NCHS Data Brief ■ No. 118 ■ March 2013

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Trends in Inpatient Hospital Deaths: National Hospital 

Discharge Survey, 2000–2010

Margaret Jean Hall, Ph.D.; Shaleah Levant, M.P.H.; and Carol J. DeFrances, Ph.D.

Key findings 

Data from the National 

Hospital Discharge 

Survey, 2000–2010

•	 The number of inpatient 

hospital deaths decreased 

8%, from 776,000 in 2000 to 

715,000 in 2010, while the 

number of total hospitalizations 

increased 11%.

•	 In 2000, 2005, and 2010, 

about one-quarter of inpatient 

hospital deaths were for 

patients aged 85 and over.

•	 Hospital death rates declined 

overall from 2000 to 2010 but 

increased 17% for septicemia.

•	 Patients who died in the 

hospital had longer hospital 

stays than all patients. In 2010, 

those who died stayed an 

average of 7.9 days compared 

with 4.8 days for all patients.

In 2000, there were 2.4 million deaths in the United States, and in 2010 

there were 2.5 million (1,2). In both years, about one-third of these deaths 

occurred in short-stay, general hospitals (3), despite research that found that 

most Americans prefer to die in their own homes (4–6). This report presents 

National Hospital Discharge Survey (NHDS) data from 2000 through 2010 on 

patients who died during hospitalization. 

Keywords: inpatient hospital utilization • hospital mortality rate 

How have hospital deaths changed from 2000 to 2010?

•	 The number of inpatient hospital deaths decreased 8% from 776,000 

in 2000 to 715,000 in 2010 (Figure 1). At the same time, total 

hospitalizations increased 11%, from 31.7 million in 2000 to 35.1 million 

in 2010 (data not shown).

•	 Female inpatient hospital deaths decreased from 411,000 in 2000 to 

Figure 1. Inpatient hospital deaths: United States, 2000–2010

1

Significant decrease from 2000 to 2010.

NOTE: Statistical significance was measured using a weighted least-squares regression method, including data from all years, to

measure linear trends over time. 

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

Year

2000 2002 2004 2006 2008 2010

0

200,000

400,000

600,000

800,000

1,000,000

Males

Females1

Total1

Number of inpatient deaths

776,000

752,000

715,000

364,000

351,000

383,000

369,000

411,000

366,000
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364,000 in 2010. Male inpatient deaths did not change significantly during this time.

What was the age distribution for patients who died in the hospital from 

2000 to 2010?

•	 In 2000, 2005, and 2010, about 75% of the inpatients who died in the hospital were aged 65 

and over (Figure 2).

•	 In both 2000 and 2005, about 25% of the hospital deaths were among patients aged 85 and 

over, and in 2010 this number rose to 27%.

•	 The percentage of hospital deaths for those under age 65 increased 9%, from 24% in 2000 

to 27% in 2010, while the proportion of inpatient hospital deaths for those aged 65 and over 

decreased 3%, from 76% in 2000 to 73% in 2010.

•	 The average age of patients who died during their hospital stay was 72–73 years throughout 

the period from 2000 to 2010.

1

Significant increase from 2000 to 2010.

2

Significant decrease from 2000 to 2010. 

NOTES: Statistical significance was measured using a weighted least-squares regression method, including data from all years, to measure linear trends over 

time. Numbers and percentages may not add to totals due to rounding. 

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

Figure 2. Inpatient hospital deaths, by age: United States, 2000, 2005, and 2010

75–84 years2 45–64 years1 85 years

and over1

Percent

65–74 years

Average age—72

Average age—72

Average age—73

Under 45

years 

2000

0 20 40 60 80 100

2005

2010

7 17 20 31 25

7 20 18 31 25

6 21 19 27 27

Year
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Has the inpatient hospital death rate decreased for all patients and for 

those with selected first-listed diagnoses?

•	 In 2000, 2.5 of every 100 inpatients died in the hospital, and this proportion decreased to 2.0 

of every 100 in 2010 (see Table).

