-- 

Series 13

DATA FROM THE NATIONAL HEALTH SURVEY Number 7 

SurgicalOperationsin 

Short-StayHospitals 

for DischargedPatients 

United States- 1965 

k~tistics are presented on the volume and classes of surgical 

operations and procedures performed in short-stay hospitals, 

based on data abstracted from a national sample of records of 

inpatients discharged. Estimates of discharges with surgery 

and all listed operations classified by surgical specialty and 

body site, are distributed by size and regional location of the 

hospital and by age and sex of the discharged patients. +?p*3c--i “F -c-q _ - - - r,“‘pJ 

c”m’r-j it-, J ‘.’- i:: ” +- -0 

e,:-ic7!h( $-\t~i*:‘Ji?>!! 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Public Health Service 

Health Services and Mental Health Administration 

National Center for Health Statistics 

Rockville, Md. April 1971 c 
Public Health Service Publication No., 1000~Seriw l&No. 7 

For sale by the Superintendent of Documents, U.S. Cbwnment Printing Oftice, IVsshington, D.C., 20403- Price 40 cents 

Stock Number li%?-0105 
NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORED. WOOLSEY,Director 

PHILIP S. LAWRENCE, Sc.D., Associate Director 

OSWALD K. SAGEN, Ph.?.,, Assistant Director for HeaIth Statistics DeveIopqent 

WALT R. SIMMONS, M.A., Assistant Director for Research and Scientific Development 

JAMES E. KELLY, D.D.S., Dental Advisor 

EDWARD E. MINTY, Executive Officer 

ALICE E. HAYWOOD, information Officer 

DIVISION OF HEALTH RESOURCES STATISTICS 

SIEGFRIED A. HOERMANN, Director 

PETER L. HURLEY, Deputy Director 

GLORIA G. HOLLIS, Chief, Health Facilities Statistics Branch 

HENRY S. MOUNT, Chief, Health Manpower Statistics Branch 

GRACE K. WHITE, Chief, Hospital Discharge Survey Branch 

NOAH SHERMAN, Chief, Family Planning Statistics Branch 

. 

. 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health 

Survey, the Public Health Service is authorized to use, insofaras possible, the services or facilities of other Federal, 

State, or private agencies. 

In accordance with specifications established by the National Center for Hea.lth Statistics, the Bureau of the Census, 

under a contractual arrangement, participated in planning the 

survey and collecting the data. 

Public Health Service Publication No. 1000~Series 13-No. 7 

Library of Congress Catalog Card Number 71408553 
----------------------------------------------------- 

------------------------------------------------ 

CONTENTS 

Page 

Introducticn---------------------------------------------------------- 1 

Mschage,s dfi Surgery--------L-------------------------------------­

patient Characteristics-------------------------~--------------------

Geogr-p& Region--------------------------------------------------

Size of Hospital 

Selected ()perations---------------------------------------------------

SurgicaLIOperations by Specialty and Body Site------------------------­

patient Ch~act&s~cs-- __________--_---_--------_--_--------------

Geogr-p& Region--------------------------------------------------

Size of Hospitdl---------------------------------------------------­

. References----------------------------------------------------------- 8 

Detailed :rables------------------------------------------------------- 9 

APPLY* 1. Tech&al Notes on Methods------------------- ____- _____-_ 22 

Statisdcal Design of the Hospital Discharge Survey--------------------- 22 

Data Collection and Processing--------------------------------------- 23 

presumption ofEstimates------------------------------------------- 27 

Relia.bl.lity of Estimates ----c---------------------------------------- 27 

Appendix II. Defintions of Certain Terms Used in This Report------------ 29 

Terms Relating to Hospitalization------------------------------------ 29 

Demographic Terms 29 

Terms Relating to Surgery------------------------------------------ 29 

. 

iii 
SYMBOLS 

Data not available------ __--___ -___-_----- _--

Category not applicable------------------- . . . 

Quantity zero---------------------------- -

Quantity more than 0 but less than 0.05---- 0.0 

Figure does not meet standards of * reliability or precision------------------
INTRODUCTION 

This report is based on data collected through 

the Hospital Discharge Survey (HDS), a continuous 

nationw;.de survey conducted by the National 

Center for Health Statistics. The data cover 

calenda:: year 1965, the first full year of the HDS. 

Presented are statistics on the frequency of surgical operations among inpatients discharged from 

short-s:ay hospitals and the volume of all-listed 

operations classified by surgical specialty and 

body site. 

The data are based on information transcribed from the hospital medical records for a 

national sample of inpatients discharged from 

nonmilitary general and special short-stay hospitals in the United States. Previous reports based 

on data collected in the Hospital Discharge 

Survey for 1965, published in VituZ and Health 

Statistics, Series 13, Nos. 2-5, presented measurements of hospttal utilization according to the 

demographic characteristics of the discharged 

patients and the size, control and location of the 

hospitak. In the latest report in Series 13,No. 6, 

“Inpatient Utilization of Short-Stay Hospitals by 

Diagnosis,” information is presented on the frequency of diseases and injuries among inpatients 

discharged during 1965. 

Cut of the universe of 6,965 hospitals, a 

sample of 315 hospitals was drawn for the HDS 

in 1965; 296 hospitals participated during all or 

part of the year. Approximately 100,400abstracts 

(sample discharges) were received and processed. 

For a detailed description of the sample design, 

data collection procedures, and the estimation 

process, see appendix I. 

SURGICAL OPERATIONS 

IN SHORT-STAY HOSPITALS 

FOR DISCHARGED PATIENTS 

Edythe A. Gray and Sue Meads, DivisZon of HeaZth Resources Statistics 

An estimated 28.8 million inpatients (excluding newborn infants) were discharged from 

the Nation’s nonmilitary short-stay hospitals 

during 1965. of these, 11.0 million (38 percent) 

had one or more surgical operations or procedures. 

The proportion of operated patients varied 

by geographic region, being lowest in the Sottth 

Region and highest in the Northeast Region. For 

the Nation as a whole, it increased consistently 

as bed size of hospital increased. 

Almost one-half of the inpatients under 15 

years of age (excluding newborn infants) had an 

operation. On the other hand, only 36 percent of 

the adult patients had an operation. However, 

adult patients accounted for 83 percent of the 

estimated volume of operations and procedures 

performed for inpatients discharged in 1965. 

Tonsillectomy was the single most frequently reported operation for inpatients discharged in 1965; it was followed by repair of 

inguinal hernia and hysterectomy. 

Appendix II contains definitions of terms 

relating to hospitalization and surgery that are 

used in this report. Since several of the terms 

have specialized meanings in the Hospital Discharge Survey, familiarity with these definitions 

will aid in interpreting the data. 

DISCHARGES WITH SURGERY 

Of the estimated 28.8 million inpatients (excluding newborn infants) discharged from shortstay hospitals during 1965, 11.0 million (or 38 

percent) had one or more surgical operations or 

procedures as defined herein. Approximately 24.0 

1 
-- 

million of the discharged patients were admitted 

for conditions other than complications of pregnancy, childbirth, and the puerperium or deliveries. Over 42 percent of these had one or more 

surgical operations or procedures. 

Patient Characteristics 

Almost one-half of the discharged inpatients 

under 15 years of age (excluding newborn infants) 

Table A. Number and percent of inpatients by of discharge, and 

discharged short-stay hospitals 

surgery, type of hospital: United States, 1965 age sex of patient, geographic region, and size 

(E;xcludes newhorn infants and Veterans Administration and military hospitals) 

-

All discharges Nonobstetric discharges1 

Characteristic Number Percent Number Percent 

Total with with Total with with 

surgery surgery surgery surgery 

(In thousands) (In thousands) 

Total’--------------_---- 28,792 10,996 38.2 23,999 42.6 

Aee 

Under 15 years---------------- 4,271 2,109 49,4 4,261 2,108 49.5 15-44 years------------------- 13,126 4,879 3702 8,355 49.2 45-64 years------------------- 6,702 2,662 6,692 4% 39.7 

65 years and over------------- 4,600 1,317 ;9s*i 0 4,600 1:31i 28.6

Sex and age 

Male, all ages----------------

Male, 15 years and over-----

Female , all ages- _-__---_ - -___ 

Female, 15 years and over---

11,159 

8,709 

Z%, 

4,493

3,266 

6,485

5,578 

11,159

8,709 

12,791

10,897 

4,493

3,266 

5,71c

4,805 

40.3 

37.5 

44.6 

44.1 

Geographic region 

Northeast---------------------

North Central-----------------

South-------------------------

West -___----_-_---------------

6,472

8,451 

9,341

4,527 

x5: 

3:135 

1,918 

4209 

37.5 

33.6 

4204 

5,277

7,010

7,971

3,741 

4804 

41.9 

37.0 

47.8 

Size of hospital 

Less than 100 beds------------ 7,297 2,183 29c.9 6,106 100-199 beds------------------ 2,432 35,4 5,741 200-299 beds------------------ 65%: 2,307 42.2 4,516 300-499 beds------------------ 6’011 2,617 43.5 5,058

500 beds or more-------------- 3:152 1,457 46.2 2,578 

+ 

'Excludes discharges with first-listed or only diagnosis classified toICDA class XI, Deliveries and Complications of Pregnancy, Childbirth, and Puerperium. 2Includes discharges for which the patient characteristic was not stated. 

2 

had an operation (2.1 out of 4.3 million); over 

1.0 million of the children had a tonsillectomy 

and/or an adenoidectomy. On the other hand, 

only 36 percent of the adult patients had an 

operation (8.9) out of 24.4 million). The proportion of operated patients was lowest for patients 

65 years of age or older (table A). Including 

obstetrical discharges the proportion of operated 

patients was about the same for males 

from with 
----------------------------- 

257 

and fernales 15 years of age or older. Ex- Size of Hospital

eluding obstetrics, 44 percent of the adult females 

had surgery compared with 37.5 percent for adult About 30 percent of the inpatients discharged 

males. from hospitals maintaining fewer than 100 beds 

had one or more surgical operations or proceGeogrc phic Region dures. The proportion increased consistently as 

bed size of hospital increased. Hospitals with 

The proportion of discharged patients with 500 or more beds reported at least one operasurgery was about 43 percent in the Northeast tion for 46.2 percent of their dischargedpatients. 

and West Regions and 37.5 and 33.6 percent in 

the North Central and South Regions, respectively. The higher proportion of operated patients SELECTED OPERATIONS 

in the Northeast and West Regions was coupled 

with relatively lower discharge rates (138 and Sex-specific rates of discharges following 

146 per 1,000 civilian, noninstitutional popu- each of 15 operations commonly used for comlation in the Northeast and West Regions, re- parative purposes are shown in table B for perspectively, compared with 159 per 1,000 in the sons of allages. Similar data are presented in 

North Central and South Regions)? table C for persons 15 years of age and over. 

