trends in the operation of community hospitals annually for 1990-92 and for selected quarters of 1990-93. Figure 1 shows percent change from the same quarter 1 year earlier in total operating expenses and inpatient expenses for 1984 through the third quarter of 1993. For purposes of national health expenditures (NHE), survey statistics on revenues (not shown on Table 1) are analyzed in estimating the growth in the largest component of health care costs—community hospital expenditures. This one segment of NHE accounted for 33 percent of all health spending in 1991 (Letsch et al., 1992). The survey also identifies important factors influencing expenditure growth patterns, such as changes in the number of beds in operation, number of admissions, length of stay, use of outpatient facilities, and number of surgeries. Figure 2 shows percent changes from the same quarter 1 year earlier in measures of hospital utilization for 1984 through the third quarter of 1993. PRIVATE HEALTH SECTOR: EMPLOYMENT, HOURS, AND EARNINGS The Bureau of Labor Statistics (BLS) collects monthly information on employment for all workers, and earnings and work hours for non-supervisory workers in a sample of 370,000 establishments. Data are collected through cooperative agreements with State agencies that also use this information to create State and local area 158

statistics. The survey is designed to collect industry-specific information on wage and salary jobs in non-agricultural industries. It excludes statistics on self-employed persons and on those employed in the military (U.S. Department of Labor, 1993a). Employment in this survey is defined as number of jobs. Persons holding multiple jobs would be counted multiple times. Approximately 5 percent of the population hold more than one job at any one time. (Other surveys that are household-based, such as the Current Population Survey [CPS], also record employment. In the CPS, however, each person's employment status is counted only once, as either employed, unemployed, or not in the labor force.) Once each year, monthly establishment-based employment statistics are adjusted to benchmarks created from annual establishment census information, resulting in revisions to previously published employment estimates. Tables 3 and 4 present statistics on employment, average hourly earnings, and average weekly hours in private (non-government) health service establishments. Figure 3 presents statistics on employment in health sector establishments and the private non-agricultural sector. Similar statistics for the all private non-agricultural sector, included on these tables, provide a basis for comparing the economy as a whole with the health sector in employment, earnings, and work hours. Table 5 and Figures 4 and 5 summarize business activity in the health sector and the overall economy by measuring change in the implied non-supervisory work hours and payroll. Implied work hours are the product of the number of non-supervisory employees and average weekly hours. Implied non-supervisory payrolls are calculated by multiplying implied work hours by average hourly earnings.

HEALTH CARE FINANCING REVIEW/Spring 1994/Volume 15, Number 3

For purposes of NHE, changes in work hours by industry combined with changes in prices (discussed in a later section) can be used to gauge the direction and magnitude of expenditure change in specific industries. We use these composite indicators in the estimation of growth in physician and dental expenditures for the most recent period. We compare the historical relationship of changes in this indicator with changes in expenditures, and estimate this relationship for the most recent period. PRICES Consumer Prices The BLS publishes monthly information on changes in prices paid by consumers for a fixed market basket of goods and services. Tables 6 and 7 and Figure 6 present information on the all urban consumer price index (CPI) that measures changes in prices faced by 80 percent of the non-institutionalized population in the United States. (The more restrictive wage earner CPI gauges prices faced by wage earners and clerical workers. These workers account for 32 percent of the non-institutionalized population [U.S. Department of Labor, 1993b].) The index reflects changes in prices charged for the same quality and quantity of goods or services purchased in the base period. For most items, the base period of 1982-84 is used to define the share of consumer expenditures purchasing specific services and products. Those shares or weights remain constant in all years, even though consumption patterns of the household may change over time. This type of index is called afixed-weightor Laspeyres index. CPIs for health care goods and services depict price changes for out-of-pocket expenditures made directly by consumers.

The composite CPI for medical care weights together product-specific or service-specific CPIs in proportion to household out-ofpocket expenditures for these items. For example, the composite medical care CPI measures inflation for the 3 percent of hospital expenditures that are made out-ofpocket by consumers; the remaining 97 percent of the costs of hospital care paid by private health insurers, Medicare, Medicaid, and other payers are not weighted into the CPI for medical care. In addition, some medical care sector indexes measure changes in list or charged prices, rather than in prices actually received by providers after discounts are deducted. In several health care areas, received or transaction prices are difficult to capture, although BLS is making advances in this area. In the NHE, a combination of CPIs for selected medical care items, input price indexes for nursing homes, and the CPI for hospital and related services, adjusted by the Health Care Financing Administration (HCFA) to provide transaction price changes, are used as measures of inflation for the health industry. The indexes are used to develop a fixed-weight price index for personal health care to depict price changes affecting the entire health care industry more accurately than does the overall CPI medical care index (Letsch, 1993). Background on Input Price Indexes In 1979, HCFA developed the Medicare hospital input price index (hospital "market basket"), which was designed to measure the pure price changes associated with expenditure changes for hospital services. In the early 1980s, the skilled nursing facility (SNF) and home health agency (HHA) input price indexes, often referred to as "market baskets," were developed to price a consistent set of goods and services over


159

time. Also in the early 1980s, the original Medicare hospital input price index was revised for use in updating payment rates for the prospective payment system (PPS). All of these indexes have played an important role in helping to set Medicare payment percent increases, and in understanding the contribution of input price increases to growing health expenditures. The input price indexes, or market baskets, are Laspeyres or fixed-weight indexes that are constructed in two steps. First, a base period is selected. For example, for the PPS hospital input price index, the base period is 1987. Cost categories, such as food, fuel, and labor, are identified and their 1987 expenditure amounts determined. The proportion or share of total expenditures included in specific spending categories is calculated. These proportions are called cost or expenditure weights. There are 28 expenditure categories in the 1987-based PPS hospital input price index. Second, a price proxy is selected to match each expenditure category. Its purpose is to measure the rate of price increase of the goods or services in that category. The price proxy index for each spending category is multiplied by the expenditure weight for the category. The sum of these products (weights multiplied by the price index) over all cost categories yields the composite input price index for any given time period, usually a fiscal year or a calendar year. The percent change in the input price index is an estimate of price change over time for afixedquantity of goods and services purchased by a provider. The input price indexes are estimated on a historical basis and forecasted out several years. The HCFA-chosen price proxies are forecasted under contract with Data Resources, Inc./McGraw Hill (DRI). Following every calendar year quarter, in March, June, September, and December, 160

DRI updates its macroeconomic forecasts of wages and prices based on updated historical information and revised forecast assumptions. Some of the data in Tables 8 through 13 are forecasted and are expected to change as more recent historical data become available and subsequent quarterly forecasts are received. The methodology and price proxy definitions used in the input price indexes are described in the Federal Register notices that accompany the revisions of the PPS, HHA, and SNF cost limits. A description of the current structure of the PPS input price index was published in the September 4, 1990, Federal Register. The most recent PPS update for payment rates was published in the September 1, 1993, Federal Register. The latest HHA regulatory input price index was published in the July 8, 1993, Federal Register, and the latest SNF input price index was published in the October 7, 1992, Federal Register. Periodically, the input price indexes are revised to a new base year so that cost weights will reflect changes in the mix of goods and services that are purchased. Each revision allows for new base weights, a new base year, and changes to certain price variables used for price proxies. Each input price index is presented in two tables: The first is a percent-change table, and the second provides the actual index numbers from which the percentages were computed. The hospital input price index for PPS is in Tables 8 and 9. The SNF input price index is in Tables 10 and 11. The HHA input price index is in Tables 12 and 13. NATIONAL ECONOMIC INDICATORS National economic indicators provide a context for understanding health-specific indicators and how change in the health


sector relates to change in the economy as a whole. Tables 14 and 15 present national indicators of output and employment Gross domestic product (GDP) measures the U.S. economy as the value of output produced within the geographic boundaries of the United States by U.S. or foreign citizens or companies. Constant dollar or "real" GDP removes the effects of prices from the valuation of goods and services produced, so that the growth of real GDP reflects changes in the "physical" output of the economy (U.S. Department of Commerce, 1993). Third Quarter Indicators Total operating expenses in community hospitals increased to $70.0 billion in the third quarter of 1993. This 6.3 percent increase in total operating expenses, measured over the third quarter of 1992, represents a 3.0-percentage-point deceleration in growth compared with the 9.3 percent increase registered in the third quarter of 1992. This third quarter increase is the smallest such increase recorded since the second quarter of 1985. Both labor and non-labor expenses contributed to the continued deceleration in the growth of operating expenses. Labor expenses increased 6.2 percent in the third quarter, as measured over the same quarter a year earlier, while non-labor expenses increased 6.5 percent. These increases compare with increases of 8.9 percent and 9.9 percent, respectively, in the third quarter of 1992. Inpatient expenses also show a similar pattern of decelerating growth in the third quarter of 1993. Inpatient expenses grew 5.0 percent in the third quarter of 1993, measured over the same period in the previous year (Figure 1). This is a 2.4-percentage-point deceleration in growth compared with the 7.4-percent increase recorded in the third quarter of 1992.

