Table 1.
Changes in demographic and clinical characteristics over time
| 1993–1997 | 1998–2002 | 2003–2007 | 2008–2012 | 1993 to 2012 | |||||
|---|---|---|---|---|---|---|---|---|---|
| (n = 27,169,722) | (n = 30,339,475) | (n = 33,155,380) | (n = 32,949,393) | % change | |||||
| n | % | n | % | n | % | n | % | ||
| Age | |||||||||
| Mean (SD) | 55.9 (21.4) | 56.8 (21.2) | 56.7 (21.1) | 57.3 (20.8) | |||||
| Median (IQR) | 59 (36–74) | 59 (38–75) | 58 (38–75) | 59 (40–75) | |||||
| 18–44 | 9,500,794 | 35.0 | 9,889,714 | 32.6 | 10,508,890 | 31.7 | 9,719,897 | 29.5 | -7.1 |
| 45–64 | 6,067,284 | 22.3 | 7,429,314 | 24.5 | 8,993,160 | 27.2 | 9,608,625 | 29.2 | 7.2 |
| 65–74 | 4,915,581 | 18.1 | 5,028,732 | 16.6 | 5,093,150 | 15.4 | 5,285,204 | 16.1 | -1.8 |
| 75+ | 6,678,417 | 24.6 | 7,985,391 | 26.3 | 8,511,332 | 25.7 | 8,295,500 | 25.2 | 1.6 |
| Sex | |||||||||
| Male | 10,685,865 | 39.3 | 11,742,697 | 38.7 | 12,873,798 | 38.9 | 13,236,534 | 40.2 | 1.0 |
| Female | 16,480,719 | 60.7 | 18,592,333 | 61.3 | 20,181,689 | 61.1 | 19,654,495 | 59.8 | -1.0 |
| Race | (n = 21,544,280) | (n = 22,735,155) | (n = 24,377,850) | (n = 28,885,723) | |||||
| White | 16,479,011 | 76.5 | 16,620,980 | 73.1 | 16,903,419 | 69.3 | 19,906,573 | 68.9 | -6.0 |
| Black | 2,813,648 | 13.1 | 2,997,642 | 13.2 | 3,335,655 | 13.7 | 4,191,906 | 14.5 | 4.1 |
| Hispanic | 1,569,632 | 7.3 | 2,050,650 | 9.0 | 2,785,390 | 11.4 | 3,001,576 | 10.4 | 4.5 |
| Asian or Pacific Islander | 289,395 | 1.3 | 451,594 | 2.0 | 550,302 | 2.3 | 682,225 | 2.4 | 1.4 |
| Native American | 56,313 | 0.3 | 70,572 | 0.3 | 124,302 | 0.5 | 194,451 | 0.7 | 0.5 |
| Other | 336,281 | 1.6 | 543,717 | 2.4 | 678,782 | 2.8 | 908,992 | 3.1 | 1.5 |
| Primary Payer | |||||||||
| Medicare | 11,796,540 | 43.4 | 13,370,051 | 44.1 | 14,719,684 | 44.4 | 14,876,249 | 45.1 | 3.9 |
| Medicaid | 3,557,888 | 13.1 | 3,813,173 | 12.6 | 4,697,822 | 14.2 | 4,986,132 | 15.1 | 2.3 |
| Private including HMO | 9,306,011 | 34.3 | 10,652,293 | 35.1 | 10,760,790 | 32.5 | 9,934,117 | 30.1 | -6.6 |
| Other | 2,379,766 | 8.8 | 2,395,003 | 7.9 | 2,916,863 | 8.8 | 3,075,694 | 9.3 | 0.2 |
| Elixhauser Comorbidities | |||||||||
| AIDS/HIV | 230,715 | 0.8 | 168,850 | 0.6 | 170,334 | 0.5 | 149,653 | 0.5 | -0.5 |
| Alcohol abuse | 1,246,608 | 4.6 | 1,352,337 | 4.5 | 1,567,882 | 4.7 | 1,810,355 | 5.5 | 1.5 |
| Blood loss anemia | 406,186 | 1.5 | 443,222 | 1.5 | 517,789 | 1.6 | 397,418 | 1.2 | -0.2 |
| Cardiac arrythmias | 3,670,598 | 13.5 | 4,454,579 | 14.7 | 5,371,365 | 16.2 | 6,148,003 | 18.7 | 8.2 |
| Chronic pulmonary disease | 3,890,058 | 14.3 | 5,040,962 | 16.6 | 6,530,526 | 19.7 | 7,067,866 | 21.5 | 9.9 |
| Coagulopathy | 445,965 | 1.6 | 623,161 | 2.1 | 856,071 | 2.6 | 1,269,182 | 3.9 | 3.4 |
| Heart failure | 3,332,632 | 12.3 | 4,083,039 | 13.5 | 4,673,433 | 14.1 | 4,644,853 | 14.1 | 3.5 |