Tab12 B. Number and rate of inpatients discharged from short-stay hospitals with 

selected surgical operations, by sex: United States, 1965 

(Excludes newborn infants and VeteransAdministrationandmilitary hospibls) 

Rate of 

Number of discharges discharges in thousands per 100,000 

Operation and ICDA-HDS codes1 population 

Both" !Jale Female Male Female sexes I 

Thyroidectomy--,------------------------O8.1-08.2 68.8 

Extraction of lens ---------------------17.3-17.3175 1282 65.: 83.1 

Tonsi. lectomy with or without 

adenoidectomy _------------------------- “7.1-27.2 1,215 585 627 635.9 641.2 

Mastectomy ----_-_----------_----------- 38.1-38.3 266 263.1 

Repair of inguinal hernia--------------40.0-40.1 517 46; 50 507.: 51.5 

Gastrs!ctomy---..-----------------------~4.2~~.~ 65 44.5 24.3 

AppendectomyS -..------------------- m-w---- --+ . 379 2:: 1;'; 217.1 181.3 

Enterectomy; colectomy-----------------46.3-46.5 45.4 58.0 

Hemor]:hoidecto3ly----- _________-------------<~.~ 29s; 1% 1% 161.9 137.4 

355 87 267 94.4 273.4 

prost;Ltectomy 

Cholecystectomy _._____- ________-----------66.1-66:3 191 191 . . . 207.9 . . . Hystel:ectomy--,--------------------72.3-72.6;72.9 505 . . . 505 . . . 516.5 

Reduction of fracture with internal 

fixation -----I_-----------------_---- -----w-82.2 208 94 113 102.4 115.3 

Excision of intervertebral cartilage--------83.4 45 48.6 33.0 

Excision and ligation of varicose veins-----88.4 1;; 32 9'2 35.1 96.3 

lFor further information, see medical coding and edit in appendix I. 

BIncludes d,ischarges for which sex of patient was not stated. 

3Provisional estimate; limited to estimated numberof first-listed appendectomies to 

exclude majority that were performed incidental to other abdominal surgery. 

3 
Table C. Number and rate of inpatients 15 years of age and over discharged from shortstay hospitals with selected surgical operations, by sex: United States, 1965 

(Excludes VeteransMmini&ration .md military hospitals) 

Number of discharges Rate of discharges 

of patients in per 100,000 persons thousands 

Operations and ICDA-HDS codes’ 

Both 

sexes 2 Male Female Male Female 

Thyroidectomy--------------------08.1-08.2 96.0 

Extraction of lens---------------17.3-17.5 5; 2 96.: 116.5 

Tonsillectomy with or without 

adenoidectomy-------------------27.1-27.2 87 142 141.7 207.2 

Mastectomy-----------------------38,1-38.3 2: 256 374.2 

Repair of inguinal hernia--------40.0-40.1 34: 54.2 

Gastrectomy----------------------44,2-44.3 3:i zz 34.7 

Appendectomy3 -------------------------45.1 237 1;:

Enterectomy; colectomy---------o-46.3-46.5 % %2 

Cholecystectomy-----------------------53.5 355 267 141.0 390.6 

Prostatectomy----------------m---66.1-66.3

Hysterectomy----------------72.3-72.6;72.9

Reduction of fracture with internal 

191 1;: . . . 505 . . . 505 309.8 . . . . . . 737.9 

fixation -_----_--_-c----------------- 82.2 195 109 138.3 

Excision of intervertebral cartilage--83.4

Excision and ligation of varicose

veins--------------------------------88.4 

78 32 

127 32 94 

72.6 

52.5 

‘24 . 

137.7 

‘See reference 2. 

21ncludes discharges for which sex of patient was not stated. 

Hemorrhoidectomy------------------3-----49,3 29s; 149 134 196: 3 

aProvisional estimate; limited to estimated number of first-listed appendectomies to 

exclude majority that were performed incidental to other abdominal surgery. 

In the aggregate, the number of discharges with 

the 15 selected operations accounted for 44 percent 

of all nonobstetric discharges. with surgery (4.5 

out of 10.2 million). 

Tonsillectomy was the single most frequently 

reported operation for inpatients discharged from 

the Nation’s nonmilitary short-stay hospitals in 

1965; it was followed by repair of inguinal hernia 

and hysterectomy (table B). Four out of five of 

the tonsillectomies and one-fourth of the inguinal 

herniorrhaphies ‘were performed for patients 

‘under 15 years of age. Inguinal herniorrhaphies 

were performed 10 times as frequently for males 

as females. The sex ratio was about the same for 

children and for patients 15 years of age and over. 

Hysterectomies, about equal in volume to repairs. 

of ingumal hernia among discharged patients, was 

4 

the leading operation among adult females. The 

number of hysterectomies per 100,000 females in 

the civilian, noninstitutional population was 516; 

it was 738 per 100,000 females Wyears of age 

and over. 

The remainder of the selected operations 

with one exception were performed almost exclusively for patients 15 years of age and over. 

Approximately 37 percent of the appendectomies 

were performed for patients under 15 years of 

age. Estimates and sex-specific rates of discharges following operations that are most prev-. 

alent among children are shown separately in 

rank order of frequency in table D. 

About 70 percent of the prostatectomies were 

performed for patients 65 years of age and over. 
-------------------------------- 

Table D. Number and 

stay hospitals with

rate of inpatients under 15 years of age discharged from short- selected surgical operations, by sex: United States, 1965 

(IExcludes newborn infants and Veterans Administration and military hospitals) 

Rate of 

Number of discharges discharges in thousands per 100,000 

Operation and ICDA-HDS codes population 

Both 

sexes 2 Male I Female Male Female 

Tonsillectomy with or without 

adenojdectomy----------------------27,1127.~ 

Reduction of fracture without internal 981 497 I 

484 1,634.4 1,649.2 

fixati.on __-_--_-------_-_-_________ 141 48 306.9 164.3 Appendectomy3 _-_-__-_-__-_____-_--------- 82-o-E~~ 141 :i 263.0 207.3 Repair of ing,uin.al hernia-----------40.0-4011 135 122 2 403.0 43.9 Operations on tympanum-------------------20.L 95 57 38 186.8 129.2 

,tSee reference 2. 

-Includes discharges for which sex of patient was not stated. 

3Pro\risional estimate; limited to estimated number of first-listed appendectomies to 

exclude majority that were performed incidental to other abdominal surgery. 

Table 12. Number and rate of inpatients 65 years of age and over discharged from shortstay hospitals with selected surgical operations, by sex: United States, 1965 

(Excludes Veterans Administration and military hospitals) 

-

Rate of 

Number of discharges discharges in thousands per 100,000 

Operation and ICDA-HDS codes1 population 

Both

sexes2 Male Female Male Female 

I I 

prostatectomy-----------------------66.1-66.3 131 1,;g.g . . . 

Extraction of lens ------------------17.3-17.5 92 . 593.0 

Reductiok of fracture with internal 

fixation 82.2 713.0 

Repair of inguinal hernia-----------40.0-40.1 ;; “8E 109.8 

Cholecystectomy ------------------_------- 53.5 74 29912 517.7 

JSee reference 2. 

YIncludes discharges for which sex of patient was not stated. 

5 
------------- 

One out of every five of the males in this age Surgical Operations by Specialty 

group who had an operation had a prostatectomp. and Body Site Extraction of lens was also largely restricted to 

the aged (92,000 out of 142,000 operations). The An estimated 14.7 million surgical operations 

rate of lens extractions per 100,000 females 65 and procedures were listed for the 11.0 million 

and over was 1.4 times the comparable rate for discharges with surgery. The estimate is based 

males (table E). on the processing of up to three S-digit codes for 

Table F. Number and percent distribution of all-listed operations for inpatients discharged from short-stay hospitals, by age and sex of patient, geographic region, and 

size of hospital: United States, 1965 

(Excludes nevl born infants and -Veterans Administration and military hospitals) 

Operations including Operations excluding obstetrical procedures obstetrical procedures 

Characteristic 

Number 

in 

thousands 

Percent 

Estribution 

Number 

in 

thousands 

Percent 

sis tribution 

Total1 ____-__- ____- _____-_--_ 14,679 100.0 13,866 100.0 

Under 15 years---------------------

15-44 years------------------------

45 -64 years ___ _____ - _____ ___ __- _ ___ 

65 years and over------------------

2,426 

63% 

1;823 

16.5 

44.9 

25.9 

12.4 

2,425 

5,776

3,802 

1,823 

17.5 

41.7 

27.4 

13.1 

Sex and age 

Male, all ages---------------------

Male, 15 years and over---------- Female, all ages- -_-_- ------_-----_ 

Female, 15 years and over--------

2326: 

81890 

7,872 

39.3 

29.4 

60.6 

53.6 

5,766

4,323

8,077 

7,060 

41.6 

31.2 

58.2 

50:9 

Geographic region 

Northeast--------------------------

North Central----------------------

South ------------------------------ West-------------------------------

3,702

4,171 

4,257 

2,550 

25.2 

28.4 

29.0 

17.4 

2% 

4:060 

2,413 

25.0 

28.3 

29.3 

17.4 

Size of hospital 

Less than 100 beds----------------- 2,809 19.1 2,656 19.2

100-199 be& ___________- ___________ 3,216 21.9 3,045 22.0 200-299 be&---- -_---- 3,127 21.3 21.2

300-499 beds----------------------- 3,533 24.1 ?% 24.2

500 be& or more------------------- 1,995 13.6 11861 13.4 

IIncludes operations for which the patient characteristic was not stated. 

6 
operations and treatments of the International 

Classification of Diseases, Adapted (1CDA)“per 

sample discharge. It includes biopsies, exploratory laparotomies, and certain other diagnostic 

procedu res coded separately, but it excludes routine ob,atetrical procedures, endoscopies, and 

certain other nonsurgical procedures. (See appendix I for further details on medical coding and 

presenta.tion of est:iates.) 

Estimates of the total number of operations 

performed, including and excluding obstetrical 

procedures, are distributed by selected patient 

characteristics, hospital size, and geographic 

region in table F. Estimates of the volume and 

rates of all-listed operations classified by special-ty and body site are presented in tables l-6. 

Patient Characteristics 

Over 60 percent of the operations reported 

for inpatients discharged from short-stay hospitals in 1965 were performed for females. In 

relation to the civilian, noninstitutional population, the rate of all-listed operations for females exceeded that for males by 45 percent. 