Table. Inpatient hospital death rates, by first-listed diagnosis: United States, 2000, 2005, and 2010

First-listed diagnosis 2000 2005 2010 Percent change1

Rate per 100 persons hospitalized for diagnosis

Total 2.5 2.2 2.0 -20

Respiratory failure 25.3 19.3 16.5 -35

Pneumonitis due to solids and liquids 17.4 15.2 13.6 -22

Septicemia 13.9 19.3 16.3 +17

Kidney disease 9.9 6.5 3.5 -65

Cancer 8.1 6.8 4.4 -46

Stroke 6.4 6.5 4.7 -27

Pneumonia 4.9 3.3 3.3 -33

Heart disease 3.7 2.8 3.1 -16

1

Percent change for total and each diagnosis is significant change from 2000 to 2010.

NOTES: Statistical significance was measured using a weighted least-squares regression method, including data from all years, to measure linear trends over

time. The percentage of total deaths for the diagnoses shown in this table was 66% in 2000 and 2005, and 70% in 2010.

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

•	 Patients with certain first-listed diagnoses had relatively high hospital death rates, but

these rates decreased over the period from 2000 to 2010. Hospital death rates decreased 

for patients hospitalized for respiratory failure by 35%, for pneumonitis due to solids and 

liquids by 22%, for kidney disease by 65%, for cancer by 46%, for stroke by 27%, for 

pneumonia by 33%, and for heart disease by 16%.

•	 Unlike the above-listed hospital death rates, the septicemia hospital death rate increased 

17% from 2000 to 2010. The number of inpatients who died in the hospital with a first-listed

diagnosis of septicemia also increased—it tripled from 45,000 in 2000 to 132,000 in 2010 

(data not shown).

•	 The first-listed diagnoses discussed above and shown in the Table account for 66% of total 

hospital deaths in 2000 and 2005, and for 70% in 2010.
NCHS Data Brief ■ No. 118 ■ March 2013

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Did the length of stay for hospitalizations ending in death in 2010 differ 

from the length of stay for all hospitalizations?

•	 Inpatients who died in the hospital stayed an average of 7.9 days in 2010, compared with an 

average of 4.8 days for all inpatients (Figure 3).

•	 Although 45% of those who died in the hospital stayed from 1–3 days, 57% of all inpatients 

had stays that were this short. Over one-quarter of the patients who died in the hospital 

stayed 10 days or more, compared with 10% of all inpatients.

1

Percentage of those who died in the hospital was higher than percentage of all inpatients.

2

Percentage of those who died in the hospital was lower than percentage of all inpatients.

NOTES: Percentages may not add to totals due to rounding. ALOS is average length of stay.

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

Figure 3. Hospitalizations ending in death and all hospitalizations, by length of stay: United States, 2010

0

Inpatients who died All inpatients

20

40

60

80

100

10 or more days1

8–9 days

6–7 days

4–5 days2

2–3 days2

1 day1

ALOS—7.9 days ALOS—4.8 days

27

6

9

14

21

24

10

19

40

17

5

9
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Summary

The number of patients who died in the hospital in the years 2000–2010 decreased, as did the 

rate of hospitalizations ending in death, but there were still over 700,000 patients who died 

in the hospital in 2010. One-quarter of the patients who died in the hospital were aged 85 and 

over. Hospital death rates declined from 2000 to 2010 for selected first-listed diagnoses with the

highest death rates in 2000, except for the septicemia death rate, which increased. Patients who 

died in the hospital had longer average hospital stays than all patients.