Most measures of hospital utilization associated with inpatient care either decreased or continued to decelerate in growth in the third quarter of 1993. The number of inpatient days and the average adult length of stay both decreased from the third quarter of 1992, a continuation of long-term trends observed since the mid1980s. The adult occupancy rate and the number of staffed beds, measures of hospital utilization, and inpatient capacity continued to decrease in the third quarter of 1993 (Figure 2). The adult occupancy rate in the third quarter of 1993 was 59.2 percent, the lowest occupancy rate in any quarter since the AHA began compiling community hospital statistics in 1963. The number of staffed beds in community hospitals decreased to 901,000, the lowest level observed since 1974. The long-term trend in hospital utilization measures reflecting the substitution of outpatient services for inpatient services continued in the third quarter of 1993. Outpatient visits grew 6.4 percent from the second quarter of 1992, a constant rate of growth compared with the year earlier. Surgical operations, which are performed on both outpatients and inpatients, grew 0.8 percent from the second quarter of 1992. This change represents a smaller deceleration than that observed in most measures of inpatient utilization for the third quarter of 1993. Employment growth in the health service industry continued to outpace growth in the private non-agricultural business sector in the third quarter of 1993. Employment in health services grew 4.0 percent from the same period in 1992, compared with an increase of 1.8 percent in all private non-agricultural establishments (Figure 3). Offices and clinics of medical doctors remained the fastest growing segment of the health services industry,


161

registering a 4.9-percent growth in employment from the third quarter of 1992. Confirming trends noted earlier in hospital expenses and utilization, the growth of hospital employment continued to decelerate in the third quarter of 1993. Employment in hospitals grew at a slower rate than employment in the overall private sector in the third quarter of 1993, registering a 1.4percent rate of increase from the same period a year earlier. Employment growth in the private sector as a whole has not exceeded employment growth in health services since in the first quarter of 1989, when employment in dentists' offices and nursing homes grew more slowly than private sector employment. Growth in implied work hours (the product of non-supervisory employees and average weekly hours) accelerated in the private non-agricultural business sector in the third quarter of 1993. This acceleration was based on increases in the growth rate of both non-supervisory employment and average weekly hours, as measured over the same period in the previous year. In contrast, growth in implied work hours in health service establishments decelerated in the third quarter of 1993 (Figure 4). The overall deceleration in health services was attributable to the marked deceleration in the growth of non-supervisory employment in private hospitals. Growth in the implied payrolls (work hours times average hourly earnings) of private health service establishments decelerated slightly in the third quarter of 1993, in contrast to the acceleration in growth of implied payrolls for all private sector establishments (Figure 5). Measured from the same period in the previous year, implied payrolls in private health sector establishments increased 7.0 percent in the third quarter of 1993, compared with an increase of 8.4 percent in the third quarter 162

of 1992. Slow growth in the implied payrolls of private hospitals accounted for most of the deceleration on health services. The growth in CPI for all items decelerated slightly in the third quarter of 1993, as compared with the third quarter of 1992. Measured from the same period in the preceding year, the CPI increased 2.7 percent in third quarter 1993, compared with an increase of 3.1 percent in 1992. The CPI for medical care decelerated more rapidly than the CPI for all items (Figure 6). Measured from the same period in the preceding year, the CPI for medical care registered a 5.9-percent increase in the third quarter of 1993, compared with an increase of 7.2 percent in the third quarter of 1992. Although the growth in medical care prices, as measured by the CPI, is decelerating, aggregate prices for medical care goods and services are still increasing at more than twice the rate of the rest of the economy. As measured over the same period in the previous year, the CPI for medical care increased 5.9 percent, compared with an increase of 2.5 percent in the CPI for all items less medical care. In the third quarter of 1993, the CPI for medical care services increased 6.4 percent over the same period in 1992, whereas the CPI for medical care commodities increased 3.7 percent. The deceleration in medical care commodities is attributable in large part to the low rate of growth of prescription drugs. The third quarter 1993 increase in prescription drugs was 3.8 percent measured over the same period in the previous year, compared with a 6.5-percent growth rate in third quarter 1992. Overall economic conditions improved in the third quarter of 1993. This was the tenth consecutive quarter in the current economic expansion, which began in the second quarter of 1992. The current expansion has been marked by relatively


sluggish growth in employment and output and low rates of inflation. The selected national economic indicators shown in Tables 14 and 15 suggest these trends continued in the third quarter of 1993. Real gross domestic product increased 2.8 percent from the third quarter of 1992. The unemployment rate fell to 6.7 percent in the third quarter of 1993, a drop of 0.8 percentage points from the 7.5 percent rate of third quarter 1992. Wage and salary employment in the private non-agricultural establishments increased by 1.6 million jobs over third quarter 1992, an increase of 1.8 percent. Prices for all items, as measured by the CPI, increased 2.7 percent from the same period a year earlier, the lowest such increase in more than 6 years.

REFERENCES American Hospital Association: National Hospital Panel Survey. Unpublished. Chicago. 1963-93. American Hospital Association: Hospital Statistics, 1992-93 Edition. Chicago. 1992. Federal Register: Medicare Program; Changes to the Inpatient Hospital Prospective Payment System and Fiscal Year 1991 Rates; Final Rule. Vol. 55, No. 170, 36043-36050 and 36169-36173. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, September 4, 1990. Federal Register: Medicare Program; Changes to the Inpatient Hospital Prospective Payment System and Fiscal Year 1994 Rates; Final Rule. Vol. 58, No. 168, 46455. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, September 1, 1993a.

Federal Register: Medicare Program; Schedules of limits of Home Health Agency Cost per Visit for Cost Reporting Periods Beginning On or After July 8, 1993. Vol. 58, No. 129, 36748. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, July 8, 1993b. Federal Register: Medicare Program; Schedules of Limits of Skilled Nursing Facility Inpatient Routine Service Costs; Final rule. Vol. 57, No.129, 4617748187. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, October 7, 1992. Letsch, S.W., Lazenby, H.C., Levit, K.R., and Cowan, CA: National Health Expenditures, 1991. Health Care Financing Review 14(2):l-30. Winter 1992. Letsch, S.W.: National Health Care Spending in 1991. Health Affairs 12(1):94-110, Spring 1993. U.S. Department of Commerce: National Income and Product Accounts. Survey of Current Business. Vol. 73, No. 7. Bureau of Economic Analysis. Washington. U.S. Government Printing Office, July 1993. U.S. Department of Labor: Employment and Earnings. Vol. 40, No. 6. Bureau of Labor Statistics. Washington. U.S. Government Printing Office, June 1993a. U.S. Department of Labor: Notes on Current Labor Statistics: Price Data. Monthly Labor Review. Vol. 116, No. 7. Bureau of Labor Statistics. Washington. U.S. Government Printing Office, July 1993b. For inquiries concerning market basket data, contact Brenda T. Maple at (410) 966-7954. For all other inquiries, contact Carolyn S. Donham at (410) 966-7947. Reprint Requests: Carolyn S. Donham, Room L-1, 1705 Equitable Building, 6325 Security Boulevard, Baltimore, Maryland 21207.


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164

HEALTH CARE FINANCING REVIEW/Spring 1994/volume 15, Number 3 283,959

3,229 3.5 88

921 64.5 3,300 3.6 85 281,502

282,874

908 62.1

366,243

3,249 3.6 87

912 63.5

344,116

22,463

32,411 206,440 6.4

191,401 927 5,905

$260,994 140,112 120,882

1992

69,886

3,241 3.5 22

920 62.6

83,417

5,496

8,171 53,012 6.5

41,646 786 5,097

$54,902 29,941 24,961

- 1 9 9 0 Q3

69,496

3,252 3.6 21

910 61.4

87,648

5,534

8,075 51,459 6.4

44,586 866 5,522

$60,214 32,516 27,698

1991 Q3

69,286

3,310 3.6 21

908 60.3

93,271

5,630

8,005 50,387 6.3

47,873 950 5,980

$65,829 35,396 30,434

1992 Q3

69,332

3,324 3.7 21

904 60.7

92,232

5,584

7,947 50,509 6.4

48,733 965 6,133

$66,894 36,073 30,821

1992 Q4

72,306

3,322 3.7 22

905 65.3

94,677

5,646

8,351 53,228 6.4

50,447 948 6,041

$68,527 36,782 31,746

1993 Q1

69,334

68,351

3,326 3.7 21

901 59.2

904 61.0 3,331 3.7 21

99,212

5,677

8,083 49,089 6.1

50,274 1,024 6,220

$70,002 37,578 32,424

1993 Q3

97,637

5,721

8,086 50,150 6.2

50,085 999 6,194

$69,245 37,250 31,994

1993 Q2

SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1990-September 1993.

NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted.

Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period. 2 Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care, plus an estimate of the volume of outpatient services, expressed in units equivalent to an inpatient day in terms of level of effort. It is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue per outpatient visit to inpatient revenue per inpatient day, and adding the product to the number of inpatient days.