Much of this excess is accounted for by gynecological surgery, which comprised 30 percent of 

the volume of operations performed for females 

(2.7 out of 8.9 million operations). Other than 

gynecological surgery, the leading group for both 

males and females was gastrointestinal and abdominal surgery. :In addition to appendectomies 

for both sexes, repairs of hernia for males and 

operations on the Iiver and biliary tract (largely 

cholecystectomies) for females contributed significantly to the relatively high frequency of operations in this surgical specialty (tables 1 and 2). 

Patients 15 years of age and over accounted 

for 83 percent of ~thevolume of surgical operations and procedures performed for discharged 

patients. Their proportion of operations grouped 

by specialty ranged from 75 to 100 percent with 

one exception; it .was 37 percent for otorhinolaryngology. Since persons 15 years and over 

comprised only 68.5 percent of the civilinn, 

noninstitutional population used to compute the 

rates of operations shown in table 2, the age-specific rates are generally higher than the rates 

based on the total population. 

Geographic Region 

The West Region had the smallest share of 

the civilian, noninstitutional population in 1965 

(16.4 percent) and an even smaller proportion of 

the number of inpatients discharged from the 

Nation’s nonmilitary short-stay hospitals (table 

G). However, the rate of operations for discharged ‘patients per 100,000 population was 

slightly higher in the West Region. The South 

Region had the lowest overall rate of operations, 

both including and excluding obstetrical procedures (table 4). Differences between the regions 

in the rates of operations grouped by specialty 

were generally in the same direction as the overall rates. Lower rates for ophthalmology and 

otorhinolaryngolo,oy in the South Region and a 

relatively high rate of orthopedic surgery in the 

West Region were contributing factors. Within 

each surgical specialty the pattern of regional 

variation in the rates of operations by body site 

was less consistent in direction and much more 

pronounced. For example, the rate of operations 

on the teeth and gums in the Northeast Region 

was 5.4 times that in the West Region and over 

twice the rates in the other two regions. Additionally, the relatively high rate of operations 

on the fallopian tube in the South Region, twice 

that in the remainder of the Nation, is inconsistent with the pattern of regional variation in 

the rates of other gynecological surgery as well 

as the rates of all-listedoperations. 

Size of Hospital 

Estimates of the number and percent distribution of operations classified by specialty 

and body site are presented in tables 5 and 6 

according to size of hospital. One-half or more 

of the operations classified as neurosurgery, 

ophthalmology, thoracic surgery, and operations 

on the peripheral blood vessels and lymphatic 

system were reported by hospitals maintaining 

300 or more beds for inpatients. While hospitals 

in the largest bed size group (500 beds or more) 

reported less than 14 percent of the total volume 

of operations for patients discharged from the 

Nation’s nonmilitary short-stay hospitals in 1965, 

they accounted for 37 percent of all operations 

on the skull, brain, and cerebral meninges; 46 

7 
Table G. Percent distribution of the population, of inpatients discharged, of inpa­ tients discharged with surgery, and all-listed operations, by geographic region : 

United States, 1965 

All North - North Measure regions east Cential South West 

Percent distribution 

Civilian, noninstitutional population----- 100.0 24.7 28.1 30.9 16.4 

Hospital discharges (inyatient)l---------- 100.0 22.0 29.2 ;3s*; 15.6 

Discharges with surgery -_----------_----- 100.0 25.2 28.8 17.4

All listed operationsl-------------------- 100.0 25.2 28.4 29:o 17.4 

‘Excludes newborn infants. 

percent of the operations on the heart, peri- cent of the overall volume of operations -and 

cardium, and intrathoracic vessels; and 32 proportionately more of the operations on the 

percent of all operations on the pancreas, spleen, appendix (35 percent), the pharynx, tonsils, and 

and intra-abdominal blood vessels. The smaller adenoids (28 percent), and the skin and subhospitals (fewer than 100 beds) reported 19 per- cutaneous tissue (25 percent). 

REFERENCES 

1

National Center for Health ‘Statistics: Inpatient utiliza- % ational Center for Health ‘Statistics: Utilization of 

tion of short-stay hospitals by diagnosis, United States, short-stay hospitals summsryofnonmedical statistics, United 

1965. Vital and Health Stafistics. PHS Pub. No. 1000~Series States, 1965. Vimf and Health Statistics. PHS Pub. No. 

13-No. 6. Public Health Service. Washington. U.S. Govern- LOOO-Series B-No. 2. Public Health ‘Service. Washington. 

ment Printing Office, May 1970. U.S. Government Printing Office, ,Aug. 1967. 

2

National Center for Health Statistics: International clas- 5National Center for Health ‘Statistics: Utilization of 

si/ication CT/ Diseases,Adapted /or Indexing Hospital Records short-stay hospitals by characteristics of discharged paby Diseases and Operution. PHS Pub. No. 719 (Rev.). Public tient,s, United States, 1965. Vilal and Health Sfatistics. PHS

Health ‘Service. Washington. U.S. Government Printing Office, Pub. No. 1000~Series 13-No. 3. Public Health ‘Service.Wash- Dec. 1962. ington. U.S. Government Printing Office, Dec. 196’7. 

3National Center for Health ‘Statistics: Development and 

maintenmce of a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. NO. lOOO-Series 

&No. 3. Public Health Service. Washington. U.S. Government 

Printing Office, Feb. l965. 

000 

8 
DETAILED TABLES 

Page 

Table 1. Number of all-l'isted operations for inpatients discharged from short-sta hospitals, by specialty and body site, and by age and sex: United States, lj;65--- 10 

2. Rates Iof all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and by age and sex: United States, 1965---- 12 

3. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and geographic region: United States, 1965- 14 

4. Rates (of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and geographic region: United States, 1965- 16 

5. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and size of hospital: United States, 1965-- 18 

6. Percent distribution of all-listed operations for inpatients discharged from 

short-stayUnited hosvitals by size of hospitals, according to specialty and body site: States, 1965----------------------------------------------------- 20
Table 1. Number of all-listed operations for inpatients discharged from short-stay hospitals, by

specialty and body site, and by age and sex: United States, 1965 

(isclur’es newborn infants and Veterans Administration and military hospitals) 

All ages 

15 years Specialty and body site with ICDAI codes and over 

w 

Number of all-listed operations in thousands 

All operations--------------------------------------- 14.679 5,766 8,890 12,212 

Operations excluding obstetrical procedures------------ 13,866 5,766 8,077 11,401 

205 110 95 179 

Skull, brain, and cerebral meninges---------------------01-02 Spinal cord, nerve roots, and spinal meninges--------------03 E ;; I'; :;

Peripheral and sympathetic nerves or ganglia------------05-06 93 42 50 87 

422 203 218 

Orbit, eyeball, and ocular muscles----------------------lo-U 117 64 

Cornea, iris, ciliary body, sclera, choroid,

retina, and lacrimal apparatus---------------------14-16,18 Lens-------------------------------------------------------l7 1;: 2:: 

41 

85 

1,839 935 901 

Ear--------------------------------------------------------20 

Nose and accessory sinuses-----------------------------'----21 

Larynx and trachea-----------------------------------------22 

pharynx, tonsils, and adenoids-----------------------------27 

229 

256 

1,25: 

123 

144 

6:: 

105 

111 

6;; 

117 

235 

2;: 

Ora1 and buccal surgery-----------------------------24-26 472 187 284 420 

Teeth and gums ---------------------------------------------24 

Salivary glands, buccal cavity, tongue, and palate------25-26 

393 

79 

150 

37 

243 

41 

359 

61 

227 133 94 189 

Eyelids and conjuncti"a---------------------------------12-13 70 31 z; 

Bronchus pericardium, and intrathoracic vessels-----------30-32 43 44 

Chest wall, pleura, and mediastinum------------------------34 89 55 2 82 

Gastrointestinal and abdominal surgery-----------28,40-57 3,178 1,619 1,554 2,797 

Repair of hernia-------------------------------------------40 736 535 200 572 Abdominal wall and peritoneum---------------------------41-42 408 276 378 

Heart, and lung---------------------------------------33,35 z: 34 z; 

Esophagus, stomach and duodenum combined with stomach--28,44 240 :281 224 a-----,,,--------,-,,,,,,,,,,,-,,,,,,,,,-----------45 Appendix 200 1% 238 Intestines----------------------------------------------46-47 3:: 136 174 296 Rectum-----------------------------------------------------48 124 120

Anus -------------------------------------------------------4g Liver and biliary tract---------------------------------51,53 $2 

ii': $8; 

:i: 

Pancreas, spleen, and intra-abdominal blood vessels-----55-57 48 31 17 45 

See footnotes at end of table. 

10 
Table 1. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and by age and sex: United States, 1965-Con. 

(Excludes newborn infants and Veterans Administration and military hospitnls) 

Specialty and body site with ICDAl codes 

Number of all-listed operations in thousands 

Genitourinary :;urgery------------------------------- 60-69 1,107 823 283 912 

Kidney -----------------------------------------------------6O

Ureter-----------------------------------------------------62 2: z 1%

Urinary bladder --------------------------------------------63 179 171 Urethra---------------------------------------------------- 200 1:: 147 Prostate 

Testis, tunica vaginalis, spermatic cord and scrotu=---------------------------------------------------67 

Epididyrris and vas deferens--------------------------------

Penis------------------------------------------------------69 

143 

1:: 

... ... ... i20 

48 

Gynecological surgery-------------------------------70-75 2,719 2,719 2,703 

Ovary ----------------------------------------~-------------7o 

Fallopian tube---------------------------------------------71 

Uterus, cervix, and supporting structures---------------72-73 Vagina, vulva, and perineum-----------------------------74-75 

21: 

1,805 397 

. . . . . . . . . . . . 

375 

142

1,805 397 

370 

141 

1,;;; 

Obstetrical procedures--------------------------76.6-78.9 813 . . . 813 811 

Orthopedic surgery ----------------------------------80-87 1,768 965 798 1.485 

Bone---------------------------------------------------- 80-82 Joint st~cture~---------------------------------------- 83-84

Muscles, tendons, fascia and bursa----------------------85-86 

Amputation and disarticulation of extremities--------------87 

951 

42 

68 

514 

fG 

41 

435

201 

136 

26 

753

%E 

63 

Other general and specialized surgery-------------------- 1,928 793 1,132 1,729 

Thyroid, parathyroid, and other endocrine glands--------08-09 17 

and s&n& vesicles------------------------------ z: 210 ... 209 

Breast, male and female ------------------------------------38 23: 3% 

Peripheral blood vessels and lymphatic system--------------88 1;: 281 Skin ant, subcutaneous tissue-------------------------------89 1,145 641 969 

'See reference 2. 

