Hospital Discharges by Payer (OASIS Detailed Causes, Nested)
Each payer's share of inpatient hospital stays (Medicaid, Medicare, private, self-pay, PeachCare, other, unknown) by principal diagnosis, Georgia and its counties, 2000-2025 (DPH OASIS).
- 2000–2025
- annual
- 1.0.0
- c6123840f031
Resumen
Payer mix of inpatient hospital stays (discharges) of Georgia residents: each payer's share of the stays, by the primary payer the hospital recorded (Medicaid, Medicare, private insurance, self-pay, PeachCare, all other payers, unknown) and by principal diagnosis in Georgia DPH OASIS's Detailed cause list, nested (15 cause groups and the 68 causes listed within them, plus all causes). Georgia and each of its 159 counties, 2000-2025: the payer's share of the stays (key metric, our calculation), the payer's stays and all stays of the place, year and cause. Georgia 2024, all causes: Medicare 40.8%, private insurance 30.4%, Medicaid 16.8%, self-pay 7.7%; by county Medicaid runs from 5.9% (Oconee) to 27.2% (Seminole) and self-pay from 1.1% (Quitman) to 24.6% (Echols). Use it for who pays for hospital stays, overall or for one condition. For discharge rates, comparisons across places, race and sex use hospital_discharges_by_cause, whose stays are this topic's num_discharges_all_payers: never add across the two.
Granularidad de fila: Una fila por year, county_fips, tract_geoid, cause, payer.
pct_of_discharges — Share of Discharges (proportion)
El valor principal que la mayoría de las consultas busca.
Variables
Todas las columnas de la tabla de hechos. El código es el nombre exacto del campo que devuelve la API.
| Columna | Tipo | Unidad | Rango | ¿Nulo? | Descripción |
|---|---|---|---|---|---|
year | integer | — | — | no | Calendar year of discharge, 2000-2025.Descripción completa▾Calendar year of discharge, 2000-2025. |
county_fips | string | — | — | yes | 5-digit FIPS of the patient's county of residence (FK to the counties dimension); NULL on Georgia's statewide row.Descripción completa▾5-digit FIPS of the patient's county of residence (FK to the counties dimension); NULL on Georgia's statewide row. |
tract_geoid | string | — | — | yes | Always NULL: state and county rows only.Descripción completa▾Always NULL: state and county rows only. |
cause | string | — | — | no | Principal diagnosis (OASIS detailed cause, nested)Descripción completa▾Principal diagnosis of the stay in OASIS's Detailed list, nested (injuries by external cause): all (every stay, OASIS's All Causes), then 15 groups, each containing the causes listed after it (68 in all). infectious_and_parasitic_diseases (A00-B99 (001-139), with COVID-19) contains septicemia (OASIS: Blood Poisoning, A40-A41 (038)), hiv_disease (OASIS: HIV/AIDS, B20-B24 (042-044)), tuberculosis (OASIS: TB, A15-A19 (010-018)), meningococcal_infection (OASIS: Meningitis, but its codes are A39 (036), meningococcal infection, only), covid_19 (U07.1, laboratory-confirmed COVID-19); cancers (malignant neoplasms, C00-C97 (140-208)) contains oral_cancer (lip, oral cavity and pharynx), esophageal_cancer (OASIS: Throat Cancer, C15 (150), the esophagus), stomach_cancer, colorectal_cancer (OASIS: Colon Cancer; colon, rectum and anus), liver_cancer, pancreatic_cancer, lung_cancer (trachea, bronchus and lung), melanoma (OASIS: Skin Cancer, C43 (172), melanoma only), breast_cancer, cervical_cancer, uterine_cancer (corpus uteri and uterus, part unspecified), ovarian_cancer, prostate_cancer, testicular_cancer, bladder_cancer, kidney_cancer (kidney and renal pelvis), brain_cancer (brain, meninges and central nervous system), hodgkin_lymphoma (OASIS: Lymph Cancer (Hodgkin's Disease), C81 (201) only; no non-Hodgkin lymphoma), leukemia; anemias (OASIS: Blood Diseases (Anemias), D50-D64 (280-285)) contains sickle_cell_anemia (D57.0-D57.3, D57.8, D58.2 (282.5-282.6): sickle-cell disease and trait); endocrine_nutritional_and_metabolic_diseases contains diabetes, other_endocrine_nutritional_and_metabolic_diseases (OASIS: All other ...); mental_and_behavioral_disorders contains substance_use_disorders (OASIS: Disorders Related to Drug Use, F10-F19: mental and behavioral disorders due to alcohol (most of them) and other drug use, not poisonings or overdoses), other_mental_and_behavioral_disorders (OASIS: All other ...); nervous_system_diseases contains alzheimers_disease, parkinsons_disease, other_nervous_system_diseases (OASIS: All other ...); major_cardiovascular_diseases (I00-I78 (390-434, 436-448), including heart failure and other heart disease, which no listed cause holds) contains hypertension (OASIS: High Blood Pressure (Hypertension), I10, I12, I1A.0 (401, 403)), rheumatic_heart_disease (OASIS: Rheumatic Fever and Heart Diseases, I00-I09), hypertensive_heart_disease (I11 (402)), ischemic_heart_disease (OASIS: Obstructive Heart Disease (incl. Heart Attack), I20-I25 (410-414, 429.2)), stroke (I60-I69 (430-434, 436-438)), atherosclerosis (OASIS: Hardening of the Arteries, I70 (440)), aortic_aneurysm_and_dissection, hypertensive_heart_and_chronic_kidney_disease (I13 (404); OASIS's label was All other Diseases of Heart until March 2025), other_arterial_diseases (OASIS: All other Other Diseases of Circulatory System, I72-I78 (442-448)); respiratory_diseases contains influenza (OASIS: Flu, J09-J11 (487)), pneumonia, bronchitis (J40-J42 (490-491); under ICD-10-CM also COPD (J44) with bronchitis as a secondary diagnosis), emphysema, asthma (J45-J46 (493); under ICD-10-CM also COPD (J44) with asthma as a secondary diagnosis), other_chronic_lower_respiratory_diseases (OASIS: All other Chronic Lower Respiratory Diseases, J44 and J47 (494, 496); OASIS's definitions say ICD-10-CM leaves J44 out, yet the category grew several-fold after the switch); digestive_diseases (OASIS: Digestive System Diseases, K00-K93 (520-579)) contains alcoholic_liver_disease (K70 (571.0-571.3)), other_chronic_liver_disease_and_cirrhosis (OASIS: All other ..., K73-K74); genitourinary_diseases (OASIS: Reproductive and Urinary System Diseases, N00-N99) contains kidney_diseases (OASIS: Kidney Diseases, N00-N07, N17-N19, N25-N27 (580-589), mostly acute kidney failure), kidney_infections, other_genitourinary_diseases (OASIS: All other ..., urinary tract infections the largest part); musculoskeletal_diseases (OASIS: Bone and Muscle Diseases, M00-M99 (710-739), such as knee and hip osteoarthritis) (no causes listed in it); perinatal_conditions (OASIS: Fetal and Infant Conditions, P00-P96) contains prematurity_and_low_birth_weight (OASIS: Prematurity, P07 (765)), lack_of_oxygen_to_the_fetus (P20-P21 (768), intrauterine hypoxia and birth asphyxia; ICD-10-CM has no P20-P21, so the cause has no rows from 2016: no series after 2015), respiratory_distress_syndrome (P22 (769), respiratory distress of newborn), perinatal_infections (OASIS: Birth-Related Infections, P35-P39); birth_defects (Q00-Q99 (740-759)) contains nervous_system_malformations (OASIS: Neural Tube Defects, but its codes are Q00-Q07 (740-742): every congenital malformation of the nervous system); sids (R95 (798.0)) (no causes listed in it); external_causes (injuries of every intent, V00-Y97 (E800-E999), assigned by external cause when the principal diagnosis is an injury) contains motor_vehicle_crashes (OASIS: Motor Vehicle Crashes (MVC)), falls, accidental_shooting (OASIS: Accidental Shooting, W32-W34 (E922)), drowning (accidental drowning and submersion), fire_and_smoke_exposure (accidental exposure to smoke, fire and flames), unintentional_poisoning (OASIS: Poisoning, X40-X49 (E850-E869, E924.1): unintentional poisoning, mostly by drugs), suffocation, other_unintentional_injuries (OASIS: All Other Unintentional Injury), self_harm (OASIS: Intentional Self-Harm (Suicide), X60-X84, Y87.0 (E950-E959): self-harm, including suicide attempts), assault (OASIS: Assault (Homicide), X85-Y09, Y87.1 (E960-E969)), legal_intervention. A group's listed causes never overlap and never add to more than the group; they add up to it exactly only in endocrine_nutritional_and_metabolic_diseases, mental_and_behavioral_disorders, nervous_system_diseases, genitourinary_diseases. The groups never overlap and add to no more than all (some stays are in none of them). Never sum across causes. Codes are ICD-10-CM (ICD-9-CM before October 2015): https://oasis.state.ga.us/dtt/content/DefMorb.html. 84 valores permitidos▾
|