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 (7). The ICD–9–CM codes for 

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

Heart disease—codes 391–392.0, 393–398, 402, 404, 410–416, and 420–429

Respiratory failure—codes 518.81 and 518.83–518.84

Septicemia—code 038

Cancer (malignant neoplasm)—codes 140–209.36, 209.70–209.75, 209.79, and 230–234

Stroke (cerebrovascular disease)—codes 430–438

Pneumonia—codes 480–486

Pneumonitis due to solids and liquids—code 507

Kidney disease—codes 580–589

Inpatient hospital death rate: The number of inpatients who died in the hospital divided by 

the total number of hospitalizations. For example, the death rate for septicemia is calculated 

by dividing the number of inpatients hospitalized for septicemia who died during their 

hospitalization by the total number of hospitalizations for septicemia. The rate is reported per 100 

hospitalizations in this report but could also be reported as a percentage.
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Data source and methods

Data are from NHDS, a national probability sample survey of discharges from nonfederal, 

noninstitutional, short-stay hospitals, or general hospitals in the United States conducted annually 

from 1965 through 2010 by the Centers for Disease Control and Prevention’s National Center 

for Health Statistics. Survey data on hospital discharges were obtained from the hospitals’ 

administrative data. It should be noted that if an individual is admitted to the hospital multiple 

times during the survey year, that individual will be counted more than once in NHDS.

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

in order 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 (8).

A weighted least-squares regression method (9), based on all 11 years of unrounded NHDS data 

from 2000 through 2010, was used to test for linear trends in Figures 1 and 2, and in the Table. 

A p value of 0.05 was used to indicate statistical significance. Figure 3 contains data from 2010.

Differences among subgroups were evaluated using unrounded numbers with two-tailed t tests 

using a p value of 0.05 as the level of significance. Calculation of rates, percentages, and percent

changes were computed using unrounded numbers, so the results may differ from what would be 

obtained using the rounded figures in the text, figures, and tables.

All comparisons reported in the text were statistically significant unless otherwise indicated. Data

analyses were performed using the statistical packages SAS version 9.2 (SAS Institute, Cary, 

N.C.) and SUDAAN version 10.0 (RTI International, Research Triangle Park, N.C.).

This is a study of inpatient hospital utilization of those who died, including the number, type, 

and length of stay for inpatients that did not live to be discharged. This study also explores how 

these factors have changed over time. These data are not a measure of the quality of hospital care. 

Fewer deaths in the inpatient hospital setting may be due to numerous factors, including more 

transfers to other settings, before patients die.
NCHS Data Brief ■ No. 118 ■ March 2013

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About the authors

Margaret Jean Hall, Shaleah Levant, and Carol J. DeFrances are with the Centers for Disease 

Control and Prevention’s National Center for Health Statistics, Division of Health Care Statistics.

References

1. Miniño AM, Arias E, Kochanek KD, et al. Deaths: Final data for 2000. National vital 

statistics reports; vol 50 no 15. Hyattsville, MD: National Center for Health Statistics. 2002. 

Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_15.pdf.

2. Murphy SL, Xu JQ, Kochanek KD. Deaths: Preliminary data for 2010. National vital 

statistics reports; vol 60 no 4. Hyattsville, MD: National Center for Health Statistics. 2012.

3. National Center for Health Statistics. Unpublished data from annual National Hospital 

Discharge Survey data files, 2000 and 2010.

4. National Center for Health Statistics. Health, United States, 2010: Chartbook with special 

feature on death and dying. Hyattsville, MD. 2011.

5. Grunier A, Mor V, Weitzen S, Truchil R, Teno J, Roy J. Where people die: A multilevel 

approach to understanding influences on site of death in America. Med Care Res Rev 64(4):351–

78. 2007.

6. Tang ST. When death is imminent: Where terminally ill patients with cancer prefer to die and 

why. Cancer Nurs 26(3):245–51. 2003.

7. CDC. International Classification of Diseases, Ninth Revision, Clinical Modification. 6th ed.

2006. Available from: http://www.cdc.gov/nchs/icd/icd9cm.htm.

8. 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.

9. 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.
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NCHS Data Brief ■ No. 118 ■ March 2013

Suggested citation

Hall MJ, Levant S, DeFrances CJ. Trends in 

inpatient hospital deaths: National Hospital 

Discharge Survey, 2000–2010. NCHS data 

brief, no 118. Hyattsville, MD: National 

Center for Health Statistics. 2013.

Copyright information

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the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

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