1

Adjusted Patient Days in Thousands

Full-Time Equivalent (FTE) Personnel Total in Thousands Number per Bed Adjusted Patient Days2 per FTE

Beds in Thousands Adult Occupancy Rate1

Outpatient Visits in Thousands

326,498

21,983

21,904

Surgical Operations in Thousands

32,670 211,475 6.5

33,017 216,836 6.6

Utilization Admissions in Thousands Inpatient Days in Thousands Adult Length of Stay in Days

178,401 844 5,461

$238,633 128,704 109,929

$217,113 117,828 99,286 165,792 765 5,021

1991

1990

Inpatient Expense in Millions Amount per Patient Day Amount per Admission

Item Operating Expenses Total in Millions Labor in Millions Non-Labor in Millions

Calendar Year

Table 1 Selected Community Hospital Statistics: 1990-93

HEALTH CARE FINANCING REVIEW/Spring 1994/volume 15, Number 3

165

11.1 11.1 11.1 9.0 10.7 9.5 -0.5 -1.6 -1.1

Operating Expenses Total Labor Non-Labor

Inpatient Expenses Amount per Patient Day Amount per Admission

Utilization Admissions Inpatient Days Adult Length of Stay

Surgical Operations

-0.5

-1.0 -0.9 0.6 1.7 -1.0 -0.4

-0.9 -0.4 2.1 3.1 -1.7 0.3

Beds Adult Occupancy Rate1

Full-Time Equivalent (FTE) Personnel Total Number per Bed Adjusted Patient Days per FTE

Adjusted Patient Days

-0.5 -1.4

0.2

2.1 3.0 -1.9

-0.8 -0.6

6.7

3.9

-0.4 -1.8 -1.3

9.5 11.5 10.0

11.7 11.8 11.6

1990 Q3

-0.6

0.3 1.4 -0.9

-1.0 -1.2

5.1

0.7

-0.3

1.8 2.1 -2.1

-0.3 -1.1

6.4

1.7

-0.9 -2.1 -1.2

7.4 9.7 8.3

7.1 10.3 8.3 -1.2 -2.9 -1.8

9.3 8.9 9.9

9.7 8.6 11.0

1992 Q3

-2.1

2.0 2.6 -4.0

-0.5 -2.4

5.2

1.6

-2.6 -4.3 -1.7

5.0 9.7 7.8

7.4 7.6 7.1

1992 Q4

1.3 2.0 -2.2 -1.0

-0.7

-0.7 -1.0

-0.4 -0.2 1.4 1.8 -2.0

6.6

1.4

0.7 6.2

-0.2 -2.3 -2.1

5.9 8.4 6.1

7.3 8.0 6.5

-0.1 -1.9 -1.8

6.2 8.2 6.3

7.5 7.7 7.3

1993 1993 Q2 Q1 Percent Change From the Same Period of Previous Year

1991 Q3

SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1989-September 1993.

NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted.

Change in rate, rather than percent change.

1.6 2.0 -2.0

5.4

6.0

Outpatient Visits

1

2.2

0.4

2.4 6.4

-0.8 -2.4 -1.6

7.3 9.9 8.1

9.4 8.9 10.0

-1.1 -2.5 -1.4

7.6 10.3 8.8

9.9 9.2 10.7

1991 1992 Annual Percent Change

1990

Item

Calendar Year

Table 2 Percent Change in Selected Community Hospital Statistics: 1990–93

-1.3

0.5 1.2 -1.8

-0.8 -1.1

6.4

0.8

1.0 -2.6 -3.5

5.0 7.8 4.0

6.3 6.2 6.5

1993 Q3

166


1,338.2 1,104.5 31.8 $10.58

Offices and Clinics of Medical Doctors (SIC 801) Total Employment in Thousands

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

1,415.4 1,278.9 32.1 $7.24 3,548.7 3,248.4 34.2 $11.79

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands


Private Hospitals (SIC 806) Total Employment in Thousands


See footnotes at end of table.

449.7 28.4 $10.14


512.9

6,947.6 32.5 $10.40

Offices and Clinics of Dentists (SIC 802) Total Employment in Thousands

8,182.9

7,814.3


3,352.5 34.2 $12.50

3,655.1

1,347.4 32.1 $7.56

1,492.6

463.5 28.3 $10.62

527.6

1,155.4 31.9 $11.13

1,404.5

7,275.8 32.5 $10.96

1991

1990

Type of Establishment and Measure Health Services (SIC 80) Total Employment in Thousands

Calendar Year

3,451.4 34.4 $13.03

3,759.8

1,393.7 32.3 $7.85

1,542.7

474.3 28.3 $11.01

541.9

1,209.4 32.1 $11.41

1,472.7

7,575.3 32.8 $11.39

8,523.3

1992

3,271.7 34.4 $11.86

3,572.8

1,288.7 32.6 $7.29

1,426.1

450.9 28.5 $10.23

514.7

1,116.3 31.9 $10.66

1,351.6

7,008.5 32.8 $10.46

7,882.1

1990 Q3

3,369.9 34.4 $12.66

3,673.0

1,358.8 32.4 $7.59

1,504.9

467.5 28.2 $10.64

531.5

1,168.2 32.0 $11.15

1,420.1

7,334.2 32.7 $11.05

8,246.9

1991 Q3

3,470.2 34.5 $13.12

3,780.0

1,403.4 32.7 $7.90

1,552.5

477.3 28.3 $10.99

545.2

1,219.9 32.2 $11.46

1,485.7

7,627.1 32.9 $11.44

8,580.5

1992 Q3

3,481.3 34.4 $13.26

3,792.4

1,417.8 32.3 $7.95

1,569.1

481.1 28.3 $11.19

549.3

1,232.9 32.2 $11.65

1,504.7

7,698.2 32.8 $11.57

8,667.4

1992 Q4

3,491.8 34.5 $13.38

3,805.5

1,428.6 32.0 $8.05

1,581.9

483.5 28.1 $11.25

552.3

1,242.0 32.1 $11.72

1,517.6

7,755.0 32.7 $11.68

8,735.7

1993 Q1

3,499.6 34.5 $13.38

3,815.4

1,449.0 32.2 $8.09

1,604.6

489.8 28.4 $11.34

560.0

1,258.4 32.2 $11.85

1,538.1

3,506.8 34.6 $13.50

3,827.2

1,468.2 32.6 $8.19

1,626.6

495.3 28.2 $11.45

565.9

1,273.0 32.3 $11.90

1,558.9

7,917.3 32.9 $11.79

8,927.2

8,836.4 7,843.9 32.7 $11.70

1993 Q3

1993 Q2

Table 3 Employment, Hours, and Earnings in Private Health Service Establishments, by Selected Type of Establishment: 1990–93 1


167

4,852.5 3,548.7 231.6 426.2 646.1

Employment in Thousands All Hospitals Private Hospitals (SIC 806) Federal Hospitals State Hospitals Local Hospitals 5,086.2 3,759.8 237.0 419.8 669.7

Excludes hospitals, clinics, and other health-related establishments run by all governments.

4,958.2 3,655.1 233.5 416.7 652.9 4,878.1 3,572.8 231.9 424.5 648.8

74,626 34.8 $10.04

92,032

1990 Q3

4,979.0 3,673.0 234.9 415.3 655.8

73,331 34.6 $10.34

90,548

1991 Q3

5,112.5 3,780.0 237.5 420.2 674.8

73,678 34.6 $10.57

90,715

1992 Q3

5,128.8 3,792.4 237.7 419.1 679.6

73,755 34.5 $10.70

90,714

1992 Q4

5,146.6 3,805.5 238.1 418.2 684.7

72,357 34.0 $10.78

89,217

1993 Q1

5,163.4 3,815.4 239.3 417.6 691.0

74,316 34.5 $10.79

91,297

1993 Q2

5,185.4 3,827.2 241.0 417.7 699.4

75,285 34.8 $10.81

92,335

1993 Q3

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U S . Government Printing Office. Monthly reports for January 1990-December 1993.

NOTES: Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series, whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted.

1

73,800 34.5 $10.01

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings 72,866 34.4 $10.57

89,866

89,854

91,115 72,650 34.3 $10.32

1992

1991

1990

Type of Establishment and Measure All Private Non-Agricultural Establishments Total Employment in Thousands

Calendar Year

Table 3 — Continued Employment, Hours, and Earnings in Private Health Service Establishments, by Selected Type of Establishment: 1990–93 1

Table 4 Percent Change in Employment, Hours, and Earnings in Private1 Health Service Establishments, by Selected Type of Establishment: 1990–93 Calendar Year Type of Establishment and Measure

1990 1991 1992 Annual Percent Change

1992 1992 1993 1990 1991 1993 1993 Q4 Q3 Q3 Q2 Q3 Q3. Q1 Percent Change From the Same Period of Previous Year

