1. Chapter 6: The Economic Contribution of Hospitals

3. Chartbook 2004 Chart 6.1: National Expenditures on Health Services and Supplies as a Percentage of Gross Domestic Product and Breakdown of National Expenditures on Health Services and Supplies 2002 Chart 6.2: Number of Full Time and Part Time Hospital Employees 1992 - 2002 Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1992 – 2002, for community hospitals Thousands Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group 59 Other – 26% Prescription Drugs – 11% Nursing Home Care – 7% Physician Services – 23% Hospital Care – 33% $1.5 Trillion U.S. GDP 2002 Health Services and Supplies 14.3% Other Sectors 85.7%

4. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.3: Impact of Community Hospitals on U.S. Economy (in $ billions), 2002 Source: The Lewin Group, using BEA RIMS-II multipliers applied to 2002 American Hospital Association Annual Survey data 60 Chart 6.4: Hospital Employment vs. Employment in Other Industries (in thousands) 2003 Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics Survey, custom data request In Thousands 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 Full-service restaurants General medical & surgical hospitals Limited- service eating places Employment services Grocery stores Offices of physicians Building equipment contractors Department stores Direct Effect Ripple EffectTotal Contribution

5. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.5: Average Weekly Earnings, Hospitals (1) vs. All Service-Providing Industries 1990 - 2002 61 Chart 6.6: Hospital Employment by Occupation Type 2002 Source: Department of Labor, Bureau of Labor Statistics, 2002 National Industry-Specific Occupational Employment and Wage Estimates All Service-Providing Industries Hospitals Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics Survey (1) Includes physicians employed by hospitals. Number of Employees (in thousands) 52.6 85.0 120.7 153.9 186.8 199.1 271.2 661.1 783.7 2,598.9 05001,0001,5002,0002,5003,000 Installation, Maintenance, and Repair Business and Financial Operations Community and Social Services Food Preparation and Serving Management Building and Grounds Cleaning and Maintenance Other Occupations Healthcare Support Office and Administrative Support Healthcare Practitioner and Technical

6. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.7: Percent Change in Employment, Seasonally-Adjusted: Hospital vs. All Industries 2001 – 2003 Source: Department of Labor, Bureau of Labor Statistics; Recession period defined by National Bureau of Economic Research (1) Recession period defined as March 2001 – November 2001 by National Bureau of Economic Research 62 Chart 6.8: Percent of Total Regional Employment (1) by Hospitals 2002 Source: The Lewin Group analysis of American Hospital Association 2002 Annual Survey data and 2002 total nonfarm employment data from the Bureau of Labor Statistics (1) Does not include farm employment. Hospitals All Industries (Total nonfarm)

7. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.9: Hospital Ranking Among Employers in Rural Communities 2003 Source: American Hospital Association Survey of Rural Hospitals, October 2003 63 Chart 6.10: Impact of Community Hospitals on U.S. Jobs (in millions) 2002 Source: The Lewin Group, using BEA RIMS-II multipliers applied to 2002 American Hospital Association Annual Survey data

8. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.11: Percent of Hospital Costs (1) by Type of Expense 4Q03 64 Professional Fees - 5.4% Utilities – 1.3% All Other: Non-Labor Intensive – 4.2% All Other: Labor Intensive – 5.5% Postage – 0.8% Telephone – 0.3% Professional Liability Insurance – 0.8% Other Products (e.g., Food, Medical Instruments) Other Services Prescription Drugs 12.2% 6.2% 18.4% Wages & Benefits 63.3% Source: Centers for Medicare and Medicaid Services, 2003 (1) Does not include capital.

9. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.12: Hospital Impact on Sectors of the U.S. Economy (in $ billions) 2002 65 Source: The Lewin Group analysis of American Hospital Association 2002 Annual Survey data using BEA industry multipliers for the hospital sector. Health Services$476.7 Finance, Insurance, and Real Estate174.2 Business Services112.6 Wholesale and Retail Trade95.2 Other Services88.4 Other Manufacturing58.5 Chemicals & Allied Products and Petroleum & Coal Products53.8 Transportation35.5 Food products32.3 Communications26.4 Utilities22.5 Construction17.2 Farm Products & Agricultural, Forestry, and Fishing Services16.6 Printing and Publishing15.1 Paper and Allied Products12.0 Mining8.3 Electronic and Other Electric Equipment6.9 Industrial Machinery and Equipment5.4 Lumber & Wood Products and Furniture & Fixtures5.0 Apparel and Other Textile Products4.5 Forestry and Fishing Products0.5 Total$1,267.5 Economic ImpactIndustry

10. The Economic Contribution of Hospitals Chartbook 2004 Chart 6.13: Impact of Community Hospitals on U.S. Economy, All States and Total U.S., 2002 Source: The Lewin Group using BEA RIMS-II multipliers for hospital SIC Code 806 applied to American Hospital Association Annual Survey data for 2002. Expenditures are defined as net patient revenues and other operating revenues. Hospital jobs are total part time and full time jobs. Hospital labor income is defined as payroll plus benefits. The percent of total employment supported by direct and indirect hospital employment is based on BLS data. (1) Expenditures are defined as net patient revenue + other operating revenue. 66