placestats

Premature mortality and Hospital stays per 1,000 Medicare enrollees

Where Premature mortality is higher, Hospital stays per 1,000 Medicare enrollees tends to be higher. The link is weak: +0.30 across 3,066 counties, on a scale from −1 (opposite) to +1 (in step). That figure compares places with the same population density, income and education, so those differences can't explain it. It holds inside states too. Measured separately within each of 40 states, the middle value of the link is +0.27.

Holds after adjusting

Every place, plotted

One dot for each place reporting both measures. Hover over or tap a dot to see its name and values. The thin line is the straight line that best fits the dots. The bold line, shown for counties, is the link after adjusting for density, income and education. A dot far from the lines is a place that does not follow the pattern.

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What each measure is

Premature mortality

Deaths before age 75 per 100,000 people. It is adjusted so places with older or younger populations can be compared fairly.

County Health Rankings · County Health Rankings v127

Hospital stays per 1,000 Medicare enrollees

Hospital stays, counted from admission to discharge, in a year for every 1,000 people in traditional Medicare. It includes all kinds of stays, not only those that better care might have prevented. It leaves out people in private Medicare Advantage plans.

CMS Medicare Geographic Variation Public Use File · CMS Medicare Geographic Variation PUF, national/state/county, all ages, IP_CVRD_STAYS_PER_1000_BENES

Highest and lowest

Where each measure is highest and lowest among the places reporting both (2023), with the other measure beside it. This is shown for every size of place where both are published. Metro-area values are added up from their counties. A measure that cannot be added up across counties, such as a middle value (median), has no metro figure. Counts are shown per 1,000 residents, since raw totals would only list the largest places. Cities and towns and ZIP codes are shown where the Census survey or the CDC publishes them; most other sources stop at the county. They are shown for places of 5,000 residents or more, and only where the survey’s margin of error is small enough for the figure to be usable. The CDC publishes its health estimates for cities in a version adjusted for age, so places with older or younger people can be compared fairly, but not for ZIP codes.

Counties

By premature mortality

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Buffalo County, SD1,949224
Dewey County, SD1,606343
Oglala Lakota County, SD1,585537
Corson County, SD1,445244
Sioux County, ND1,416309
Lowest
Pitkin County, CO140135
Teton County, WY152151
Summit County, CO156105
Eagle County, CO167123
San Juan County, WA168116

By hospital stays per 1,000 Medicare enrollees

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Oglala Lakota County, SD1,585537
North Slope Borough, AK436425
Red River Parish, LA667408
Caldwell Parish, LA736401
Todd County, SD1,413388
Lowest
Ouray County, CO18278.6
San Miguel County, CO18885.9
Gilpin County, CO26192.9
Boundary County, ID35898.9
Prairie County, MT364101
States

By premature mortality

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Mississippi629235
West Virginia625249
Alabama569245
Kentucky565236
Louisiana563241
Lowest
Massachusetts303259
Hawaii310144
Minnesota315217
Utah317167
Connecticut323251

By hospital stays per 1,000 Medicare enrollees

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Massachusetts303259
Florida398259
Illinois390252
Connecticut323251
West Virginia625249
Lowest
Hawaii310144
Idaho348153
Montana403158
Oregon363160
Utah317167
Metro areas

By premature mortality

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Gallup, NM1,079238
Clarksdale, MS1,070212
Middlesborough, KY929214
Cleveland, MS927292
Greenwood, MS891203
Lowest
Edwards, CO167123
Los Alamos, NM178127
Jackson, WY-ID184145
Breckenridge, CO189110
Heber, UT202137

By hospital stays per 1,000 Medicare enrollees

Premature mortalityHospital stays per 1,000 Medicare enrollees
Highest
Durant, OK639371
Moultrie, GA661370
Rio Grande City-Roma, TX535349
Frankfort, KY542345
Okeechobee, FL625329
Lowest
Sandpoint, ID333106
Breckenridge, CO189110
Ellensburg, WA289119
Kahului-Wailuku, HI305119
Steamboat Springs, CO304121

Counties furthest from the pattern

Compared with the straight line that best fits all 3,080 counties: the five with far more hospital stays per 1,000 Medicare enrollees than their premature mortality would suggest, and the five with far less.