Health Services (SIC 80) Total Employment

4.7

4.7

4.2

4.9

4.6

4.0

4.2

4.3

4.3

4.0

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

4.7 0.3 5.9

4.7 -0.0 5.3

4.1 0.7 3.9

4.9 0.5 5.7

4.6 -0.3 5.6

4.0 0.6 3.6

4.1 0.5 3.7

4.2 -0.4 4.0

4.1 0.4 3.5

3.8 0.0 3.1

Offices and Clinics of Medical Doctors (SIC 801) Total Employment

5.5

5.0

4.9

5.8

5.1

4.6

5.1

5.4

5.3

4.9


5.5 -0.4 8.1

4.6 0.4 5.3

4.7 0.7 2.5

5.8 -0.1 8.2

4.7 0.1 4.6

4.4 0.6 2.8

4.9 0.6 3.0

4.9 -0.4 4.4

4.8 0.6 4.7

4.4 0.4 3.8

Offices and Clinics of Dentists (SIC 802) Total Employment

2.6

2.9

2.7

2.4

3.3

2.6

2.7

3.5

3.9

3.8


2.8 -0.2 7.8

3.1 -0.4 4.7

2.3 0.2 3.7

2.5 0.6 8.6

3.7 -1.1 4.0

2.1 0.4 3.3

2.5 0.0 3.8

3.4 -1.3 3.1

3.8 0.7 3.4

3.8 -0.4 4.2

Nursing and Personal Care Facilities (SIC 805) Total Employment

4.4

5.5

3.4

4.5

5.5

3.2

3.6

4.2

4.8

4.8


4.3 0.9 6.5

5.4 0.1 4.4

3.4 0.5 3.9

4.3 1.3 6.4

5.4 -0.5 4.2

3.3 0.8 4.0

3.7 0.2 3.8

4.2 -0.7 3.8

4.8 0.4 3.6

4.6 -0.4 3.7

3.2

3.0

2.9

3.3

2.8

2.9

2.6

2.3

1.8

1.2

3.3 0.7 5.2

3.2 -0.0 6.0

2.9 0.6 4.2

3.3 0.7 4.8

3.0 -0.1 6.7

3.0 0.3 3.6

2.6 0.4 3.9

2.2 0.4 4.2

1.8 0.5 3.7

1.1 0.5 2.9

1.1

-1.4

0.0

1.2

-1.6

0.2

0.6

1.3

1.5

1.8


1.0 -0.3 3.7

-1.6 -0.6 3.1

0.3 0.2 2.5

1.1 -0.1 3.8

-1.7 -0.6 3.0

0.5 -0.0 2.3

1.0 0.1 2.5

1.7 -0.1 2.6

1.9 0.4 2.5

2.2 0.6 2.3

Employment All Hospitals Private Hospitals (SIC 806) Federal Hospitals State Hospitals Local Hospitals

2.4 3.2 1.9 -3.7 2.2

2.2 3.0 0.8 -2.2 1.1

2.6 2.9 1.5 0.7 2.6

2.4 3.3 1.5 -3.7 2.2

2.1 2.8 1.3 -2.2 1.1

2.7 2.9 1.1 1.2 2.9

2.5 2.6 1.1 0.6 3.6

2.2 2.3 0.9 -0.4 3.9

1.9 1.8 1.1 -0.6 3.9

1.4 1.2 1.5 -0.6 3.6

Private Hospitals (SIC 806) Total Employment Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings All Private Non-Agricultural Establishments Total Employment

1


NOTES: Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series' whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1989-December 1993.

168

HEALTH CARE FINANCING REVIEW/Spring 1994/Volume 15. Number 3

Table 5 Percent Change in Implied Non-Supervisory Payrolls and Work Hours in Private1 Health Service Establishments, by Selected Type of Establishment: 1990–93 Calendar Year Type of Establishment Private Health Service Establishments (SIC 80) Payrolls Work Hours

1990 1991 1992 Annual Percent Change

1990 1991 1992 1992 1993 1993 1993 Q3 Q3 Q3 Q4 Q1 Q2 Q3 Percent Change From the Same Period of Previous Year

11.2 5.0

10.3 4.7

8.9 4.8

11.4 5.4

10.1 4.3

8.4 4.6

8.5 4.6

7.9 3.7

8.3 4.6

7.0 3.8

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 13.6 Work Hours 5.1

10.6 5.1

8.1 5.4

14.3 5.7

9.6 4.8

8.0 5.1

8.7 5.5

9.1 4.5

10.4 5.5

8.8 4.8

Offices and Clinics of Dentists (SIC 802) Payrolls Work Hours

10.6 2.6

7.5 2.6

6.4 2.5

11.9 3.1

6.7 2.6

5.8 2.5

6.4 2.5

5.3 2.1

8.1 4.6

7.7 3.4

Nursing and Personal Care Facilities (SIC 805) Payrolls Work Hours

12.1 5.2

10.1 5.5

8.0 4.0

12.5 5.7

9.3 4.9

8.3 4.1

7.8 3.9

7.4 3.5

9.0 5.2

8.0 4.2

Private Hospitals (SIC 806) Payrolls Work Hours

9.4 4.0

9.4 3.2

7.9 3.5

9.0 4.0

9.8 2.9

7.0 3.3

7.1 3.0

6.9 2.6

6.0 2.3

4.5 1.5

All Private Non-Agricultural Establishments Payrolls Work Hours

4.5 0.8

0.9 -2.1

3.0 0.5

4.8 1.0

0.6 -2.3

2.7 0.5

3.6 1.1

4.3 1.6

4.9 2.3

5.1 2.8

1


NOTES: Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series, whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1989–December 1993.


169

Table 6 Selected Items of the Consumer Price Index for All Urban Consumers: 1990–93 Calendar Year Item

1990

1991

1992

1990 Q3

All Items

130.7

136.2

140.3

All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter

128.8 124.1 102.1 132.1 140.0

133.8 128.7 102.4 136.8 146.3

137.5 131.9 103.0 138.7 151.2

Medical Care Medical Care Services1 Professional Services Physicians' Services Dental Services Hospital and Related Services Hospital Room Other Inpatient Services2 Outpatient services2

162.8 162.7 156.1 160.8 155.8 178.0 175.4 142.7 138.7

177.0 177.1 165.7 170.5 167.4 196.1 191.9 158.0 153.4

Medical Care Commodities Prescription Drugs Non-Prescription Drugs and Medical Supplies2 Internal and Respiratory Over-the-Counter Drugs Non-Prescription Medical Equipment and Supplies

163.4 181.7

1 2

1991 Q3

1992 Q3

1992 Q4

1993 Q1

1993 Q2

1993 Q3

131.6

136.7

140.9

141.9

143.1

144.2

144.8

129.6 123.3 103.8 132.7 141.9

134.3 128.0 103.1 136.8 147.2

138.0 130.9 105.8 138.7 152.0

138.9 133.6 104.3 139.3 152.5

140.0 133.1 102.7 140.7 154.3

141.0 134.6 104.7 141.4 155.2

141.5 132.0 105.4 141.5 156.6

190.1 190.5 175.8 181.2 178.7 214.0 208.7 172.3 168.7

164.8 164.7 157.7 162.6 157.1 180.3 177.6 144.7 140.1

178.7 178.7 167.0 171.6 169.4 197.9 193.3 159.5 155.1

191.5 192.1 177.0 182.6 180.4 216.0 210.6 173.9 170.1

194.1 195.0 179.0 184.6 182.6 220.6 215.2 177.0 174.7

197.7 198.8 181.6 187.7 184.8 226.2 220.6 181.1 179.9

200.3 201.8 184.1 190.5 187.6 230.0 224.6 183.9 183.0

202.8 204.4 185.9 192.7 189.2 233.8 228.2 187.2 185.6

176.8 199.7

188.0 214.7

165.0 183.8

178.9 202.4

189.0 215.6

190.4 218.0

193.0 221.4

194.2 221.6

196.0 223.9

120.6

126.2

131.2

121.2

127.2

132.1

132.1

133.2

135.6

136.7

145.9

152.4

158.2

146.4

153.7

159.9

159.3

160.4

163.4

165.3

138.0

145.0

150.9

138.9

145.9

151.2

152.1

153.8

156.4

156.5

Includes net cost of private health insurance not shown in professional or hospital and related services. December 1986 = 100.

NOTES: 1982-84 = 100.0 unless noted. Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office. Monthly reports for January 1990-September 1993.

170


Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers: 1990–93 Calendar Year Item All Items

1992 1990 1991 Annual Percent Change 5.4 4.2 3.0

1991 1992 1993 1992 1993 1993 Q3 Q3 Q4 Q1 Q2 Q3 IDercent Change From the Same Period of Previous Year 5.5 3.9 3.1 3.1 3.2 3.1 2.7

1990 Q3

5.2 4.6 8.2 5.8 5.4

3.9 3.7 0.4 3.6 4.5

2.7 2.5 0.5 1.4 3.4

5.3 5.7 6.8 5.6 6.0

3.6 3.9 -0.7 3.1 3.7

2.8 2.2 2.6 1.4 3.3

2.8 1.4 2.4 1.7 3.1

2.9 2.0 3.4 1.8 3.0

2.9 1.6 2.0 2.1 3.1

2.5 0.8 -0.3 2.0 3.0

Medical Care Medical Care Services1 Professional Services Physicians' Services Dental Services Hospital and Related Services Hospital Room Other Inpatient Services Outpatient Services

9.1 9.3 6.6 7.2 6.7 10.9 10.9 10.7 11.2

8.7 8.9 6.2 6.0 7.5 10.2 9.4 10.7 10.6

7.4 7.6 6.1 6.3 6.7 9.1 8.8 9.1 10.0

9.3 9.6 6.9 7.4 6.9 10.9 11.1 10.7 10.6

8.5 8.5 5.9 5.5 7.8 9.8 8.9 10.2 10.7

7.2 7.5 6.0 6.4 6.5 9.1 9.0 9.1 9.7

6.8 7.2 5.8 6.3 6.1 9.0 9.0 8.4 10.2

6.3 6.8 5.4 5.9 5.8 8.7 8.8 7.8 10.1

6.1 6.8 5.3 5.7 6.0 8.8 9.0 8.0 10.0

5.9 6.4 5.0 5.6 4.9 8.3 8.4 7.6 9.1

Medical Care Commodities Prescription Drugs Non-Prescription Drugs and Medical Supplies Internal and Respiratory Over-the-Counter Drugs Non-Prescription Medical Equipment and Supplies

8.4 10.0

8.2 9.9

6.4 7.6

8.3 9.9

8.4 10.1

5.7 6.5

5.2 6.0

4.3 5.0

3.4 3.3

3.7 3.8

5.2

4.7

3.9

5.1

5.0

3.9

3.4

3.0

3.5

3.4

5.2

4.5

3.8

5.0

5.0

4.0

3.7

3.3

3.2

3.4

5.3

5.0

4.1

5.2

5.0

3.6

2.7

2.4

4.0

3.5

All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter

1

Includes net cost of private health insurance not shown in professional or hospital and related services.

NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office. Monthly reports for January 1989-September 1993.


171

Table 8 Percent Change in Four-Quarter Moving Averages in the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992–95 Expense Category1 Total Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive

Base Year Weights 19872 100.000

1992 Q1 3.4

1992 Q2 3.1

1992 Q3 3.0

61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.838 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

4.5 4.2 6.4 4.3 -5.5 -18.3 5.3 -3.0 -15.5 7.6 2.4 1.8 1.2 8.3 0.8 -0.6 3.1 -4.0 1.6 -1.4 0.4 -2.7 1.9 1.4 1.4 3.0 2.9 2.2 1.4 1.7 2.1 13.1 4.1 3.6

4.3 3.9 6.3 4.2 -6.2 -17.7 3.4 -4.2 -15.1 7.6 3.9 1.5 1.0 7.9 0.7 -0.5 2.8 -5.2 1.8 -1.2 -0.1 -2.7 1.7 0.9 0.8 2.6 2.5 1.5 1.0 1.7 4.5 8.8 3.9 3.2

4.1 3.7 6.2 4.0 -5.0 -14.4 1.8 -1.9 -11.2 7.1 4.8 1.5 1.1 7.2 0.9 0.0 2.4 -4.4 1.9 -0.7 -0.3 -2.1 1.6 0.5 0.8 2.4 2.4 1.3 1.0 1.2 6.5 4.9 3.4 3.0

Four Quarters Ending 1992 1993 Q4 Q1 3.1 3.1 3.9 3.4 6.2 3.9 -0.9 -5.5 1.2 2.0 -2.6 6.8 3.3 1.7 1.4 6.5 0.8 0.2 2.0 -2.3 2.2 -0.2 0.0 -1.4 1.7 0.3 1.2 2.2 2.1 1.4 2.2 0.6 5.8 1.2 2.9 3.0

3.7 3.3 6.2 3.8 2.3 3.2 1.1 5.0 2.0 6.5 3.5 1.8 1.8 5.9 1.0 0.5 1.7 0.1 2.3 -0.4 0.6 -0.6 1.8 0.2 1.6 1.9 1.5 1.8 3.0 0.2 4.5 0.0 2.4 3.1

1993 Q2 3.1

1993 Q3 3.0

1993 Q4 3.0

3.6 3.1 6.1 3.6 2.5 1.8 1.1 10.5 1.1 6.2 3.7 2.0 2.0 5.4 1.1 0.8 1.7 1.7 2.3 -0.6 0.9 -0.4 1.7 0.3 1.8 1.9 1.5 2.6 3.2 0.0 1.7 0.0 2.2 3.1

3.6 3.1 5.9 3.4 1.0 -2.2 1.2 10.2 -2.8 5.9 4.3 1.9 1.9 5.0 1.3 1.1 1.7 1.5 2.5 -0.8 0.9 -0.4 1.9 0.5 1.6 1.9 1.4 3.1 3.1 0.2 -0.2 0.0 2.1 3.0

3.5 3.1 5.7 3.3 1.2 0.3 1.0 7.1 -3.9 5.4 5.0 1.9 1.8 4.6 1.6 1.5 1.8 1.3 2.5 -0.9 0.9 -0.3 1.9 0.6 1.4 2.1 1.7 3.5 3.0 0.6 -0.3 0.0 2.3 3.0


172


Table 8 — Continued Percent Change in Four-Quarter Moving Averages in the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992–95

Expense Category1 Total Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive 1 2

Four Quarters Ending


1994 Q1 3.1

1994 Q2 3.1

1994

61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.838 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

3.5 3.1 5.6 3.2 1.8 1.8 1.3 8.2 -4.7 5.3 5.4 2.1 1.9 4.5 2.0 2.0 2.0 0.9 2.5 -0.3 0.7 0.1 1.9 0.8 1.2 2.5 2.2 3.9 3.0 1.0 0.5 2.1 2.4 2.8

3.5 3.1 5.6 3.1 2.5 4.5 1.3 5.4 -1.7 5.5 5.8 2.3 2.0 4.5 2.3 2.3 2.3 0.4 2.4 0.3 0.6 0.9 2.1 1.0 1.0 3.1 2.5 3.6 3.6 1.6 1.0 11.1 2.6 2.8

1995 Q1 3.6

1995 Q2 3.7

1995

3.4

1994 Q4 3.6

3.7

1995 Q4 3.7

3.6 3.1 5.7 3.3 4.7 12.0 0.3 4.7 5.9 5.7 6.1 2.7 2.2 4.4 2.6 2.6 2.6 1.2 2.3 0.7 0.5 2.1 1.9 1.3 1.5 3.7 3.0 3.5 4.4 2.0 1.4 20.0 2.9 2.9

3.7 3.2 5.8 3.4 5.5 13.4 0.1 4.7 10.6 5.9 6.5 3.2 2.6 4.5 2.9 2.8 3.0 2.2 2.3 1.2 0.4 3.5 1.8 1.7 2.1 4.3 3.4 3.4 5.1 2.2 1.6 29.0 3.0 3.0

3.6 3.2 5.9 3.3 4.6 10.7 0.0 2.9 11.8 5.8 7.2 3.4 2.8 4.5 2.9 2.7 3.3 2.9 2.5 1.3 0.4 4.5 1.9 2.0 2.5 4.6 3.8 3.3 5.3 2.5 1.5 33.0 3.2 3.2

3.7 3.2 5.9 3.4 4.2 9.1 0.3 2.6 10.7 5.7 7.9 3.5 3.1 4.6 2.9 2.6 3.5 3.6 2.8 1.4 0.6 5.1 2.1 2.2 2.9 4.4 4.0 3.4 5.2 2.5 2.1 22.3 3.3 3.3

3.7 3.2 6.0 3.3 3.7 5.9 1.7 2.5 7.6 5.6 8.6 3.5 3.2 4.9 2.8 2.4 3.6 3.7 2.9 1.7 0.8 5.2 2.1 2.3 2.9 4.1 4.1 3.6 5.0 2.4 2.6 13.2 3.4 3.2

3.7 3.2 6.0 3.2 3.3 4.5 2.2 3.0 4.8 5.6 9.0 3.5 3.4 5.3 2.8 2.2 3.7 3.6 2.9 2.1 1.1 5.2 1.9 2.2 2.9 3.9 4.1 3.8 4.6 2.3 2.8 5.3 3.5 3.3

Q3

Q3

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1990). Category weights may not sum to total because of rounding.

NOTES: Data through 1993, Quarter 3 are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change is calculated: Use the quarterly index levels shown in Tables 9,11, and 13. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, Quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, Quarter 3; 1994, Quarter 2; 1994, Quarter 1; 1993, Quarter 4). Average these four quarters (add the index levels and divide by 4). Now take the four quarters previous to the four quarters that you just used (e.g., 1993, Quarter 3; 1993, Quarter 2; 1993, Quarter 1; 1992, Quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Fourth quarter 1993 forecasts were produced by Data Resources, Inc./McGraw-Hill.


173

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992–95

Expense Category

1

Total Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive

Base Year 1992 Weights 19872 Q1 100.000 123.9 126.2 124.2 136.9 123.9 108.9 108.3 111.6 96.8 110.9 134.7 133.5 120.3 120.1 148.1 115.8 113.1 120.7 115.0 112.5 114.2 112.2 115.1 111.2 112.3 116.5 120.6 120.9 129.5 119.8 103.4 111.3 131.9 119.1 123.4

61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.838 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

1992 Q4 126.7

1993 Q1 127.7

1993 Q2 128.7

1993 Q3 129.6

1993 Q4

124.8

1992 Q3 126.1

127.0 125.0 138.3 124.9 114.6 120.5 114.9 92.3 126.8 137.0 134.1 121.0 121.0 150.6 116.5 114.0 121.1 115.8 113.2 113.9 112.5 115.7 112.0 112.1 117.6 120.9 120.0 130.2 121.5 103.1 115.4 131.9 119.6 124.4

128.5 126.2 140.9 126.4 120.0 125.0 120.4 101.5 129.5 140.3 135.3 121.6 121.7 152.1 116.5 113.7 121.6 118.1 113.3 114.2 113.0 115.4 112.4 112.0 118.0 121.4 120.4 131.3 122.3 102.8 112.9 131.9 120.5 125.4

129.4 127.0 142.6 127.1 117.0 123.9 113.5 109.6 122.6 141.9 137.0 122.0 122.1 153.5 116.5 113.5 122.0 118.1 113.7 114.2 113.4 115.1 113.1 112.2 118.5 121.8 120.2 132.4 124.0 102.7 112.3 131.9 121.0 126.3