* SIncludes

BProvi.sionaldischarge data for which sex of patient was not stated.estimate; limited to estimated number of first-listed appendectomies to exclude 

majoritq' that were performed incidental to other abdominal surgery. 

11 
Table 2. Rates of all-listed operations for inpatients discharged from short-stay hospitals, by

specialty and body site, and by age and sex: United States, 1965 

(Excludes newborn infants “d Veterans Administration and military hospitals) 

Specialty and body site with ICDA’ codes 

Lte of all-listed operations

100,000 population per 

All operations _-_-____-_-_---__---------------------- 7,735 6,269 9,090 9,391 

Operations excluding obstetrical procedures------------ 7,306 6,269 8,259 8,767 

Neurosurgery ----------------------------------------01-06 108 119 97 138 

Skull, brain, and cerebral meninges---------------------01-02 Spinal cord, nerve roots? and spinal meninges--------------03 Peripheral and sympathetrc nerves or ganglia------------05-06 

43 24 E 21 

49 2:: 52 

:z 

67 

Ophthalmology ---------------------------------------lo-l8 223 220 223 242 

Orbit, eyeball, and ocular muscles ----------------------lo-l1 

Eyelids and conjunctiva ---------------------------------12-13 ;: 3: 2: 

Appendix3 

Cornea, iris, ciliary body, sclera, choroid, retina, and 

lacrimal apparatus ----------------------------------14-16,18

Lens-------------------------------------------------------l7 45 

79 

47 

69 t: 

Otorhinolaryngology ------------------------------20-22,27 969 1.016 921 517 

Ear--------------------------------------------------------20 

Nose and accessory sinuses ---------------------------------2l 

Larynx and trachea -----------------------------------------22 

Pharynx, tonsils and adenoids ------------------------------27 

121 

‘2 

672 

134 108 

114 ‘:i 

671 6:: 

1:: 

56 

191 

Oral and buccal,surgery -----------------------------24-26 249 204 291 323 

Teeth and gums ---------------------------------------------24 

Salivary glands, buccal cavity, tongue, and palate------25-26 

207 

42 

163 249 

40 42 

276 

47 

Thoracic surgery ------------------------------------30-35 120 145 96 145 

Bronchus 

Heart, pericardium, and intrathoracic vessels-----------30-32 and lung---------------------------------------33,35 

Chest wall, pleura, and mediastinum------------------------34 

46 

:: 

47 45

6’;: 41 

44 

37 

63 

Gastrointestinal and abdominal surgery-----------28,40-57 1,674 1,760 1,589 2,151 

Repair of hernia -------------------------------------------4o 

Abdominal wall and peritoneum ---------------------------41-42 

Esophagus, stomach and duodenum combined with stomach---28,44 

388 

215 

127 

582 205 

283

:i: 94 

440 

291 

172 ---------------------------------;----------------45 200 218 182 183 Intestines----------------------------------------------46-47 163 148 178 228

Rectum -------------------------------------------------------48 66

Anus -------------------------------------------------------4g 235 2% 2:: 3:; Liver and biliary tract ---------------------------------51-53 256 149 356 371

Pancreas, spleen, and intra-abdominal blood vessels-----55-57 25 34 17 35 

See footnotes at end of table. 

12 
Table 2.. Bates of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and by age and sex: United States, 1965-Con. 

(Excludes newborn infants and Veterans Administration and military hospitals) 

All ages 

Specia.lty and body site with ICDA' codes 15 years 

Both and over 

sexes B II 

Male 

I 

Female 

Late of all-listed operations per 100,000 population 

Genitourinary surgery -__-_--_-__-_-_---_------------- 60-69 584 895 289 701 

-------, 37 36 49 

Ureter,.---------.,------------------------------------------- 62 2: 

Ur-napr bladder---------------------------------------------63 Gi 1:; ;I; Urethra -----------------------------------------------------64 105 1;;

Prostaze and seminal vesicles -------------------------------66 111 29; . . . 161

Testis, tunica vaginalis, spermatic cord and scrotum--------67 155 . . . Epidid:rmis and vas deferens ---------------------------------68 zz 88 . . . 232 penis-.---------.,--------------------------------------------69 54 112 . . . 37 

Gynecological surgery --------------------------------70-75 1.433 . . . 2,078 

Ovary -------------------------------------------------------7o 198 . . . 285 

Uterus, cervix, and supporting structures----------------72-73 

Vagina, vulva, and perineum ------------------------------74-75 2; . . . . . . 1,;;; 

Obstetrical procedures -_---------_-_---__-------- 76.6-78.9 428 . . . 831 624 

Orthopedic surgery -------_------_-------------------- 80-87 932 1,048 816 1,142 

Bone------------,.-----------------------------------------80-82

Joint structures,.----------------------------------------83-84

Muscles tendons fascia and bursa -----------------------85-86 

Amputation and dksarticulation of extremities---------------87 

501 

253 

141 

36 

559 

301 

143 

45 

444 

206 

139 

27 

579 

338 

176 

48 

Other general and specialized surgery--------------------- 1,016 862 1,329 

Thyroid, parathyroid, and other endocrine glands---------08-09 Breast, male and female-------------------------------------38 2;; ;zJ 

Fallopian tube ----------------------------------------------7l . . . 109 

Peripheral blood vessels and lymphatic system---------------88 155 Skin and subcuta]~eous tissue---------------------------------89 603 745 

*See reference 2. 

DIncludes

3Provisional discharge data for which sex of patient was not stated.

estimate; limited to estimated number of first-listed appendectomies to exclude 

majority that were performed incidental to other abdominal surgery. 

13 
Table 3. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and geographic region: United States, 1965 

(Excludes newborn infants and Veterans Administration and military hospitals) 

-

Geographic region 

Specialty and body site with ICDAl codes I I I 

1Northeast1 CE$:tlI South 1 West 

I I I 

1Number of all-listed operations

in thousands 

: 3,702 4,171 4,257 2,550 

Operations excluding obstetrical procedures------------- 3,464 3,930 4,060 2,413 

Neurosurgery-----------------------------------------01-06 43 53 62 47 

SkulL, brain, and cerebralmeninges----------------------01-02 Spinal cord, nerve roots, and spinal meninges---------------03 Peripheral and sympathetic nerves or ganglia-------------05-06 

89 145 105 83 

Orbit, eyeball, and ocular muscles -----------------------lo-l1 

Eyelids and conjunctiva----------------------------------l2-13 

26 

16 

24 

it 24 

24 

10 

Cornea, iris, ciliary body, sclera, choroid,

retina, and lacrimal apparatus------------------------14-16,18 Lens--------------------------------------------------------l7 5:: :z iz 

Otorhinolaryngology-------------------------------20-22,27 445 593 478 324 

Ear---------------------------------------------------------20 

Nose and accessory sinuses----------------------------------21 

Larynx and trachea------------------------------------------22 

pharynx, tonsils and adenoids------------------------------27 

46 

64 

3;: 

FE zi 

20 

39290 346 

2:

2:: Ora1 and buccal surgery------------------------------24-26 201 121 116 

Teeth and gums----------------------------------------------24 180 99 

Salivary glands, buccal cavity, tongue, and palate-------25-26 22 22 '2; 

moracic surgery-------------------------------------30-35 43 62 63 60 

Bronchus 

Heart, pericardium, and intrathoracic vessels------------30-32

and lung---------------~------------------------33,35 

Chest wall, pleura, and mediastinum-------------------------34 

14 

:i 

f i 5; 20 

33 

1: 

Gastrointestinal and abdominal surgery------------28,40-57 808 897 929 545 

Repair of hernia--------------------------------------------40 199 201 208 129 Abdominal wall. and peritoneum----------------------------41-42 91 100 156 60 

Esophagus, stomach and duodenum combined with stomach---28,44

Appendix" ---------------------------------------------------45

Intestines -----------------------------------------------46-47 2 1% 1:: 

Rectum------------------------------------------------------48 

Anus--------------------------------------------------------49 3; E 2 

122

Liver and biliary tract -----*----------------------------51-53 149 EZ

Pancreas, spleen, and ititra-abdominal blood vessels------55-57 

::;

16 13 12 

See footnotes at end of table. 

14 
---------- --- ----- ------- ----- 

----- 

Table 3. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and geographic region: United States, 1965-Con. 

. (Excludes newkxxn infants and Veterans Administration and miiitaly 

-

I

hospitals) 

Geographic region 

Specialty and body site with ICDAl codes I I I 

Northeast1 C~~~~l 1 South 1 West 

Number of all-listed operations

in thousands­

&nitourinary surgery-------- ____________ ------------60-69 275 307 333 192 

Kidney------------------------------------------------------60 17 Ureter-----------~------------------------------------------62 32 2 2 1’1 Urinary bladder---.------------------------------------------63 45 40 57 38 Urethra-----------------------------------------------------64 

Prostate and seminal vesicles 46 z95 z2 2 2;

Testis, tunica vag:Lnalis, spermatic cord and scrotum-------67 41 40 22 Epididymis and vas deferens---- _____________________________ 68 22 19 23 

Penis -------------.------------------------------------------ 69 24 28 38 :: 

Gynecological :surgery------------_-------------------70-75 680 760 839 440 

&ary---------- ---.-------------____------------------------- 70 

Fallopial tube----.------------------------------------------71 

Uterus, cervix, and supporting structures----------------72-73 Vagina, .mlva, and perineum------------------------------74-75 

94 

4;:

88 

106 

5% 

116 

119 

5631 

120 

56 

28265 

72 

Obstetrical pr()cedmes- - __-______----__ -----j’6.6 -78.9 239 241 197 136 

Orth>pedic surgery---------- ________________ _______ --80-87 414 479 503 373 

Joint structures _ _.~__~~_~~_~_~_~~___ __ -_ __ ________ ___ __ -8-j -84 104 129 131 

Muscles, tendons, :Eascia and bursa----------------------85-86 

Amputation and disarticulation of extremities---------------87 

65 

16 I: :: 

Other general and specialized surgery--------------------- 466 513 633 

Thyroid, parathyroid, and other endocrine glands---------08-09 , nale and female-------------------------------------38 1;: 

Bone-----------------------------------------------------80-82 229 251 279 

Breast 

Peripheral blood vessels and lymphatic system---------------88 Skin and subcutme()us tissue--- ________________________ -_-_- 89 69 

272 

'See reference 2. 

aProvisional estimate; limited to estimated number of first-listed 

majority that were performed incidental to other abdominal surgery. 

appendectomies to exclude 

15 
Table 4. Rates of all-listed operations for inpatients discharged from short-stay hospitals, by specialty and body site, and geographic region: United States, 1965 

(Excludes nev:horn infants and Veterans Administration and military hospitals) 

