NCHS Data Brief ■ No. 182 ■ January 2015

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

From 2000 through 2010, the number of adults aged 85 and over in the 

United States rose 31%, from 4.2 million to 5.5 million, and in 2010, this age 

group represented almost 14% of the population aged 65 and over (1). It is 

estimated that by 2050, more than 21% of adults over age 65 will be aged 85 

and over (2). Given this increase, adults aged 85 and over are likely to account 

for an increasing share of hospital utilization and costs in the coming years 

(3). This report describes hospitalizations for adults aged 85 and over with 

comparisons to adults aged 65–74 and 75–84.

Keywords: inpatient care • health care utilization • National Hospital 

Discharge Survey

What percentage of hospital care was provided to adults 

aged 85 and over?

• In 2000, adults aged 85 and over accounted for only 2% of the U.S. 

population but 8% of hospital discharges. In 2010, adults aged 85 

Key findings

Data from the National 

Hospital Discharge Survey

• In 2010, adults aged 85 and 

over accounted for only 2% of 

the U.S. population but 9% of 

hospital discharges.

• From 2000 through 2010, 

the rate of hospitalizations 

for adults aged 85 and over 

declined from 605 to 553 

hospitalizations per 1,000 

population, a 9% decrease.

• The rate of fractures and 

other injuries was higher for 

adults aged 85 and over (51 

per 1,000 population) than for 

adults aged 65–74 (9 per 1,000 

population) and 75–84 (23 per 

1,000 population).

• Adults aged 85 and over 

were less likely than those 

aged 65–74 and 75–84 to be 

discharged home and more 

likely to die in the hospital.

Hospitalizations for Patients Aged 85 and Over 

in the United States, 2000–2010

Shaleah Levant, M.P.H.; Karishma Chari, M.P.H.; and Carol J. DeFrances, Ph.D.

NOTE: Population is the U.S. civilian noninstitutionalized population.

SOURCE: CDC/NCHS, National Hospital Discharge Survey, 2000–2010.

Figure 1. Population, discharges, and days of care, by age: United States, 2000 and 2010

Percent

0 3 10 20 0 40 50 60 70 80 90 100

2010

2000

Days of care

Discharges

Population

Days of care

Discharges

Population

Under 65 65–74 75–84 85 and over
NCHS Data Brief ■ No. 182 ■ January 2015

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and over still accounted for 2% of the U.S. population but accounted for 9% of hospital 

discharges (Figure 1).

• In 2000 and 2010, adults aged 85 and over accounted for 12% and 14%, respectively, of 

those aged 65 and over. However, adults aged 85 and over accounted for more than 20% of 

hospital discharges for those aged 65 and over for both years.

• Adults aged 85 and over accounted for a disproportionate share of the total days of care, 

10% in 2000 and 11% in 2010.

Were adults aged 85 and over more likely than other age groups to be 

hospitalized?

• The hospitalization rate for adults aged 85 and over declined by 9% from 2000 through 

2010, from 605 to 553 per 1,000 population, respectively (Figure 2).

• From 2000 through 2010, the hospitalization rate for adults aged 85 and over remained 

significantly higher than the rates for adults under age 65, aged 65–74, and aged 75–84. 

• In 2010, the hospitalization rate for adults aged 85 and over (553 per 1,000 population) was 

more than five times higher than the rate for adults under 65 (80 per 1,000 population).

1

Rate of hospitalization exceeds the rate for younger age groups for every year from 2000 through 2010 (p < 0.05).

SOURCE: CDC/NCHS, National Hospital Discharge Survey, 2000–2010. 

Figure 2. Hospitalizations, by age: United States, 2000–2010

Year

2000 2002 2004 2006 2008 2010

0

100

300

500

400

200

600

700

Rate per 1,000 population

Under 65

65–74

Total

75–84

85 and over1
NCHS Data Brief ■ No. 182 ■ January 2015

■  3  ■

What were common causes of hospitalization for adults aged 85 and over?

• In 2010, congestive heart failure (43 per 1,000 population) was the most frequent first-listed 

diagnosis for adults aged 85 and over, but in 2000 and 2005, pneumonia (51 and 52 per 

1,000 population, respectively) was the most common first-listed diagnosis for adults aged 

85 and over (Table).

• Hospitalization rates for congestive heart failure, pneumonia, stroke, and hip fracture 

decreased from 2000 through 2010 for adults aged 85 and over, and the rates for urinary 

tract infections and septicemia increased from 2000 through 2010.