| Deficiency anemia | 380,993 | 1.4 | 476,310 | 1.6 | 632,612 | 1.9 | 890,402 | 2.7 | 1.8 |
| Depression | 1,381,748 | 5.1 | 2,132,557 | 7.0 | 3,101,654 | 9.4 | 4,196,257 | 12.7 | 10.4 |
| Diabetes with complications | 944,087 | 3.5 | 1,102,217 | 3.6 | 1,317,941 | 4.0 | 1,544,587 | 4.7 | 1.0 |
| Diabetes without complications | 2,908,635 | 10.7 | 4,151,389 | 13.7 | 5,245,770 | 15.8 | 6,046,590 | 18.4 | 11.0 |
| Drug abuse | 814,703 | 3.0 | 922,268 | 3.0 | 1,296,003 | 3.9 | 1,543,072 | 4.7 | 2.6 |
| Fluid and electrolyte disorders | 3,947,372 | 14.5 | 4,298,265 | 14.2 | 5,759,900 | 17.4 | 7,198,154 | 21.8 | 10.3 |
| Hypertension (Complications) | 1,012,064 | 3.7 | 1,407,058 | 4.6 | 2,180,686 | 6.6 | 3,610,658 | 11.0 | 9.5 |
| Hypertension (Uncomplicated) | 5,854,638 | 21.5 | 8,773,827 | 28.9 | 11,365,544 | 34.3 | 12,373,099 | 37.6 | 21.1 |
| Hypothyroidism | 1,091,362 | 4.0 | 1,823,771 | 6.0 | 2,516,676 | 7.6 | 3,362,677 | 10.2 | 8.5 |
| Liver disease | 511,243 | 1.9 | 684,954 | 2.3 | 971,289 | 2.9 | 1,291,010 | 3.9 | 2.8 |
| Lymphoma | 238,356 | 0.9 | 264,031 | 0.9 | 305,388 | 0.9 | 342,741 | 1.0 | 0.2 |
| Metastatic cancer | 1,062,218 | 3.9 | 929,280 | 3.1 | 968,550 | 2.9 | 984,424 | 3.0 | -1.1 |
| Obesity | 683,048 | 2.5 | 1,132,672 | 3.7 | 1,917,909 | 5.8 | 3,130,289 | 9.5 | 9.7 |
| Other neurological disorders | 1,387,585 | 5.1 | 1,653,846 | 5.5 | 1,941,674 | 5.9 | 2,419,531 | 7.3 | 3.8 |
| Paralysis | 648,845 | 2.4 | 414,692 | 1.4 | 412,789 | 1.2 | 533,673 | 1.6 | -0.4 |
| Peptic ulcer disease excluding bleeding | 312,792 | 1.2 | 294,334 | 1.0 | 272,056 | 0.8 | 278,181 | 0.8 | -0.1 |
| Peripheral vascular disorders | 1,098,796 | 4.0 | 1,350,332 | 4.5 | 1,595,583 | 4.8 | 1,881,090 | 5.7 | 2.9 |
| Psychoses | 617,981 | 2.3 | 688,462 | 2.3 | 879,623 | 2.7 | 950,439 | 2.9 | 0.7 |
| Pulmonary circulation disorders | 350,189 | 1.3 | 504,127 | 1.7 | 704,896 | 2.1 | 1,151,164 | 3.5 | 3.0 |
| Renal failure | 940,027 | 3.5 | 1,304,618 | 4.3 | 2,324,209 | 7.0 | 3,835,816 | 11.6 | 10.4 |
| Rheumatoid arthritis/collagen vascular diseases | 479,137 | 1.8 | 633,590 | 2.1 | 779,436 | 2.4 | 879,591 | 2.7 | 1.5 |
| Solid tumor without metastasis | 1,739,872 | 6.4 | 1,748,258 | 5.8 | 2,180,072 | 6.6 | 1,992,505 | 6.0 | -0.7 |
| Valvular disease | 1,428,958 | 5.3 | 1,624,206 | 5.4 | 1,883,620 | 5.7 | 1,780,169 | 5.4 | 1.5 |
| Number of Comorbidities | |||||||||
| 0 | 8,542,050 | 31.4 | 8,471,718 | 27.9 | 7,800,679 | 23.5 | 6,292,038 | 19.1 | -16.4 |
| 1 | 6,152,596 | 22.6 | 6,297,214 | 20.8 | 6,034,422 | 18.2 | 5,179,642 | 15.7 | -9.3 |
| 2 | 5,494,607 | 20.2 | 6,130,892 | 20.2 | 6,491,272 | 19.6 | 5,892,560 | 17.9 | -3.7 |
| ≥ 3 | 6,980,469 | 25.7 | 9,439,651 | 31.1 | 12,829,007 | 38.7 | 15,585,153 | 47.3 | 29.5 |
Abbreviations: AIDS/HIV: Acquired Immunodeficiency Syndrome/Human immunodeficiency virus; HMO: Health Maintenance Organizations; IQR: Interquartile Range; SD: Standard Deviation