Geographic region 

Specialty and body site with ICDA1 codes I I I 

lortheast 1 ,",$$& 1 South 1 West 

Rate of all-listed operations 

per 100,000 population 

All operations -__-__---_-__-_-------------------------- 7,909 7,824 7,264 8,206 

Excluding obstetrical procedures------------------------- 7,399 7,372 i,928 7,767 

Neurosurgery ------------------------------------------01-06 91 100 106 153 

Skull, brain, and cerebral meninges-----------------------01-02 Spinal cord, nerve roots, and spinal meninges----------------03 Peripheral and sympathetic nerves or ganglia--------------05-06 

f F s: ;:

44 45 44 

46 

32 

74 

Ophthalmology -----------------------------------------lo-l8 191 272 179 267 

Orbit, eyeball, and ocular muscles------------------------lo-l1 

Eyelids and conjunctiva _____-___-_-_-_-_-__--------------- 12-13 35: 

Cornea, iris, ciliary body, sclera, choroid, retina, and 

lacrimal apparatus --__--r___-_---__-_-_______L________ 14-16,18 Lens---------------------------------------------------------l7 33 

69 

Otorhinolaryngology --------------------------------20-22,27 1,113 1,041 

Ear----------------------------------------------------------20 

Nose and accessory sinuses --___-_---_-_-_-_---_______________ 

Larynx and trachea -__----__-_-------------------------------- i: 

Pharynx, tonsils and adenoids--------------------------------27 

165 

162 

54 

732 

145 

142 

6;; 

Oral and buccal surgery ____--____--_--_----___________ 24-26 430 227 198 110 

Teeth and gums -----------------------------------------------24 

Salivary glands, buccal cavity, tongue, and palate--------25-26 

384 186 

47 41 

159 

39 

Thoracic surgery __--__---___-__I_-____________I___c___ 30-35 91 117 107 192 

Heart, pericardium, and intrathoracic vessels-------------30-32 

Bronchus and lung -----------------------------------------33,35 

Chest wall, pleura, and mediastinum __-_-_--_---__--_---______ 34 

106 

5; 

Gastrointestinal and abdominal surgery-------------28,40-57 1.725 1.682 L,585 1.754 

Repair of hernia _____-______"__--_---------------------------

Abdominal wall and peritoneum -__-_--__-----_-_--_---------

stomach and duodenum combined with stomach-----28,44

41-t; 

377 ‘;29; 187 354 

267 

415 

194 

Esophagus, 120 120 111 178

Appendix2 ----------------------------------------------------45 180 210 209 198 Intestines------------------------------------------------46-47 164 175 134 197 Rectum-------------------------------------------------------48 

Anus---------------------------------------------------------49 2:: 2:; 2:; 2% 

Liver and biliary tract -----------------------------------51-53 285 279 226 228 

Pancreas, spleen, and intra-abdominal blood vessels-------55-57 34 25 20 * 

See footnotes at end of table. 

16 
'Table 4. Bates of all-listed operations for inpatients discharged from short-stay specialty and body site, and geographic region: United States, 1965-Con.hospitals, by 

(Excludes newborn infants and Veterans Administration and military hospitals) 

Geographic region 

Specialty and body site with ICDA' codes I I I 

iortheast 1 $l~~~~l ISouth 1 West 

I I I 

Bate of all-listed operations 

per 100,000 population 

Genitourinary surgery -_-_-_--_---*----------------- ---60-69 588 576 568 619 

Kidney --..------_--_----------------------"------------------- 60 43 24 

64 22

Urinary bladder -____--------_-_------------------------------ 74 897 122

Urethra -_---____--_--_-___----------------------------------- 117 126

Prostate and seminal vesicles _--_----_-----_----------------- ii2 114 ii: _ 1::

Testis, tunica vaginalis, spenimtic cord and scrotum---------67 

Epididymz.s and vas deferens ---_-_--_-_--------_--"----------- 3; 40 2 Penis---..---------------------------------------------------- Et 53 65 40 

Gynecological s.urgery ---------------------------------70-75 1,426 1,431 1,417 

Uterus, cervix, and supporting structures-----------------72-73 

Vagina, vulva, and perineum -----_-------_----------------- 74-75 

1,OZ

189 

949 

218 

909 

205 

9;: 

233 

Obstetrical procedures ----------------------------76.6-78.9 510 452 336 439 

Orthopedic surgery ----_---__-------------------------- 80-87 883 898 858 1,201 

Bone----.---------~--------------------------------------- 619 -

Muscles, tendons, jiascia and bursa------------------------85-8~ 

Amputation and disarticulation of extremities----------------87 

139 

33 

144 

40 

131 

29 l:: 

Ovary -__..-___--__-o----------------------- ------------------------7l 

‘E 114 

-------------------7o 200 203 182 Fallopiarl tube----.,------------------

Joint st:ructures--~--------------------------------------- 8Z2 

“;E 4:: i:z 377 

Other general and specialized surgery---------------------- 997 963 1,081 1,013 

Thyroid, parathyroid, and other endocrine glands----------08-05 42 46 57

Breast, male and female _----------___------------------------ 3s 227 207 192 2;; Peripheral blood vessels and lymphatic system----------------88 146 164 145 171 Skin and subcutaneous tissue---------------------------------89 581 545 688 577 

'See reference 2,, 2Provisional estimate; limited to estimated number of first-listed appendectomies to exclude

majority that were performed incidental to other abdominal surgery. 

17 
Table 5. Number of all-listed operations for inpatients discharged from short-stay hospitals, by specialty

and body site, and size of hospital: United States, 1965 

(Excludesnewborninfants and VeteransAdministrationand military hospitals) 

Size of hospital 

Specialty ayd body site with ICDA' codes 

All Less than loo-199 200-299 300-499 500 beds 

sizes 100 beds beds beds beds or more 

Number of all-listed operations in thousands 

All operations----------------------------- 14,679 2,809 3,216 3,127 3,533 1.995 

Operations excluding obstetrical procedures-- 13,866 2,656 3,045 2,944 3,360 1,861 

Neurosurgery ------------------------------01-06 205 22 26 42 62 53 

Skull, brain, and cerebralmeninges-----------01-02 * * 

Spinal cord, nerve roots? and spinal meninges----03 zi 

Peripheral and sympathetic nerves or ganglia--05-06 93 1; 1;: 

Ophthalmology -------"---------------------lo-l8 422 26 80 

Orbit, eyeball1 and ocular muscles------------lo-l1 117 * 

Eyelids and conjunctiva -----------------------12-13 70 * I2

Cornea, iris, ciliary body, sclera, choroid,

retina, and lacrimal apparatus------------14-16,18 * 

Lens----------------------------------,,---------l7 lE50 72 if 

Otorhinolaryngology --------------------20-2i,2i 1,839 395 421 178 

Ear---------------------------------,--,---------20 229 12 

Larynx and trachea-------------------------------22 

Pharynx, tonsils and adenoids--------------------27 ,,2:: 35: 3:; 

:;

261 

100 

2292 

?2 

80 

Oral and buccal surgery-------------------24-26 472 66 113 123 110 59 

Teeth and gums-----------------------------------24

Salivary glands, buccal cavity, tongue, and palate---------------------------------------25-26 

393 

79 

54 

12 

99 

14 

106 

17 

88 

22 

46 

14 

Thoracic surgery --------------------------30-35 227 12 22 57 61 76 

Heart, pericardium, and intrathoracic vessels-30-32 

Bronchus and lung -----------------------------33,35 

Chest wall, pleura, and mediastinum--------------34 ;I

89 

4 

1.f E 

20 

Gastrointestinal and abdominal surgery-28,40-57 3,178 695 740 648 

Repair of hernia ---------------------------------4O 

Abdominal wall and peritoneum-----------------41-42

Esophagus, stomach and duodenum combined with 

736 

408 

153 

100 

192 

82 

139 

85 

Nose and accessory sinuses -----------------------21 256 23 E 

65 76 40 

stsmach-----------------------------------,-,28,44 240 

Appendix2 ----------------------------------------45 3.80 1% ;:: Intestines----------------------------,,------46-47 310 47 Rectum------------,--------------------,---------48 124 262 Anus-------------------------------,,,,----------49 446 923 100 

Liver and bi.liary tract -----------------------51-53 486 104 114 

Pancreas, spleen, and intra-abdominal blood

vessels--------------------------------------55-57 48 * .k 

See footnotes at end of table. 

18 
Table 5. Number of alLlisted operations for inpatients discharged from short-stay hospitals, by specialty and body site, and size of hospital: United States, 1965-Con. 

(Escludes na~lmm infants Md Voter3ns \dministmtion and mil'itnry hospitals) 

Size of hospital 

Specialty and body site with ICDA' codes 

All ;;;sbke loo-199 

,izes beds 

200-299 

beds 

300-499 500 beds 

beds or more 

Number of all-listed,o: rations n thousands 

Genitourinary surge!ry---------------------60-69 1,107 233 257 293 I 171 

Kidney----------------..--------------------------60 

Ureter----------------..---------;------------------62 127: Urinary bladder-------~--------------------------63 179 Urethra---------------~--------------------------64 200 

Prostate and seminal vesicles -------------and----66 210 

scrotum--------------~--------------------------67 

Epididymis and vas defc!rens----------------------68 

Penis---------------------------------------------69 

143 

1% 

Gynecological surgery---------------------70-75 2,719 575 617 

Ovary -----------------~--------------------------7o Fallopian tube--------~--------------------------71 

24725 3972 75 73 85 

2560 

Uterus, cervix, and supporting structures-----72-73 

Vagina, vulva, and perj:neum-------------------74-75 1,;;; 3i97 

4;;

98 

3% 

76 

4% 

94 

204 

60 

Obstetrical procedures----------------76.6-78.9 

Orthopedic surgery~.-----------------------gO-g7 

r-l813(1 183 

372 

Bone------------------,------------------------80-82 205 Joint structures------,------------------------83-84 89 

Muscles tendons fasoia and bursa------------85-86 

Amputatron and d&sarticulation of extremities----87 f'; 

Other general and specialized surgery---------- 1,928 I/ 412 1 413 388 468 246 

Testis, tunica vaginalis, spermatic cord 

Thyroid, parathyroid, and other endocrine

glands---------------------------------------O8-09 20 21 

Breast, male and femal e--------------------------38 3;: 1% 2; 

Peripheral blood vessels and lymphatic system----88 294 z; E 51 

Skin and subcutaneous tissue---------------------89 1,145 259 217 -I- 251: 133 

'See reference 2 

SProvisional estimate; limited to estimated number of first-listed appendectomies to exclude majority that were performed incidental to other abdominal surgery. 