Table. Common causes of hospitalization for adults aged 85 and over: United States, 2010

First-listed diagnosis 2000 2005 2010 Percent change1

(2000 to 2010)

Rate of hospitalization per 1,000 population

Congestive heart failure 48 47 43 –9.5

Pneumonia 51 52 34 –32.8

Urinary tract infection 19 24 30 +55.9

Septicemia 15 18 28 +84.8

Stroke 37 27 28 –25.0

Hip fracture 28 23 21 –25.4

1

Percent change for each diagnosis is significant from 2000 through 2010 (p < 0.05).

NOTE: First-listed diagnosis is considered to be the main cause or reason for the hospitalization. The diagnoses were chosen because they were the top six firstlisted diagnoses in 2010.

SOURCE: CDC/NCHS, National Hospital Discharge Survey, 2000–2010.
NCHS Data Brief ■ No. 182 ■ January 2015

■  4  ■

How likely were adults aged 85 and over to be hospitalized for injury?

• The rate of all injuries for adults aged 85 and over (51 per 1,000 population) was higher 

than the rates for adults aged 65–74 and 75–84 (9 and 23 per 1,000 population, respectively) 

(Figure 3).

• The rate of hip fractures for adults aged 85 and over (21 per 1,000 population) was higher 

than the rates for adults aged 65–74 and 75–84 (2 and 8 per 1,000 population, respectively).

• The rate of other fractures for adults aged 85 and over (18 per 1,000 population) was 

higher than the rates for adults aged 65–74 and 75–84 (4 and 10 per 1,000 population, 

respectively).

• The rate of other injuries for adults aged 85 and over (12 per 1,000 population) was higher 

than the rates for adults aged 65–74 and 75–84 (3 and 6 per 1,000 population, respectively).

1

All differences between adults aged 85 and over and both the 65–74 and the 75–84 age groups are statistically significant (p < 0.05).

SOURCE: CDC/NCHS National Hospital Discharge Survey, 2010.

Figure 3. Injury hospitalizations, by age and selected diagnoses: United States, 2010

Rate per 1,000 population

0 10 20 30 5 40 0 60

85 and over1

75–84

65–74

Age (years)

Hip fracture Other fracture Other injury

2 4 3

8

21 18

10 6

12
NCHS Data Brief ■ No. 182 ■ January 2015

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Where were adults aged 85 and over discharged to after hospitalization? 

• Adults aged 85 and over were less likely to be discharged to their homes (44%) than adults 

aged 65–74 and 75–84 (71% and 58%, respectively), and they were more likely to be 

discharged to a long-term care facility (36% compared with 14% and 24%, respectively) 

(Figure 4).

• Adults aged 85 and over were more likely to die during hospitalization than those aged 

65–74 and 75–84 (6% compared with 3% and 4%, respectively).

1

Differences between adults aged 85 and over and both the 65–74 and the 75–84 age groups are statistically significant (p < 0.05).

NOTE: Percentages may not add to totals due to rounding. 

SOURCE: CDC/NCHS National Hospital Discharge Survey, 2010.

Figure 4. Discharge status, by age group: United States, 2010

Age (years)

65–74 75–84 85 and over

0

20

60

80

40

100

Percent

Other

Died

Long-term care

Short-term care

Home

8

3

14

5

71

10 10

5

1

44

1

6

1

36

4

24

5

58
NCHS Data Brief ■ No. 182 ■ January 2015

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Summary

This analysis examined hospitalizations for adults aged 85 and over from 2000 through 2010 

and compared these adults with adults aged 65–74 and 75–84. In 2010, adults aged 85 and over 

accounted for 2% of the total U.S. population. However, they accounted for a disproportionate 

share of hospital discharges and days of care—9% and 11%, respectively. The hospitalization 

rate for adults aged 85 and over decreased between 2000 and 2010, but it remained significantly 

higher than all other age groups. 

The life expectancy of people who reach age 85 is another 6.5 years; those who reach age 90 can 

expect to live another 4.6 years (4). As the number of adults aged 85 and over in the 

United States continues to rise, the recognition of age differences in the utilization and provision 

of inpatient services among this population will be important. Prevention efforts to keep adults 

aged 85 and over out of inpatient settings will help reduce health care costs and maintain quality 

of life. For example, falling causes more than 95% of hip fractures, one of the leading causes of 

hospital admission, and can ultimately result in nursing home admission, long-term functional 

impairment, and increased mortality (5).