130.8 128.1 145.2 128.3 113.2 117.9 112.5 102.0 115.7 143.2 138.9 122.5 122.5 155.8 117.3 114.2 122.6 117.7 115.1 112.6 113.4 114.6 113.1 112.7 118.9 122.6 121.9 133.0 124.4 103.4 111.1 131.9 121.6 127.3

131.6 128.9 146.4 129.2 116.9 120.0 115.8 107.8 123.3 144.7 140.6 123.4 123.4 157.7 118.2 115.3 123.3 119.1 116.0 112.7 113.6 115.3 113.5 112.7 119.9 123.5 122.1 135.4 125.2 103.2 113.4 131.9 122.3 128.3

132.9 130.0 148.8 130.3 116.6 111.0 121.8 108.1 114.5 147.3 142.6 123.8 123.8 158.8 118.6 115.7 123.8 118.2 116.2 113.6 113.9 114.9 115.1 112.8 118.9 123.9 122.5 136.0 125.4 103.8 112.2 131.9 123.1 128.8

133.9 130.9 150.3 131.1 119.0 129.9 114.9 110.8 117.3 148.9 144.9 124.4 124.1 160.0 119.0 115.9 124.5 117.8 116.8 113.5 114.3 114.8 115.6 113.0 119.3 124.9 123.3 137.3 127.5 104.2 113.8 131.9 124.1 129.7

1992 Q2

130.6


174


Table 9 — Continued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992–95 1

Expense Category Total

Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive 1 2

Base Year Weights 1994 19872 Q1 100.000 132.0 61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.838 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

135.4 132.2 153.4 132.5 120.5 135.2 114.9 111.8 116.1 151.6 146.9 125.7 125.3 163.1 120.4 117.4 125.6 118.8 117.7 113.9 113.9 116.4 115.2 113.8 120.6 126.6 125.1 138.5 128.8 104.9 114.5 143.0 125.0 130.8

1994 Q2 133.0

1994 Q3 134.5

1994 Q4 135.5

1995 Q1 136.8

136.2 132.8 154.9 133.1 122.5 132.7 116.4 112.9 134.8 153.4 149.2 127.1 126.2 165.0 121.4 118.3 126.8 119.9 118.3 114.2 114.0 118.3 115.9 114.3 121.4 128.8 126.0 139.5 131.9 105.8 114.0 179.1 125.7 132.0

137.9 134.4 157.5 135.1 123.4 131.9 118.6 112.0 135.7 156.2 152.1 128.0 127.2 165.7 122.2 119.1 127.8 122.1 118.8 114.7 114.5 120.1 116.9 115.0 122.1 129.7 126.9 140.6 132.7 106.5 113.0 179.1 127.0 133.1

139.0 135.3 159.3 135.8 125.0 143.3 115.9 112.3 133.8 157.6 155.5 128.9 127.9 167.2 122.5 119.0 128.8 122.5 120.0 114.9 114.6 120.9 117.6 115.6 123.1 130.9 128.2 141.6 134.7 106.6 116.0 179.1 128.2 134.0

140.2 136.2 162.5 136.6 123.9 141.2 116.4 114.4 122.5 159.8 159.5 130.3 129.3 170.6 123.8 120.2 130.2 123.4 121.5 115.5 114.7 122.7 117.9 116.4 124.0 132.3 130.4 143.2 134.8 107.5 117.7 179.1 129.2 135.0

1995 Q2 137.9

1995 Q3 139.5

1995 Q4 140.7

141.2 137.0 164.2 137.4 126.6 138.6 118.7 116.3 142.3 162.0 162.9 131.4 130.4 173.2 124.8 121.0 131.5 124.0 121.9 116.3 115.2 124.3 118.8 116.9 124.9 133.5 131.3 144.7 138.1 108.4 117.3 179.1 129.9 136.3

143.1 138.7 167.0 139.3 127.8 137.6 121.6 115.6 143.7 165.2 166.2 132.4 131.4 174.6 125.6 121.6 132.6 126.2 122.0 117.4 116.0 125.8 119.1 117.6 125.5 134.4 132.2 146.2 139.0 108.8 116.4 179.1 131.6 137.4

144.4 139.9 168.8 140.2 129.3 149.8 119.2 116.2 136.7 166.5 169.5 133.6 132.5 177.5 125.9 121.4 133.8 126.8 123.1 118.4 116.2 127.8 118.8 118.2 126.6 135.7 133.4 147.4 140.6 109.0 118.9 179.1 133.1 138.5

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1990). Category weights may not sum to total because of rounding.

NOTES: Data through 1993, Quarter 3, are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Fourth quarter 1993 forecasts were produced by Data Resources, Inc./ McGraw-Hill.


175

Table 10 Percent Change in Four-Quarter Moving Averages in the Skilled Nursing Facility Input Price Index, by Expense Category: 1992–95 Expense Category1 Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil. and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Four Quarts rs Ending


1992 Q1 4.0

1992 Q2 3.8

1992 Q3 3.8

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

4.5 4.1 7.8 -1.3 -8.3 3.2 0.6 7.6 1.4 -0.6 3.1 4.7 8.3 3.6 5.7 4.6 3.6

4.3 3.9 7.7 -1.9 -9.6 3.0 0.5 7.6 1.3 -0.5 2.8 4.4 7.9 3.2 5.9 4.3 3.2

4.3 3.9 7.3 -1.5 -8.5 2.6 0.9 7.1 1.3 0.0 2.4 4.1 7.2 3.0 6.1 4.0 3.0


1994 Q1 3.8

1994 Q2 3.9

1994 Q3 4.0

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

4.1 3.9 5.7 2.9 0.6 2.1 6.0 5.3 2.1 1.9 2.2 3.6 4.5 2.9 5.5 3.8 2.9

4.2 4.1 5.5 2.8 1.1 1.8 4.8 5.5 2.2 2.2 2.3 3.5 4.5 2.8 5.3 3.6 2.8

4.3 4.2 5.3 2.8 2.8 1.1 2.9 5.7 2.5 2.5 2.5 3.5 4.4 3.0 5.0 3.4 3.0

1992 Q4 3.8 4.2 3.9 6.8 0.5 -3.8 2.0 1.9 6.8 1.2 0.1 2.1 4.0 6.5 3.0 6.3 3.8 3.0 Four Quarts rs 1994 Q4 4.0 4.2 4.1 5.1 3.1 4.4 0.7 2.2 5.9 2.7 2.7 2.8 3.5 4.5 3.1 4.9 3.4 3.1

1993 Q1 3.8 4.1 3.9 5.9 2.2 -0.1 1.9 3.5 6.5 1.2 0.5 1.8 4.0 5.9 3.1 6.3 3.8 3.1 Ending 1995 Q1 3.8 3.9 3.9 4.6 3.1 5.2 0.4 1.2 5.8 2.8 2.6 3.0 3.6 4.5 3.2 4.8 3.4 3.2

1993 Q2 3.7

1993 Q3 3.6

1993 Q4 3.7

4.0 3.8 5.6 2.8 0.7 1.9 4.9 6.2 1.4 0.8 1.8 3.9 5.4 3.1 6.1 3.8 3.1

3.9 3.7 5.3 2.7 0.0 2.0 6.1 5.9 1.5 1.1 1.9 3.8 5.0 3.0 5.9 3.9 3.0

3.9 3.8 5.2 2.8 0.5 2.0 6.0 5.4 1.8 1.5 2.1 3.7 4.6 3.0 5.6 3.8 3.0

1995 Q2

1995 Q3

1995 Q4

3.8

3.9

4.0

3.9 3.9 4.4 3.2 5.6 0.5 1.3 5.7 2.9 2.6 3.1 3.7 4.6 3.3 4.9 3.4 3.3

4.0 4.0 4.2 3.5 5.3 0.8 2.2 5.6 2.8 2.4 3.1 3.7 4.9 3.2 5.1 3.5 3.2

4.3 4.3 4.1 3.6 4.9 1.2 2.8 5.6 2.7 2.2 3.0 3.8 5.3 3.3 5.4 3.5 3.3

1 2

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1992c).

Category weights may not sum to total because of rounding.

NOTES: Data through 1993, Quarter 3, are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change is calculated. Use the quarterly index levels shown in Tables 9 , 1 1 , and 13. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, Quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, Quarter 3; 1994, Quarter 2; 1994, Quarter 1; 1993, Quarter 4). Average these four quarters (add the index levels and divide by 4). Now, take the four quarters previous to the four quarters that you just used (e.g., 1993, Quarter 3; 1993, Quarter 2; 1993, Quarter 1; 1992, Quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCES: Health Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Fourth quarter 1993 forecasts were produced by Data Resources, Inc./ McGraw-Hill.