19 
Table 6. Percent distribution of all-listed operations for inpatients discharged from short-stay hospitals by size of hospital, according to specialty and body site: United States, 1965 

(Excludesnewborninfants and Veterans Administrationand military hospitals) 

Size of hospital 

Specialty and body site with ICDA' codes 

All Less than loo-199 200-299 300-499 500 beds 

sizes 100 beds beds beds beds or more 

Percent distributitiil 

All operations-----------------------------. 100.0 19.1 21.9 21.3 24.1) 13.6 

Operations excluding obstetrical procedures-- 100.0 19.2 22.0 21.2 24.2 13:4 

Neurosurgery------------------------------~-O6 100.0 10.6 12.8 20.5 30.4 25.7 

Skull, brain, and cerebralmeninges-----------01-02 100.0 * * 28.6 37.; Spinal cord, nerve roots and spinal meninges----03 100.0 * 

Peripheral and sympathetic nerves or ganglia--05-06 100.0 16.; 15.3 2:. 21.8 

Ophthalmology-----------------------------lO-lg 100.0 6.1 18.9 26.0 

Orbit, eyeball, and ocular muscles------------l&11 100.0 * 19.7 28.0

Eyelids and conjunctiva-----------------------l2-13 100.0 * 20.5 27.0 

Cornea, iris, ciliary body, sclera, choroid,

retina, and lacrimal apparatus------------14-16,18 100.0 4 13.8 26.8 22.6

Lens---------------------------------------------l7 100.0 -a 20.4 23.5 29.9 2:. 

Otorhinolaryngology-------------Y------20-22,27 100.0 21.5 22.9 21.6 

Ear----------------------------------------------20 100.0 15.3 

Nose and accessory sinuses-----------------------21 100.0 17.6 Ii-2

Larynx and trachea-------------------------------22 100.0 

2:

‘* 14.3 2414 

Pharynx, tonsils and adenoids--------------------27 100.0 27.9 25.9 20.5 

Oral and buccal surgery-------------------24-26 100.0 14.0 23.9 26.1 23.4 12.5 

Teeth and gums-----------------------------------24 100.0 13.8 25.1 27.1 22.4 11.6 

Salivary glands, buccal cavity, tongue, and 

palate---------------------------------------25-26 100.0 15.3 17.9 21.5 28.1 17.2 

Thoracic surgery--------------------------30-35 100.0 5.3 9.5 25.1 26.6 33.5 

Heart,

Bronchus pericardium, and intrathoracic vessels-30-32 100.0 * 25.5 25.4 45.9 and lung-----------------------------33,35 100.0 28.8 30.5 26.5 

Chest w&l, pleura, and mediastinum--------------34 100.0 11.: 14.; 22.5 25.7 25.3 

Gastrointestinal and abdominal surgery-28,40-57 100.0 21.9 23.3 20.4 -I- 22.2 12.3 

Repair of hernia---------------------------------40 100.0 20.8 26.1 20.5 21.7 10.8 

Abdominal wall and peritoneum--------------m--41-42 100.0 24.5 20.1 19.9 20.9 14.6 

Esophagus, stomach and duodenum combined with

stomach--------------------------------------28,44 100.0 14.8 22.6 26.4 15.1 

Appendix2 ---------------------------------------45 100.0 34.9 22ki 16.3 15.9 

Intestines------------------------------------46-47 100.0 15.1 23:l 19.7 24.7 154 Rectum--------;----------------------------------48 100.0 17.5 20.9 25.1 1219 Anus---------------------------------------------49 100.0 22.1 22.5 E 25.2 8.4 Liver and biliary tract-----------------------51-53 100.0 21.5 23.4 2014 21.8 12.9 

Pancreas, spleen, and intra-abdominal blood 

vessels--------------------------------------55-57 100.0 * 1 26.0 20.61 32.2

See footnotes at end of table. 

20 
Table 6. Percent distribution of all-listed operations for inpatients discharged by size of hospital, according to specialty and body site: United States, 1965-Con.

from short-stay hospitals 

(Excludes newborn infants and Veterans 

-

Administration and military hospitals) 

Size of hospital 

Specialty and body site with ICDA' codes 

All Less than loo-199 200-299 300-499 500 beds 

S ises 100 beds beds beds beds or more 

Epididymis and vas deferens----------------------;; Penis---------------~---------------------------- I-100.0 z-i . 27.3 16.9 20.7 15.3 

Gynecological surgery ---------*-----------70-75 100.0 21.1 22.7 I 20.2 23.5 I 12.5 

Ovary---------------,. -m---m -m---m m m--em m-w---.,---

Fallopian tube------~-------------

Uterus, cervix, and rwpporting structures-----72-73 

Vagina, vulva, and perineum-------------------74-75 

100.0 24.6 

100.0 25.8

100.0 20.9 

100.0 17.3 

19.9 

22.7 

22.8 

24.8 

19.5 

11.3 

21.2 

19.1 

2: 

23:8 

23.7 

13.2 

18.1 

11.3 

15.0 

Obstetrical procedures----------------76.6-78.9 100.0 18.8 21.2 16.5 

Orthopedic surgery------------------------go-87 100.0 16.9 25.9 14.6 

Bone----------------------------- ------------80-82 Joint st~ctures---------I-------------------- 83-84 

Muscles, tendons, fascia and bursa------------85-86 

Amputation and disarticulation of extremities----87 

19.3

%x 12.4

1oo:o 16.5

100.0 17.4 

:3-z 

25:8 

21.3 

13.7

15.9 

15.0 

17.5 

Other general and specialized surgery---------- 100.0 21.4 21.4 1 20.1 24.3 12.8 

Thyroid, parathyroicl, and other endocrine 

glands------------..- ----I--------------------og-og 100.0 13.6 27.1 16.1 

1 Percent distribution 

Genitourinary surgery---------------------60-69 100.0 13.8 21.1 23.2 26.4 I 15.4 

Kidney -------------------------------------------6O 100.0 19.0 17.8 37.2 17.0 Ureter--------------~----------------------------62 9.x 22.2 26.9 28.8 12.9 

Urinary bladder----------------------------------63 %E 22.7 28.0 Urethra-------------~----------------------------64 

Prostate and seminal vesicles--------------------66 

100: 0 E % 22.7 

27.7 

26.7 2; Testis, tunica vaginalis, spermatic cord and 

100.0 9:5 1818 26.8 -r 17:3 

scrotum------------~-------------------~--------67 100.0 17.0 26.9 22.1 19.9 14.1 

100.0 19.1 26.1 24.9 12.8 

Breast, male and fenlale-------------T-------------38 19.1 27.7 11.9 

Peripheral blood vessels and lymphatic system----88 %E 11.4 30.4 17.3 

Skin and subcutaneous tissue---------------------89 100: 0 25.4 21.3 11.7 

iSee reference 2. _._ _ _ . . zProvisional estimate; limited to estimatea number of first-listed appendectomies to exclude majority that 

were performed incidental to other abdominal surgery. 

21 
APPENDIX I 

TECHNICAL NOTES ON METHODS 

Statistical Design of the Hospital 

Discharge Survey 

Scope of the survey.-The scope of the Hospital 

Discharge Survey (HDS) encompasses patients other 

than well newborn infants discharged from noninstitutional hospitals which have six beds or more for inpatient use, which are located in the 50 States and the 

District of Columbia, and in which the average length 

of stay for all patients is less than 30 days. 

Table I. Distribution of short-stay hospitals size of hospital and geographic 

Size of hospital 

All sizes 

Universe------------------------------------------------

Sample--------------------------------------------------

6-49 beds 

Universe------------------------------------------------

Sample--------------------------------------------------

SO-99 beds 

Universe------------------------------------------------

Sample--------------------------------------------------

100 -199 beds 

Universe------------------------------------------------

Sample--------------------------------------------------

200-299 beds 

Universe------------------------------------------------

Sample--------------------------------------------------

300-499 beds 

Universe------------------------------------------------

Sample----_----_----------------------------------------

500-999 beds 

Universe------------------------------------------------

Sample------------------------------------------------;­

1,000 beds or more 

Universe------------------------------------------------

Sample--------------------_________________I__----.-----

22 

in 

Sampling frame and size of sample.-The sampling frame for hospitals in the HDS is the Master 

Facility Inventory of Hospitals and Institutions (MFI). 

A detailed description of how the MFI was developed, 

its content, plans for maintaining it, and procedures 

for assessing the completeness of its coverage has 

been published in an earlier report.3 

The universe for the HDS consisted of 6,965 shortstay hospitals, excluding military and Veterans Administration hospitals, contained in the MFI in 1963. The 

the universe (MFI) and in the NDS sample by region: United States, 1965 

Number of hospitals 

6,965 1,107 1,979 2,620 1,259 315 85 93 91 46 

3,113 199 1,438 646 

39 5 15 8 

1,623 288 587 306

44 8 16 8 

1,144 378 157

63 20 8 

182 134 85

19 12 8 

110 129 51

16 19 8 

129 46 28 13

37 4% 12 8 5 

% 3 i 
distributions of short-stay hospitals by size and region 

in the MFI and the HDS sample for 1965 are shown in 

table I. 

The sample of hospitals for 1965 as originally 

drawn consisted of 315 hospitals. Of these hospitals, 

eight refused to participate; five did not submit any 

abstracts during the year; and six were out of scope 

either because the hospital had gone out of business or 

because it failed to meet the definition of a short-stay 

hospital. (See appendix II for the definition of shortstay hospital used in the HDS.) Thus 296 in-scope hospitals participated in the survey during 1965. 

Sample desQn.-All hospitals of 1,000 beds or 

more in the universe (excluding Veterans Administration and military hospitals) were selectedwithcertainty 

in the sample. All hospitals of fewer than 1,000 beds 

were stratified with the primary strata being the 24 

size-by-region classes as shown in table I. Withineach 

of these 24 primary strata, the allocation of the hospitals was made through a controlled selection technique so that hospitals in the sample would be properly 

distributed with regard to ownership and geographic 

division. Sample hospitals were drawn with probabilities ranging from certainty for the largest hospitals 

to 1 in 40 for the smallest hospitals. 

The within-hospital, sampling ratio for selecting 

discharges varied inversely with the probability of 

selection of the hospital. The smallest sampling fraction 

of discharged patients was taken in the largest hospitals, 

and the largest fraction was taken in the smallest hospitals. This was done to compensate for the fact that 

hospitals were selected with probabilities proportionate 

to size class and to make sure that the overall probability of selecting a discharge would be approximately 

the same in all hospitals. 

In nearly all hospitals the daily listing sheet of 

discharges was tb.e frame from which the subsamples 

of discharges were selected within the sample hospitals. 