Definitions

First-listed diagnosis: The principal diagnosis, considered to be the main cause or reason for the 

hospitalization. Diagnoses are coded according to the International Classification of Diseases, 

Ninth Revision, Clinical Modification (ICD–9–CM) coding system (6). The ICD–9–CM codes for 

the first-listed diagnoses included in this report are the following:

Congestive heart failure—codes 428.0 and 428.2–428.4

Pneumonia—codes 480–486

Stroke—codes 430–438

Urinary tract infection—code 599.0

Hip fracture—code 820

Other fracture—codes 800–819 and 821–829

Other injury—codes 830–959

Rate: The number of hospitalizations per unit of population (e.g., per 10,000 population). Using 

rates removes the influence of different population sizes (e.g., for adults aged 75–84 and 85 and 

over in the same year or for the same age group over multiple years) so that data can be compared 

across these groups. For 2000–2010, rates were calculated using U.S. Census Bureau 2000-based 

postcensal civilian population estimates.
NCHS Data Brief ■ No. 182 ■ January 2015

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Data source and methods

Data for this report are from the National Hospital Discharge Survey (NHDS), a national 

probability sample survey of discharges from nonfederal, short-stay hospitals or general hospitals 

in the United States. The survey was conducted annually until 2010 by the Centers for Disease 

Control and Prevention’s (CDC) National Center for Health Statistics, Division of Health Care 

Statistics. NHDS uses a modified three-stage design. Units selected at the first stage consist 

of either hospitals or geographic areas, such as counties, groups of counties, or metropolitan 

statistical areas. Within a sampled geographic area, hospitals are selected. Finally at the last 

stage, systematic random sampling is used to select discharges within sampled hospitals. Survey 

data on hospital discharges were obtained from the hospitals’ administrative data. Note that if an 

individual is admitted to the hospital multiple times during the survey year, that individual could 

be counted more than once in NHDS.

Because of the complex multistage design of NHDS, the survey data must be inflated or weighted 

to produce national estimates. Estimates of inpatient care presented in this report exclude 

newborns. More details about the design of NHDS have been published elsewhere (7). 

A weighted least-squares regression method (8), based on all 11 years of NHDS data from 2000 

through 2010, was used to test for linear trends in the table and all figures. This is the case even 

if only selected years of data are shown. A p value of less 0.05 indicated statistical significance. 

Differences among subgroups were evaluated with two-tailed t tests using p < 0.05 as the level 

of significance. Terms that express differences such as “higher,” “lower,” “largest,” “smallest,” 

“leading,” “increased,” or “decreased,” were used only when the differences were statistically 

significant. When a comparison is described as “similar,” it means no statistically significant 

difference was found. All comparisons reported in the text were statistically significant unless 

otherwise indicated. Data analyses were performed using the statistical packages SAS version 

9.3 (SAS Institute, Cary, N.C.) and SUDAAN version 11.0 (RTI International, Research Triangle 

Park, N.C.).

About the authors

Shaleah Levant, Karishma Chari, and Carol J. DeFrances are with CDC’s National Center for 

Health Statistics, Division of Health Care Statistics.

References

1. Werner CA. The older population: 2010. C2010BR–09. U.S. Census Bureau: Washington, 

DC. 2011.

2. Vincent GK, Velkoff VA. The next four decades. The older population in the United States: 

2010 to 2050. Current population reports P25–1138. U.S. Census Bureau: Washington, DC. 2010.

3. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2012: Key 

indicators of well-being. Federal Interagency Forum on Aging-Related Statistics. Washington, 

DC: U.S. Government Printing Office. 2012.
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Suggested citation

Levant S, Chari K, DeFrances CJ. 

Hospitalizations for patients aged 85 and 

over in the United States, 2000–2010. 

NCHS data brief, no 182. Hyattsville, MD: 

National Center for Health Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown., M.S., Director

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Center for Health Statistics. 2012. Available from: http://www.cdc.gov/nchs/

data/nvsr/nvsr60/nvsr60_04.pdf.

5. National Center for Injury Prevention and Control. Home and

recreational safety: Hip fractures among older adults. 2013. Available from: 

http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html. 

6. CDC. International classification of diseases, ninth revision, clinical

modification. 6th ed. 2006. Available from: http://www.cdc.gov/nchs/icd/

icd9cm.htm. 

7. Hall MJ, DeFrances CJ, Williams SN, et al. National Hospital Discharge

Survey: 2007 summary. National health statistics reports; no 29. Hyattsville, 

MD: National Center for Health Statistics. 2010. Available from: 

http://www.cdc.gov/nchs/data/nhsr/nhsr029.pdf.

8. Gillum BS, Graves EJ, Kozak LJ. Trends in hospital utilization:

United States, 1988–92. National Center for Health Statistics. Vital Health 

Stat 13(124). 1996. Available from: http://www.cdc.gov/nchs/data/series/

sr_13/sr13_124.pdf.