176


Table 11 Quarterly Index Levels in the Skilled Nursing Facility Input Price Index, by Expense Category: 1992–95 Expense Category

1

Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs 1 2

Base Year 1992 Weights 19772 Q1 100.000 236.2

1992 Q2 238.2

1992 Q3 240.5

1992 Q4 242.4

1993 Q1 244.8

1993 Q2 246.8

1993 Q3 249.2

1993 Q4

239.3 237.3 256.3 221.3 204.2 216.8 226.1 281.3 186.8 164.6 209.7 257.5 345.4 229.1 303.0 266.9 229.1

241.3 239.1 259.2 223.0 205.2 217.8 228.7 285.9 187.4 165.4 210.0 260.1 351.2 230.8 308.1 269.2 230.8

243.9 241.7 262.2 227.2 210.4 218.7 234.0 292.8 187.4 164.7 210.6 262.2 354.9 232.4 312.1 271.3 232.4

245.8 243.4 265.6 228.6 208.6 220.7 239.3 296.3 188.3 165.3 211.8 264.6 358.2 234.2 315.5 274.2 234.2

248.6 246.3 267.6 227.9 207.5 219.7 237.7 298.9 189.4 166.1 213.3 267.6 363.5 236.4 320.9 276.9 236.4

250.4 247.7 273.3 231.1 208.8 222.6 244.7 302.0 190.7 167.4 214.7 270.1 367.8 238.1 325.7 279.8 238.1

253.3 250.4 276.7 233.2 207.5 224.5 251.3 307.5 190.9 167.6 214.9 271.7 370.5 238.8 329.5 282.0 238.8

256.3 253.5 279.9 233.5 208.5 224.5 249.5 310.8 192.4 168.8 216.6 273.9 373.1 240.8 332.4 284.1 240.8

Base Year Weights 1994 19772 Q1 100.000 255.1

1994 Q2

1994 Q4 261.2

1995 Q1 263.8

1995 Q2 266.9

1995 Q3

256.6

1994 Q3 259.1

270.2

1995 Q4 272.8

259.9 256.9 284.3 235.7 212.2 224.0 250.8 316.4 194.0 170.4 218.2 277.0 380.4 243.1 337.7 286.6 243.1

261.2 258.1 286.9 237.6 216.1 224.2 250.3 320.3 195.4 171.5 219.9 279.3 384.9 244.9 341.5 288.9 244.9

264.0 260.9 289.4 239.6 218.9 224.4 251.0 326.0 196.8 172.5 221.6 281.4 386.5 246.8 344.9 291.3 246.8

266.2 263.1 292.4 241.5 221.6 224.9 252.6 329.0 198.1 173.4 223.4 283.8 390.0 248.7 348.2 293.8 248.7

268.8 265.5 296.4 243.7 224.3 225.6 254.6 333.6 199.5 174.5 225.1 287.1 398.0 250.9 354.5 296.6 250.9

272.3 269.0 298.9 245.8 226.6 226.5 257.0 338.1 200.8 175.4 226.8 289.8 404.1 252.9 359.5 299.1 252.9

276.2 273.2 301.1 248.3 228.9 227.6 259.3 344.8 201.9 176.2 228.3 292.3 407.2 254.8 364.2 301.7 254.8

278.9 275.9 303.5 250.5 231.5 228.6 261.9 347.5 203.1 177.1 229.8 295.3 414.0 257.2 368.0 304.3 257.2

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

251.8

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1992c). Category weights may not sum to total because of rounding.

NOTES: Data through 1993, Quarter 3, are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Fourth quarter 1993 forecasts were produced by Data Resources, Inc./ McGraw-Hill.


177

Table 12 Percent Change in Four-Quarter Moving Averages in the Home Health Agency Input Price Index, by Expense Category: 1992–95

Expense Category1 Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services 1 2

Four Quarte rs Ending

Base Year Weights 19772

1992 Q1

1992 Q2

1992 Q3

1992 Q4

1993 Q1

1993 Q2

1993 Q3

1993 Q4

100.000

5.8

5.2

4.6

4.2

3.9

3.9

3.7

3.5

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

6.4 6.3 7.8 1.4 4.6 5.5 3.3 -1.3 3.6 5.8

5.8 5.6 7.7 1.0 4.3 5.2 2.9 -1.9 3.2 5.2

5.0 4.8 7.3 1.0 4.0 4.9 2.6 -1.5 3.0 4.6

4.5 4.2 6.8 2.2 3.8 4.1 2.5 0.5 3.0 4.2

4.1 3.9 5.9 3.0 3.8 3.2 2.3 2.2 3.1 3.9

4.0 3.8 5.6 3.2 3.8 3.2 2.3 2.8 3.1 3.9

3.8 3.7 5.3 3.1 3.9 3.2 2.4 2.8 3.0 3.7

3.6 3.4 5.2 3.0 3.8 3.3 2.3 2.9 3.0 3.5

Base Year Weights 19772

1994 Q1

1994 Q2

1994 Q3

1994 Q4

1995 Q1

1995 Q2

1995 Q3

1995 Q4

100.000

3.3

3.3

3.6

3.9

4.1

4.1

4.1

4.2

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

3.4 3.1 5.7 3.0 3.8 3.5 2.0 3.0 2.9 3.3

3.4 3.1 5.5 3.6 3.6 3.1 1.6 2.8 2.8 3.3

3.7 3.6 5.3 4.4 3.4 3.0 1.1 2.9 3.0 3.6

4.0 3.9 5.1 5.1 3.4 3.0 0.8 3.2 3.1 3.9

4.2 4.2 4.6 5.3 3.4 3.2 0.9 3.2 3.2 4.1

4.3 4.2 4.4 5.2 3.4 3.6 1.2 3.4 3.3 4.1

4.2 4.2 4.2 5.0 3.5 4.0 1.7 3.6 3.2 4.1

4.3 4.3 4.1 4.6 3.5 4.2 2.2 3.6 3.3 4.2

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1993b). Category weights may not sum to total because of rounding.

NOTES: Data through 1993, Quarter 3, are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change is calculated, Use the quarterly index levels shown in Tables 9 , 1 1 , and 13. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, Quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, Quarter 3; 1994, Quarter 2; 1994, Quarter 1; 1993, Quarter 4). Average these four quarters (add the Index levels and divide by 4). Now take the four quarters previous to the four quarters that you just used (e.g., 1993, Quarter 3; 1993, Quarter 2; 1993, Quarter 1; 1992, Quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCES: Health Care Financing Administration, Office of the Actuary, Data from the Office of National Health Statistics, Division of Health Cost Analysis. Fourth quarter 1993 forecasts were produced by Data Resources, Inc./McGraw-Hill.

178


Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index, by Expense Category: 1992–95 Expense Category1 Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services 1 2


285.5

1992 Q3 289.6

292.7

1993 Q1 295.3

294.3 295.4 284.9 225.7 287.3 248.1 238.5 249.2 243.9 283.9

295.8 296.7 288.1 229.0 289.9 248.5 239.4 251.3 245.8 285.5

300.5 301.6 291.4 230.5 292.1 249.8 240.5 256.1 247.4 289.6

303.8 304.9 295.2 233.7 295.2 251.3 242.7 257.7 249.4 292.7

306.6 307.7 297.4 234.4 298.2 254.1 243.8 256.9 251.7 295.3

307.2 307.6 303.8 235.9 301.3 258.5 245.3 260.5 253.5 296.3

310.2 310.5 307.6 236.4 303.6 258.6 246.5 262.9 254.3 298.8

313.7 314.0 311.1 240.2 305.9 259.7 247.5 263.3 256.4 302.0


1994 Q2 307.7

1994 Q3 311.9

1994 Q4 314.4

1995 Q1 316.7

1995 Q2 320.2

1995 Q3 325.2

1995 Q4

319.5 319.6 318.9 248.5 311.0 265.2 246.8 268.2 260.8 307.7

324.4 324.7 321.7 250.0 313.6 266.3 248.0 270.4 262.7 311.9

326.9 327.1 325.0 253.8 316.3 268.9 249.8 272.6 264.8 314.4

329.3 329.2 329.4 254.0 319.4 271.1 249.9 275.1 267.1 316.7

332.7 332.7 332.2 260.3 322.1 276.3 251.3 277.6 269.2 320.2

338.5 338.9 334.6 261.9 324.9 278.6 254.6 280.5 271.3 325.2

342.0 342.6 337.4 265.0 327.6 280.8 257.2 283.0 273.8 328.5

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

316.2 316.2 316.0 242.7 308.6 261.7 246.7 265.9 258.8 304.5

1992 Q2

1992 Q4

1993 Q2 296.3

1993 Q3 298.8

1993 0.4 302.0

328.5

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1993b). Category weights may not sumto total because of rounding.

NOTES: Data through 1993, Quarter 3, are historical. Data beginning with 1993, Quarter 4, are forecasted. Q designates quarter of year. SOURCE: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis.