payer | string | — | — | no | Primary payer (Medicaid, Medicare, private, ...)Descripción completa▾The primary payer the hospital recorded for the stay (OASIS: the primary entity responsible for payment): medicaid (Medicaid (Title XIX)); medicare (Medicare: people 65 and older, some disabled people under 65, and people with end-stage kidney disease); private_insurance (OASIS: Private Insurance, which includes Blue Cross/Blue Shield, HMO and other managed care, commercial insurance, PPO and POS plans and the State Health Benefit Plan); self_pay (OASIS: Self-Pay: no proof of insurance, patients filing their own claims or paying their own bills, Hill-Burton and charity cases); peachcare (PeachCare for Kids, Georgia's Children's Health Insurance Program, for children through 18 who do not qualify for Medicaid); other (OASIS: All other payors (all other plans)); unknown (OASIS: Unknown payors (no payer recorded)). The payers never overlap and add up to every one (the all-payer count beside them); there is no total row. Definitions: https://oasis.state.ga.us/dtt/content/DefMorb.html. 7 valores permitidos▾
|
pct_of_discharges | number | — | yes | The payer's share of the stays (our calculation)Descripción completa▾The payer's share of all stays of the place, year and cause: num_discharges / num_discharges_all_payers, our calculation from OASIS's counts. Unknown payer is in the denominator, so the payers' shares add up to 1. Combine places or years within one payer and cause as SUM(num_discharges) / SUM(num_discharges_all_payers), never an average of shares. Georgia 2024, all causes: medicare 0.4082, private_insurance 0.3042, medicaid 0.1682, self_pay 0.077, other 0.0407, unknown 0.0016, peachcare 0.0001. | |
num_discharges | integer | — | no | Inpatient stays (discharges): a person admitted twice counts twice. The stays of the place, year and cause whose primary payer is this payer. OASIS publishes every count, however small; never NULL. The payers add up to num_discharges_all_payers; never sum across causes.Descripción completa▾Inpatient stays (discharges): a person admitted twice counts twice. The stays of the place, year and cause whose primary payer is this payer. OASIS publishes every count, however small; never NULL. The payers add up to num_discharges_all_payers; never sum across causes. | |
num_discharges_all_payers | integer | — | no | All stays of the place, year and cause, every payer and unknown payer included (OASIS's All Payors, the payers' num_discharges summed), repeated on each payer's row as the share's denominator. Never sum it across payers or causes.Descripción completa▾All stays of the place, year and cause, every payer and unknown payer included (OASIS's All Payors, the payers' num_discharges summed), repeated on each payer's row as the share's denominator. Never sum it across payers or causes. |
Filtros
Parámetros de consulta que acepta el endpoint de hechos. Los valores separados por comas son OR dentro de un parámetro; varios parámetros se combinan con AND.
| Parámetro | Tipo | Valores permitidos | Notas |
|---|---|---|---|
year | year_exact | cualquier valor | — |
year_min | year_range | cualquier valor | — |
year_max | year_range | cualquier valor | — |
detail | detail | countiesstates | enum validado, predeterminado: counties |
county_fips | foreign_key | cualquier valor | valores múltiples |
tract_geoid | foreign_key | cualquier valor | valores múltiples |
cause | categorical | 84 valores permitidos▾
| valores múltiples, enum validado |
payer | categorical | 7 valores permitidos▾
| valores múltiples, enum validado |
Ejemplos de solicitudes
Ejecútalos contra la URL base: devuelven datos en vivo.
All rows (first page), counties level
curl "https://georgiacivicdata.org/api/v1/health/hospital_discharges_by_payer"counties data for 2025
curl "https://georgiacivicdata.org/api/v1/health/hospital_discharges_by_payer?year=2025"Filtered to cause = infectious_and_parasitic_diseases for 2025
curl "https://georgiacivicdata.org/api/v1/health/hospital_discharges_by_payer?year=2025&cause=infectious_and_parasitic_diseases"One county (FIPS 13067), 2025
curl "https://georgiacivicdata.org/api/v1/health/hospital_discharges_by_payer?county_fips=13067&year=2025&detail=counties"Download 2025 as CSV
curl "https://georgiacivicdata.org/api/v1/health/hospital_discharges_by_payer?year=2025&format=csv"Notas y limitaciones
Manejo de NULL
- El cero es un valor real y reportado.