Well newborn infants are out of scope of the survey. 

The sample discharges were selected by random techniques, usually on the basis of the terminal digit(s) of 

the patient’s medical record number-a number assigned when the patient was admitted to the hospital. 

If the hospital’s daily Idischarge listing did not show 

me medical record numbers, the sample was selected 

by starting with a randomly selected discharge and 

taking every kth discharge thereafter. 

Data Collection and Processing 

Data coZZection.- During 1965, survey hospitals 

used an optical mark page reader form (abstract form) 

to transcribe data from the hospital records. This form, 

shown in figures I and II, has two sides. The front (fig.1) 

provides for demographic data, admission dates, and 

discharge dates. The reverse side (fig. II) provides for 

information on discharge diagnoses and surgical operations or procedures. All discharge diagnoses andoperations were transcribed onto the abstract form in the 

order in which they were listed on the face sheet of the 

hospital medical record. Depending on the procedure agreed upon with the hospital administrator, the 

sample selection and the transcription of information 

from the hospital records to the abstract form were 

performed either by the hospital staff or by representatives of the National Center for Health Statistics 

(NCHS) or by both. In more than three-fourths of the 

hospitals that participated in the HDS during 1965, this 

work was performed by the staff ofthe hospital medical 

records department. In nearly all of theremaininghospitals, the work was performed by U.S. Bureau of the 

Census personnel acting for NCHS. 

Shipments of completed abstract forms for each 

sample hospital were transmitted, along with sample 

selection control sheets, to NCHS for processing. For 

data year 1965, approximately 100,400 abstracts were 

received from the 296 hospitals that participated in the 

survey during part or all of the year. Conversion to 

computer tape by an optical mark page reader, edit, 

and estimation procedures were accomplished for nonmedical information (from front of sample patients 

abstracts) independently and prior to the coding and 

computer processing of medical data. 

Medical coding and edit.-The medical information 

recorded on the. reverse side of the sample patient 

abstracts (for data year 1965) was coded centrally by 

NCHS staff. A maximum of five diagnostic codes and 

three codes for surgical operations were assigned per 

sample abstract. Following conversion to computer 

tape and collation with nonmedical sample data, final 

“medical” edit was accomplished by computer inspection runs and a review of rejected abstracts. If sex 

and/or age of patient was incompatible with the recorded 

medical information, priority was given to the latter in 

the editing decision. 

The basic system used for coding the medical 

terminology on HDS sample patient abstracts is the 

detailed 3- and 4-digit codes of the ICDA” exclusive of 

the following sections: 

Supplementary Classification of External Cause 

of Injury (E802-E998) 

Classification of Causes of Stillbirth (Y30-Y39) 

part of Classification of Liveborn Infants ACcording to Type of Birth (Y20, Y22-23, Y26-27). 

23 
CONFIDENTIAL-All information which would permit identification of an individual or an establishment will be held confidential, will be used ml 

by persons engaged in and for We purposes of tbe survey and will not be disclosed or released to 

purpose (22 FR 1687). 

ABSTRACT OF PATlEM RECORD-Hospital Discharge Survey 

2. HDS NUMBER 

3. MEDICAL RECORD NUMBER 

4.a. DATE OF BIRTH 

Complete 4b and 4c if 

date of birth is not given. 

4.b. AGE 

4.~. AGE IS STATED IN 

5. SEX 

6. RACE OR COLOR 

7. MARITAL STATUS 

a. DATE OF ADMISSION 

9. DATE OF DISCHARGE 

10. DISCHARGE STATUS 

Figure I. Nonmedical section of optical mark page reader form. 

24 
_.___ 

.._.. 

._.__ -__ --- 

11. FINAL. DIAGNOSES: 

12.3. WAS AN OPERATION 

PERFORMED 7 

12b. OFERATIONS: 

____. _. . ._ z:::: ::::: _____ -___ _____ 

:A: ::A:: & ,,f-, ..?.. III ._... 

::::: ::::: :::I: ::::: I::;: 

. ..-- --___ __... .._.. ::I:: _.._- -.-- ___.. . . . . . 

::::: I:::: :::I: _l_l . ..-. . ..-. 

::::: ::::: ::::: :::I: ::::: L2) ::::: ::::: ::z: ::;:: ;:; 

::& ::t,: ..L.

_.._. 111:: :I::: 

_.... ___._ _... _ _____ . . . . . _._._ . ..__ _.._. _-_.

__... __.._ ____. -___ __... :=:I . ..__ ..__. ____. 

.._.. .____ _-_._ .._- -____ ::I:: :::1 ::::: ::::: (3) . . . . . ..__. ___.. _..__ _.___ 

..?.. 2.. .A ..!.. ..?.. _.__. ..___ .-___ . . . . . _____ 

_._.. ::::I :z:: 3::: _.... ::1:1 ::::: z:=: I:::: 

. . . . . _..__ _..__ __.._ . .._. . .._. _..__ ..___ ._.._ _____ 

.__.. _..__ _____ ___._ .._._ ::::: z::: :z:: ::I:: _.... __._. ---_ __.. _ .__._ MI -1.. ____. :::& :::2!,. 2, ..!.- ._---

___.* __.._ ::::: 11::: :::z z::z ___.. __.. _ __-_ _I_- -___ 

:I::: * .:zII 1:::: ;:=I =II: :z:: :z:: ::z == :zII 

Figure II. Medical section of optical mark page reader form. 

25 
---- 

--------------------------------------------- 

‘Ibe basic system for coding surgical operations 

and procedures was modified in certain areas by directives of the Hospital Discharge Survey to accommodate incomplete terminology on the source 

documents, i.e., lack of specificity of the body site 

ICDA Code 

17.3 - Extraction of lens, extracapsular

17.4 - Extraction of lens, intracapsular ------_----------------------------------------

30.4 - Catheterization of the right heart 

30.5 - Catheterization of the left heart 

72.3 - Hysterectomy, partial or subtotal 

72.4 - Hysterectomy, complete or total 

72.5 - Hysterectomy, radical 

72.6 - Hysterectomy, vaginal -_---_-_------_--------------------------------

- Reduction of fracture and fracturedislocation of bones (except nasal 

and skull) 

82.0 - Closed reduction of fracture of shaft 

of long bone 

82.1 - Open reduction of fracture of shaft of 

long bone without internal fixation 

82.2 - Open reduction of fracture of shaft of 

long bone with internal fixation 

mm --__-__ -----me_-- -___- --^----_-------_--­

84.0 - Arthroplasty of hip without mechanical 

device 

84.1 - Arthroplasty of hip with mechanical 

device 

involved, surgical method or approach, or other details 

prescribed by the ICDA. HDS modifications that are 

pertinent to estimates presented in this report are as 

follows: 

HDS modi.ca tion 

---------------------I------,--. ---,m--,p.-rC*.m 

-----_-----_____-__-__________I_________----­

add 17.5 - Extraction of lens, not otherwise 

specified 

redefine 30.4 - Catheterization of the heart 

30.5 not used 

--------------------,-----L--.------------------,­

-*I------------------------------L----~-.-~,­

-------_--_---__----____________________-----

add 72.9 - Hysterectomy, not otherwise 

specified 

redefine 82.0 - Reduction (closed or not 

otherwise specified) of fracture in 82 without mention of 

fixation 

redefine 82.1 - Reduction (open) of fracture 

in 82 without mention of 

fixation 

redefine 82.2 - Reduction (closed or open) of 

fracture in 82 with mention 

of fixation 

82.3-82.8 not used 

redefine 84.0 - Arthroplasty of hip 

84.1 not used 

26 

82 
--- --- 

--- --- 

--- 

--- 

Presentation of Estimates 

Grou$?y of Jpera?ions.-Estimates of thenumber, 

rate, and distribution of operations by surgical specialty and body site are based on the classification of 

operations reported on sample patient abstracts in the 

J-digit detail provided by the ICDA. The groupings by 

surgical specialty that are used in this report are 

similar to but somewhat broader than the major 

classes (numbered l-1.5) of the ICDA section “Classification of Operations and Treatments.” (ICDA class 

No. 16-Certain Nonsurgical Procedures-was not 

used in this report.) A. comparison of the two systems 

of grouping operations by 2-digit codes is as follows: 

HDS specialty qfoups ICDA class 

Neurosurgery (Ol-06)---------- No.13 iK$-Fz] Ophthalmology (lo-IX)--------- -

Or& and*buccal surgery -_--------_-----__--- 5 (24-28) ThZZZ)surgery (30-35)------ 6 (30-32), & 

7 (33-35) 

Gastrointestinal and abdominal 

surgery (28,40-57)---------- 9 (40-57) Genitourinary surgery (60-69)- 10 (60-69) Gynecological surgery (70-75)- 11 (70-75) Obstetric?1 procedures w-----w--w----ss---- 12 (76-78) Or~lZ&I%c surgery (80-87)---- 13 (80-87) Other general and specialized 

surgery (08-09,38,88,89)---- 2 (OS-OS), 

& 

'3-digit codes 76.0-76.5 are not used in 

this report. 

Subgroupings of operations are shown for most of 

the surgical specialties. These are described in terms 

of the body site involved with two minor exceptions, 

namely “repair of hernia” and “amputation and disarticulation of extremities.” 

Patient characteristics not stated.-Estimates of 

surgical operations distributed by sex or age are exclusive of a negligible number of operations for which 

the personal characteristic was not reported. In the 

detailed tables presenting frequencies and rates, “not 

stated” cases are included in the totals. The proportion of operations for which sex was not reported was 

1.0 percent for “thyroid, parathyroid, and other endocrine glands”; it was less than 1.0 percent for all other 

operations classified by specialty and body site. Similarly, the highest proportion of operations for which 

age of patient was not reported was 1.3 percent for 

“esophagus, stomach, and duodenum combined with 

stomach.” 

Rounding of numbws.- Estimates of the number 

of surgical operations have been rounded to thenearest 

thousand for tabular presentation. Rates and percents 

were calculated on the basis of unrounded figures. 

Population figures.-The base populations used in 

computing rates are unpublished estimates for the U.S. 

civilian, noninstitutional population as of July 1, 1965, 

provided by the Bureau of the Census. These estimates 

are consistent with estimates of the civilian, resident 

population published by the Bureau of the Census in 

Cuwent Population Rep&s, Series P-25, but they are 

not to be considered official population estimates. 