179

Table 14 Selected National Economic Indicators: 1990–93 Calendar Year 1990

1991

1992

1990 Q3

1991 Q3

1992 Q3

1992 Q4

1993 Q1

1993 Q2

1993 Q3

$5,546 $4,897 113.2

$5,723 $4,861 117.7

$6,038 $4,986 121.1

$5,584 $4,907 113.8

$5,759 $4,873 118.2

$6,060 $4,998 121.2

$6,194 $5,068 122.2

$6,262 $5,078 123.3

$6,328 $5,102 124.0

$6,396 $5,138 124.5

5.5

6.7

7.4

5.6

6.7

7.5

7.3

7.0

6.9

6.7

Private Non-Agricultural Workers: Total Employment in Thousands 91,115 Average Weekly Hours 34.5 Average Hourly Earnings $10.01

89,854 34.3 $10.32

89,866 34.4 $10.57

92,032 34.8 $10.04

90,548 34.6 $10.34

90,715 34.6 $10.57

90,714 34.5 $10.70

89,217 34.0 $10.78

91,297 34.5 $10.79

92,335 34.8 $10.81

Health Services Workers: Total Employment in Thousands Average Weekly Hours Average Hourly Earnings

7,814 32.5 $10.40

8,183 32.5 $10.96

8,523 32.8 $11.39

7,882 32.8 $10.46

8,247 32.7 $11.05

8,580 32.9 $11.44

8,667 32.8 $11.57

8,736 32.7 $11.68

8,836 32.7 $11.70

8,927 32.9 $11.79

Personal Income and Savings Income in Billions Disposable Income in Billions Savings in Billions Personal Savings Rate

$4,674 $4,051 $170 4.2

$4,851 $4,231 $201 4.7

$5,145 $4,500 $239 5.3

$4,702 $4,073 $152 3.7

$4,859 $4,239 $187 4.4

$5,140 $4,497 $220 4.9

$5,328 $4,658 $280 6.0

$5,255 $4,598 $178 3.9

$5,373 $4,692 $209 4.4

$5,413 $4,724 $180 3.8

Prices1 Gross Domestic Product FixedWeight Price Index (1987=100.0) Consumer Price Index, All Items All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter Medical Care

113.5 130.7 128.8 124.1 102.1 132.1 140.0 162.8

118.2 136.2 133.8 128.7 102.4 136.8 146.3 177.0

122.1 140.3 137.5 131.9 103.0 138.7 151.2 190.1

114.3 131.6 129.6 123.3 103.8 132.7 141.9 164.8

118.7 136.7 134.3 128.0 103.1 136.8 147.2 178.7

122.5 140.9 138.0 130.9 105.8 138.7 152.0 191.5

123.5 141.9 138.9 133.6 104.3 139.3 152.5 194.1

124.8 143.1 140.0 133.1 102.7 140.7 154.3 197.7

125.6 144.2 141.0 134.6 104.7 141.4 155.2 200.3

126.3 144.8 141.5 132.0 105.4 141.5 156.6 202.8

Producer Price Index2, Finished Consumer Goods

118.2

120.4

121.7

118.4

120.3

122.3

122.5

122.8

124.2

122.8

Indicator Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 = 100.0)

Employment, Hours, and Earnings Unemployment Rate, All Workers

1 2

Base period = 1982–84, unless noted. Formerly called the "Wholesale Price Index."'

NOTES: Q designates quarter of year. Unlike tables 1–13, quarterly data on GDP, personal income, disposable personal income, and savings are seasonally adjusted at annual rates. In addition the unemployment rate is seasonally adjusted. SOURCES: U.S. Department of Commerce, Bureau of Economic Analysis: Survey of Current Business. Washington. U.S. Government Printing Office. Monthly reports for January 1990–December 1993; U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1990–December 1993.

180


Table 15 Percent Change in Selected National Economic Indicators: 1990–93 Calendar Year Indicator Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 = 100.0)

1990 1992 1991 *Annual Percent Change

1992 1990 1992 1993 1993 1991 1993 Q3 Q4 Q3 Q3 Q2 Q1 Q3 Percent Change From the Same Period of Previous Year

5.6 1.2 4.3

3.2 -0.7 3.9

5.5 2.6 2.9

5.8 1.4 4.3

3.1 -0.7 3.8

5.2 2.6 2.6

6.7 3.9 2.8

6.0 3.2 2.7

5.6 2.9 2.6

5.6 2.8 2.7

Employment, Hours, and Earnings Unemployment Rate, All Workers1 0.3

1.2

0.7

0.3

1.2

0.8

0.3

-0.2

-0.6

-0.8

1.1 -0.3 3.7

-1.4 -0.6 3.1

0.0 0.2 2.5

1.2 -0.1 3.8

-1.6 -0.6 3.0

0.2 -0.0 2.3

0.6 0.1 2.5

1.3 -0.1 2.6

1.5 0.4 2.5

1.8 0.6 2.3

4.7 0.3 5.9

4.7 -0.0 5.3

4.2 0.7 3.9

4.9 0.5 5.7

4.6 -0.3 5.6

4.0 0.6 3.6

4.2 0.5 3.7

4.3 -0.4 4.0

4.3 0.4 3.5

4.0 0.0 3.1

6.7 7.0 11.8 0.1

3.8 4.4 18.5 0.6

6.1 6.4 18.4 0.6

7.1 7.3 17.5 0.3

3.3 4.1 23.2 0.7

5.8 6.1 17.6 0.5

8.1 8.3 32.1 1.1

4.7 4.8 -18.2 -1.1

5.5 5.2 -12.3 -0.9

5.3 5.0 -18.2 -1.1

Prices2 Gross Domestic Product Fixed-Weight: Price Index (1987 = 100.0) 4.5

4.1

3.3

4.7

3.8

3.2

3.3

3.3

3.1

3.1

Consumer Price Index, All Items All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter Medical Care

5.4 5.2 4.6 8.2 5.8 5.4 9.1

4.2 3.9 3.7 0.4 3.6 4.5 8.7

3.0 2.7 2.5 0.5 1.4 3.4 7.4

5.5 5.3 5.7 6.8 5.6 6.0 9.3

3.9 3.6 3.9 -0.7 3.1 3.7 8.5

3.1 2.8 2.2 2.6 1.4 3.3 7.2

3.1 2.8 1.4 2.4 1.7 3.1 6.8

3.2 2.9 2.0 3.4 1.8 3.0 6.3

3.1 2.9 1.6 2.0 2.1 3.1 6.1

2.7 2.5 0.8 -0.3 2.0 3.0 5.9

Producer Price Index,3 Finished Consumer Goods

5.5

1.9

1.0

5.4

1.7

1.6

1.5

2.1

2.1

0.5

Private Non-Agricultural Workers: Total Employment Average Weekly Hours Average Hourly Earnings Health Services Workers: Total Employment Average Weekly Hours Average Hourly Earnings Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

1 2 3

Change in rate, rather than percent change. Base period = 1982–84, unless noted. Formerly called the "Wholesale Price Index."

NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCES: U.S. Department of Commerce, Bureau of Economic Analysis: Survey of Current Business. Washington. U.S. Government Printing Office. Monthly reports for January 1989–December 1993; U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1989–December 1993.


181

Figure 1 Percent Change in Inpatient Expense and Operating Expense From the Same Period of Previous Year: 1984–93

14

12

Percentage Points

10

8

6

4

Inpatient Expense Operating Expense

2

0 1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

Quarters SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1983September 1993.

182

HEALTH CARE FINANCING REVIEW/Spring 1994/Volume 15. Number 3

Figure 2 Percent Change in Beds and Level Change in Occupancy Rates From Same Period of Previous Year: 1984-93 2

Percentage Points

0

-2

-4

-6

-8 1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

Quarters SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1983September 1993.


183

Figure 3 Percent Change in Employment From Same Period of Previous Year: 1984–93

8

Percentage Points

6

4

2

0 All Private Non-Agricultural Employment

-2

Health Service Total Employment Hospital Total Employment

-4 1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

Quarters SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1983-December 1993.

184


Figure 4 Percent Change for Non-Supervisory Work Hours From the Same Period of Previous Year: 1984–93 8

6

4

2

0 Private Health Establishments -2

All Private Non-Agricultural Private Hospitals SIC 806

-4

1984

1985

1986

1987

1988

1989 Quarters

1990

1991

1992

1993

NOTE: SIC is Standard Industrial Classification. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1983-December 1993.


185

Figure 5 Percent Change for Non-Supervisory Payroll From the Same Period of Previous Year: 1984–93

14

12

Percentage Points

10

8

6

4 All Private Non-Agricultural Private Health Establishments

2 Private Hospitals SIC 806

0 1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

Quarters NOTE: SIC is Standard Industrial Classification. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1983–December 1993.

Figure 6 Percent Change in Measures of Price Inflation From the Same Period of Previous Year: 1984–93

12

Percentage Points

10-

a 6-

4 Consumer Price Index—All Items

2

Consumer Price Index—Medical Care

01984

1985

1986

1987

1988

1989

1990

1991

1992

1993

Quarters SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office Monthly reports for January 1983–September 1993.

HEALTH CARE FINANCING REVIEW/Spring 1994/Voiume 15, Number 3

187

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators.

Health Care Indicators: Hospital, Employment and Price Indicators for the Health Care Industry: Third Quarter 1997.

Quality Indicators for Primary Health Care: A Systematic Literature Review.

Quality Indicators for Physical and Behavioral Health Care Integration.

Patient reported outcomes as indicators of pediatric health care quality.

Development of indicators for patient care and monitoring standards for secondary health care services of Mumbai.

Development of health equity indicators in primary health care organizations using a modified Delphi.

Health indicators in Yemen.

Measuring progress in maternal and newborn health care in Mexico: validating indicators of health system contact and quality of care.

Disparities in Health Care Quality Indicators among US Children with Special Health Care Needs According to Household Language Use.

interRAI home care quality indicators.

Maternal health Indicators Signal Optimism.

Physical health indicators in SMI.

Underprivileged areas and health care planning: implications of use of Jarman indicators of urban deprivation.

Perinatal quality indicators: yardsticks for quality of care, measures of population health.

Equity in Distribution of Health Care Resources; Assessment of Need and Access, Using Three Practical Indicators.