Premature mortalityHospital stays per 1,000 Medicare enrollees
Above the line
North Slope Borough, AK436425
Oglala Lakota County, SD1,585537
Red River Parish, LA667408
Ohio County, IN405373
Franklin County, KY562386
Below the line
Buffalo County, SD1,949224
Prince of Wales-Hyder Census Area, AK603121
Rio Arriba County, NM806144
Kingman County, KS1,289201
Pend Oreille County, WA559119

Two series, one county

Both measures over time for a county you pick. The two charts are stacked, so they share only the years along the bottom. You can pick from the thirty largest counties reporting both. This panel covers 2010–2024, and a measure published only once shows as a single dot.

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Every version of the link

Each row measures the same link, from −1 to +1, in a different way. If the rows mostly agree, the link does not depend on one choice of method.

Before adjusting for anything+0.4373,066 counties reporting both
After adjusting for density, income and education+0.305the part of the link that is not just how urban, rich and educated a place is
Also adjusting for population size+0.303size taken out as well as density
Also comparing only within each state+0.268each county is compared only with others in its own state, so this is no longer a comparison between states
Giving bigger counties more weight+0.177the adjusted link for the average resident rather than the average county. With this weighting, the data counts for about 282 equally weighted counties
Middle value inside single states+0.272the link worked out inside each of 40 states with at least 20 counties reporting
Using ranks, after adjusting+0.256uses each county’s rank, not its value, so a few extreme counties cannot create the link

How much to believe it

Could it be chance?

The p-value is the chance of seeing a link this strong if there were really none. A value of 0.05 or less means the link is unlikely to be chance. Very small values are written in short form: 3.1e-16 means 0.00000000000000031, and the bigger the number after “e-”, the smaller the value. Treating every county as a separate case gives p = 4.8e-67. But counties in the same state tend to resemble each other, so the better figure allows for that: p = 2.9e-10. The site tested 29,403 pairs, and testing so many turns up some flukes. The q-value allows for that too. For this pair it is 3.8e-66.

Do nearby places look alike?

Moran’s I measures how much nearby places look alike: 0 means no map pattern, and higher means neighbours are more similar. For the part of each county that the adjustment leaves unexplained, it is +0.41 (p = 0.001). That unexplained part still clusters on the map. So some regional factor shared by both measures is not accounted for.

Did they change together?

The figures above compare counties at one moment. This asks a different question: where premature mortality rose most, did hospital stays per 1,000 Medicare enrolleesmove too? Each county’s change is compared with the average change in its own state. That takes out ups and downs that hit a whole region at once. Each change is the gap between two estimates that both contain some error. That error pulls these links towards zero, so a weak one is weak partly for that reason. The q column shows whether a link could be a fluke, allowing for the many pairs tested: 0.05 or less means it is unlikely to be chance.

PeriodCountiesChange togetherWithin statesq
2014–2019 the main test: each Census survey figure averages five years, and these two do not overlap; before the pandemic3,051+0.01+0.020.583
2019–2023 a repeat check: its two five-year survey figures both include 2019, and it covers the COVID years3,065-0.12-0.100.005

Measured over the nearest years published: Premature mortality: 2013–2019 for the 2014–2019 row; Premature mortality: 2019–2022 for the 2019–2023 row.

Over the main period, any link between the changes could easily be chance. How change is measured.

Related pairs

Association only. Nothing here shows that either measure changes the other. This describes counties, not the people in them. Two measures going together across places does not mean the same people have both. How the US county data works · Explore Premature mortality and Hospital stays per 1,000 Medicare enrollees