The population data used to compute rates in this 

report are as follows: 

Group 

Population in thousands 

Total ________ 97,798 

Age -

Under 15 years----- 29,350

15-44 years-------- 38,709 45-64 years-------- 19,956

65 years and over-- 9,783 

Geographic region 

Northeast---------- 46,812

North Central------ 53,305 South----------- 58,599 D-e 

West---- --__ -_---__ 31,071 meReliability of Estimates 

Estimation.-Statistics produced by the Hospital 

Discharge Survey are derived by a complex estimating 

procedure. The basic unit of estimation is the sample 

inpatient discharge abstract. The estimating procedure 

used to produce essentially unbiased national estimates 

in the HDS has three principal components: (1) inflation by reciprocals of the probabilities of sample 

selection, (2) adjustment for nonresponse, and (3) ratio 

adjustments to fixed totals. These components of estimation are described in the appendixes of two earlier 

publications$>5 

Measurement e7707s.-As in any survey, the 

results are subject to nonsampling or measurement 

errors which include errors due to hospital nonresponse, missing abstracts, information incompletelyor 

inaccurately recorded on abstract forms, and processing errors. 

27 
Sampling errors.-The standard error is primarily 

a measure of the variability that occurs by chance because a sample rather than the entire universe is surveyed. ln this report the standard error also reflects 

part’ of the measurement error, but it does not measure 

any systematic biases in the data. The relative standard 

error of an estimate is obtained by dividing the 

standard error of the estimate by the estimate itself 

and is expressed as a percentage of the estimate. The 

relative standard errors given in table II are for the 

corresponding estimates of discharges by selected 

operations shown in table B. For example, the estimated number of thyroidectomies performed is 77,600. 

The relative standard error for this statistic is 8.2 

percent. The chances are 68 out of 100 that the value 

that would be obtained in a complete enumeration is 

contained in the interval 77,600 f 8.2 percent of 77,600, 

i.e., between 71,200 and 84,000 thyroidectomies; 95 out 

of 100 for the interval 77,600 + 8.2 percent of 77,600 

multiplied by 2; 99 out of 100 for the interval 77,600 

+ 8.2 percent of 77,600 multiplied by 2.5. 

Relative standard errors are not available for 

estimates of all-listed operations by specialty and body 

site. 

-000 

Table II. Relative standard errors of the 

estimated nmber of discharges by selected 

operations: United States, 1965 

Relative standard 

Operation 

Thyroidectomy-------------

Extraction of lens--------

Tonsillectomy with or 

without adenoidectomy----

Mastectomy----------------

Repair of inauinal herniaGastrectomy---------------

Appendectomy--------------

Enterectomy; colectomy----

Hemorrhoidectomy----------

Cholecystectomy----------­

prostatectcjmy ____ ,,i,,,,,, 

Hysterectomy--------------

Reduction of fracture with 

internal fi.xati.on--------

Excision of intervertebral 

cartilage----------------

Excision and ligation of 

varicose veins----------­

error 

(in percent) 

8.2 

7.5 

4.0 

5.0

3.7

E 

f-t 

4:3 

82 

5.4 

10.5 

6.2 

28 
-- 

-- 

APPENDIX II 

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Hospitalization 

Short-stay hospitals.-General and short-term 

special hospitals having six beds or more for inpatient use and an average length of stay of less than 

30 days, excluding military and Veterans Administration hospitals and hospital units of institutions. “Haspitals” and “short-stay hospitals” are used synonymously. 

Inpatient.-A person who is formally admitted to 

the inpatient service of a short-stay hospital for observation, care, diagnosis, or treatment. In this reportthe 

number of inpatients refers to the number of discharges during 1965, including multiple discharges of 

the same individual (if any) from one short-stay hospital or more. 

Newborn infants admitted by birth or admitted to 

the inpatient service on the calendar day of birth 

(directly or by transfer from another medical facility) 

are not included in this report. 

Discharge.-The formal release of an inpatient by 

a hospital, i.e., the termination of a period of hospitalization by death or disposition to place of residence, 

nursing home, or another hospital. In this report the 

number of discharges from short-stay hospitals during 

1965 (alive or dead) is exclusive of hospital newborn 

infants and other infants admitted to the inpatient 

service on the calendar day of birth. “Discharges” and 

“patients (or inpatients) discharged” are used synonymously. 

Episode (kospitul).-A continuous period of inpatient stay in one hospital from date of admission to 

(but not including) date of discharge. In this survey the 

number of hospital episodes (inpatient) in short-stay 

hospitals is equivalent to the number of discharges. 

Demographic Terms 

Age. -Age of discharged patients (excluding newborn infants) refers to the age at last birthday prior to 

admission to the hospital inpatient service. 

The aged.- Persons 65 years of age and over. 

Adults.--Persons 15 years of age and over. 

Children. - Persons under 15 years of age. 

United States.--The 50 States and the District of 

Columbia. 

Geographic region. -For the purpose of classifying 

hospitals by geographic area, the States are grouped 

into four regions. They correspond to those used by the 

U. S. Bureau of the Census and are as follows: 

Region states Included 

Northeast------ Maine, New Hampshire, Vermont, 

Massachusetts, Rhode Island, 

Connecticut, New York, New Jersey, 

and Pennsylvania 

North Central-- Minnesota, Iowa, Missouri, North 

Dakota, South Dakota, Nebraska, 

Kansas, Michigan, Ohio, Illinois, 

Indiana, and Wisconsin 

south- ----..- Delaware, Maryland, District of 

Columbia, Virginia, West Virginia, 

North Carolina, South Carolina, 

Georgia, Florida, Kentucky, 

Tennessee, Alabama, Mississippi, 

Arkansas, Louisiana, Oklahoma, 

and Texas 

Weat_--_ _-_ Montana, Idaho, Wyoming, Colorado, 

New Mexico, Arizona, Utah, Nevada, 

Washington, Oregon, California, 

Hawaii, and Alaska 

Terms Relating to Surgery 

Discharges with surgery.-The estimated number 

of operated patients (see definition) discharged from 

nonmilitary short-stay hospitals during 1965. 

Operation(sl.- One or more surgical operations, 

procedures, or special treatments that are assigned by 

the physician to the medical record of patients discharged from the inpatient service of short-stay hospitals. In this survey, all terms listed onthe face sheet 

(summary sheet) of the medical record under the 

captions “operations, ” “operative procedures,” “operations and/or special treatments,” etc., are transcribed 

in the order listed. A maximum of th?ee S-digit codes 

are assigned per sample discharge, based on the operations and treatments section of the ICDA” and Hospital 

Discharge Survey directives. (See “Medical Coding and 

29 
Edit” in appendix I for further details.) “Operations” 

and “surgical operations” are used synonymously. 

All-listed op6?ratiOnS.- In terms of the classification system used and the processing of notmore than 

three codes per sample discharge, the estimated number of surgical operations and procedures performed 

for inpatients discharged from nonmilitary short-stay 

hospitals during 1965. The aggregate of individually 

coded operations, procedures, and special treatments 

in code positions 1-3 exclusive of spinal puncture, 

endoscopy, radiography, shock therapy, and certain 

other treatments not generally considered as surgery. Operated patikts .-Inpatients for whom at least 

one operation or procedure is performed during one 

period of hospitalization, exclusive of spinal puncture, 

oooendoscopy, radiography, shock therapy, and certain 

other treatments not generally considered as surgery. 

Obstetrical procedures .-Includes procedures or 

operations inducing or assisting delivery by surgical 

means; repair of obstetrical lacerations and other 

operations performed after delivery or abortion; and 

obstetrical operations without delivery, excludingoperations for the termination of pregnancy. Includes cesarean section but excludes any accompanying division 

or ligation of fallopian tubes, sterilization, or hysterectomy (classified to gynecological surgery). 

Volume of operations.- The estimated number of 

all-listed operations (see definition) performed for inpatients discharged from nonmilitary short-stay hospitals during 1965. 

U. S. GOVERNMENTPRINTING OFFICE: 19?1-435-565/27 

30 
VITAL AND HEALTH STATISTICS PUBLICATION SERIES 

Public Health Service Publication No. 1000 

Series 1. R-og/ams and collection p-?ocedu~es.- Reports which describe the general programs of the National 

Center for Health Statistics and its offices anddivisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Se9fies 2. Data e~almtion and meUwds 7eseaz42 .-Studies of new statistical methodology including: eszerimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collecteddata, contributions to statistical theory. 

Swies 3. Anal~lical s&.&es.-Reports presenting 3nalytical or interpretive studies basedon vital and health 

statistics, carrying the analysis further than the expository typo­bs of reports in the other series. 

Sez?ies4. Docmnents and committee ~efioyts. -Final xeports of major committees concerned v&h vital and 

health statistics, and dacuments such as recommended model vital registration lazs and revised 

birth and death certificates. 

Senks 10. Dala jY0l-n the Health IntemimJ Swwv.-Statistics on illness, accidental injuries, disability, use 

of hospital, medical, dental, and other services, and other health-related topics, based on data 

collected in a continuing national household intervien survey. 

Se-n’es II. Data p?orn t/w HcaItk Examination Str/uey. -Data from direct examination, testing, and msasurement of national samples of the civilian, noninstitutional population provide the basis for tv;o types 

of reports: (1) estimates of the medically deflned prevalence of spec1f.k diseases in the LInited 

States and the distributians of the population v:ith respect to physical, physiolo$cal, and psychological characteristics; and (2) analysis of relationships among the various measurements vzithont 

reference to an explicit finite universe of persons. 

S&es 12. Data @am the InsfihrEioml Pc$x&Eion Sumeys .- Statistics relating to the health characteristics of 

per sons in institutions, and their medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples o’I the residents or patients. 

Swies 13. Datu j+om the Hospiial Disclmqe S~ueg. -Statistics relating to diEcharged patients in short-stay 

hospitals, based on a sample of patiene records in a national sample of hospitals. 

Sg;ies 14. Data on health ~eso~ces: manpower and facilities. -Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health 

occupations, hospitals, nursing homes, and outpatient facilities. 

Swies 20. Data on mo~taliky.- Various statistics on mortality other than as included in regular annual ox 

monthly reports-special nnalyses by cause of death, age, and other demo,graphic variables, also 

geographic and time series analyses. 

Series 21. Data on naiaality, ma”&age, and dimi-ce. --Various statistics on natality, marriage, and divorce 

other than as included in regular annual or monthly reports -special analyses by demographic 

variables, also geographic and time series analyses, studies of fertility. 

Series 22. Data f/on-z th12eXational Xatality and Jlo&alitg SW-vegs.- Statistics an characteristics of births 

and deaths not available from the vital records, based on sample surveys stemming from these 

records, including such topics as mortality by socioeconomic class, hospital expexience in the 

last year of life, medical care during pregnancy, health insurance coverage, etc. 

For a list of titles of reports published in these series, v:ritc to: Office of Information 

National Center for Health Statistics 

Public Health Service, HSAIHA 

Rocltville, hid. 20852