Compare by service category
When it may fit: Overall volume hides category differences.
Evidence needed: Consistent category definitions across hospitals.
Trade-off: Small categories have noisy numbers; use multiple years.
Hospital Intelligence Brief
How to Compare Hospital Utilization Patterns
Comparing volumes across hospitals is easy. Comparing them fairly takes care about what is being counted and what is being left out.
1. The business problem
What does it take to compare hospitals’ utilization without misleading yourself?
It is tempting to line up a hospital against its neighbors and read differences as strengths and weaknesses. But hospitals differ in size, service mix, patient acuity and the setting where care is delivered, so raw volumes can mislead.
This matters because decisions based on a flawed comparison, such as a service launched to “match” a competitor, can be costly.
2. What the evidence can reveal
Fair comparisons require attention to several things:
- Calculated Same definitions: the same service categories and time periods across hospitals.
- Calculated Share, not just volume: a larger hospital will have more of everything.
- Information gap Acuity and case mix: a complex case is not the same as a simple one, and discharge counts treat them alike unless adjusted.
- Information gap Care setting: inpatient counts miss care delivered as outpatient.
Verified fact Public discharge data generally supports like-for-like service categories and time periods across hospitals in a state. Adjusting for acuity usually needs additional fields and methods.
3. Investigate the problem
In the synthetic market: Illustrative
| Hospital | Discharges FY25 | Discharges FY26 | Share FY25 | Share FY26 |
|---|---|---|---|---|
| Demo Community Hospital (us) | 6,043 | 5,888 | 27.7% | 26.4% |
| St. Mary’s Regional | 5,113 | 5,815 | 23.5% | 26.1% |
| Riverside Health | 4,275 | 4,095 | 19.6% | 18.4% |
| County General | 3,630 | 3,702 | 16.7% | 16.6% |
| Valley Medical | 2,739 | 2,800 | 12.6% | 12.6% |
Calculated St. Mary’s Regional rose 13.7% and gained 2.6 pts of share. Riverside Health fell 4.2%, while County General and Valley Medical each grew about 2%. Our hospital fell 2.6%. The pattern is of one clear winner, one clear loser, and us between.
Hypothesis The comparison shows what happened but not why. St. Mary’s growth could be from new programs, a physician group joining, or acquisitions, any of which would make it a different kind of competitor. Understanding those drivers changes the right response more than the volume numbers do.
4. Explore the interactive experience
Investigate it yourself.
Hospital Market Explorer: a market dashboard comparing a five-hospital market by service category, an outmigration capture scenario, evidence-linked answers from APIS, and a sample brief, all on synthetic data.
The experience below uses a synthetic five-hospital market built to look like public discharge data. It is not New York data, or data for any real market, and every figure is illustrative. The counts are discharges, not dollars.
- Sort the hospital table by Market share and by Discharges. Do the rankings agree?
- Select a different service category and see how each hospital’s rank changes.
- Ask APIS how our market share has changed, and where.
5. Evaluate possible solutions
Utilization comparisons are most useful when they raise specific questions.
6. What leadership should do next
Questions to answer
- Are we comparing like with like?
- Does share tell a different story from volume?
- How much of the difference is case mix or setting?
- Who changed, and why?
Data to gather
- Consistent discharge data across the market
- Acuity measures
- Outpatient data
- Competitor service and physician changes
Steps to take
- Standardize categories and periods.
- Compare share by category.
- Adjust for acuity where feasible.
- Investigate the largest movers.
7. Engage Two Pillars
Explore Your Hospital’s Opportunities
Two Pillars can help hospital leadership investigate market, financial, operational, and strategic questions using relevant organizational data, public information, and a structured assessment process. A good first step is a like-for-like utilization comparison that shows where your hospital really stands against its market.
Sources and data notes
- The organization, its figures, and every number in this article and its interactive experience are synthetic and illustrative. They are not real data, a benchmark, or a forecast.
- New York State Department of Health, SPARCS: www.health.ny.gov/statistics/sparcs/ — information on the Statewide Planning and Research Cooperative System and its public-use data files.
- CMS, Cost Reports: www.cms.gov/data-research/statistics-trends-and-reports/cost-reports — public information on the annual cost reports that Medicare-participating hospitals file.
- Reviewed October 2026. This article describes an approach to investigation. It does not replace review by qualified professionals.