Limitaciones
Our calculation from OASIS's counts: each payer's share of inpatient stays of Georgia residents in Georgia's non-federal hospitals, the payer's stays over all stays of the place, year and cause. These are stays, not people. Unknown payer is in the denominator, so the payers' shares add up to 1. For rates, race or sex, use hospital_discharges_by_cause, which counts the same stays: never add the two. Causes nest: never add them. Some county-years reflect a hospital's payer coding. peachcare (PeachCare for Kids, which began covering children in 1998) has no stay in any place before 2006, so it has no rows then (not recorded, so no value can exist), then 1,329 in Georgia in 2006, 270 in 2007 and 67-183 a year after: hospitals rarely record it as the primary payer, and its stays are probably counted under other payers (our reading). Coding shifts between payers: in 2006 Georgia's Medicaid stays fall (244,112 in 2005, 224,806 in 2006, 247,788 in 2007) while private insurance rises (340,658, 369,835, 343,558), the year Georgia moved most Medicaid and PeachCare members into managed-care plans (Georgia Families; the link is our reading); all other payers jump in 2007 (19,347 in 2006, 48,117) as unknown falls (18,337, 6,031), and move again in 2016 (62,668 in 2015, 75,632, then 55,148 in 2017) and 2023 (64,276 in 2022, 44,405, as private insurance rises from 269,336 to 300,354). Medicaid's share falls from 20.0% in 2023 to 16.8% in 2024 (210,111 to 185,973 stays), after Medicaid's pandemic continuous enrollment ended in 2023 (our reading). In 43 county-years one payer takes a block of a county's stays and then drops back, which probably reflects one hospital's payer coding, not the county's payer mix (our reading; a payer's share more than 25 points from the county's own median over the years, with 300 or more stays). Dougherty 2016: Medicare 3.0% and all other payers 81.8% of 10,390 stays, against Medicare 24.9% in 2015 and 42.1% in 2017. Baker, Calhoun, Lee, Mitchell, Randolph, Schley, Sumter, Terrell and Worth look the same in 2016; with Dougherty they make 75% of Georgia's 2015-2016 rise in all other payers and 85% of its 2017 fall, and the 2022 counties 44% of its 2023 fall. All of them: 2003 Miller; 2007 Chattahoochee, Dougherty, Lee, Stewart, Washington; 2008 Washington; 2009 Stewart; 2010 Washington; 2011 Sumter; 2012 Houston, Sumter; 2013 Murray, Pickens, Sumter, Whitfield; 2014 Sumter; 2015 Baker, Colquitt, Dougherty, Lee, Randolph, Schley, Sumter, Terrell; 2016 Baker, Calhoun, Dougherty, Lee, Mitchell, Randolph, Schley, Sumter, Terrell, Worth; 2017 Bacon; 2020 Upson; 2021 Upson; 2022 Baldwin, Bibb, Crawford, Taylor, Upson. Compare a county's shares across years with care. Unknown payer is 0.4%-2.9% of Georgia's stays a year before 2012 and at most 0.35% from 2012, but up to 29.5% of a county's (Chattahoochee 2007; from 2012 at most 8.7%, Dade 2022), which lowers every other payer's share there. The payer is the primary payer as recorded on each record, and coding shifts show as jumps between payers. OASIS counts HMO and other managed care under private insurance and does not say where Medicare Advantage or Medicaid managed-care plans fall (our caution). A discharge is one inpatient stay in a non-federal acute-care hospital in Georgia, counted in the year the patient left (alive or dead), by the patient's county of residence: a person admitted twice counts twice, newborns' birth stays and deliveries are included, and stays of Georgia residents in other states' hospitals or in federal (VA and military) hospitals are not, so counties near another state's hospitals may look low. Causes are coded in ICD-9-CM until September 2015 and ICD-10-CM from October 2015, which breaks some causes' series (OASIS's reporting-issues page), 2015 mixing both; lack_of_oxygen_to_the_fetus has no rows from 2016 (P20-P21, codes ICD-10-CM does not have, so no stay can carry it). There is no payer total row: num_discharges_all_payers is every stay of the place, year and cause. A share is NULL only where the place had no stays for the cause in the year. OASIS documents reporting gaps: external causes and falls undercounted in 2009 (mostly DeKalb, Fulton and Cobb residents aged 0-19); no 2012 data from Hart County Hospital (Hart and nearby counties low); and in 2013 Candler County's hospital did not report (Candler low, Bulloch, Evans, Emanuel and Tattnall slightly), with mental and behavioral disorders under-reported mainly for Clayton and Spalding residents (https://oasis.state.ga.us/dtt/content/KDIMorb.html). 2025, the newest year, was added to OASIS on 2026-09-03; OASIS marks no year provisional. Counties add up to Georgia. OASIS's payer 'rates' are not served: each divides a payer's count by the whole place's population, not by that payer's enrollees. Also not served: OASIS's deduplicated measures (people rather than stays), significance flags and percents. tract_geoid is always NULL.