{
  "version": 1,
  "generatedAt": "2026-09-07T04:32:07.308636+00:00",
  "data": {
    "asOf": "2026-08-23",
    "californiaPopulation": "299 comparable general acute hospitals in California",
    "unitedStatesPopulation": "5,121 AHA community hospitals unless otherwise stated",
    "comparisons": [
      {
        "id": "staffedBedsPerHospital",
        "domain": "capacity",
        "measure": "Staffed beds per reporting hospital",
        "unit": "beds per hospital",
        "california": 156.61,
        "unitedStates": 151.4,
        "californiaNumerator": 46825.0,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 775297,
        "unitedStatesDenominator": 5121,
        "period": "2024",
        "comparability": "aligned concept; different hospital populations",
        "source": "California HCAI HAFD 2024; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "California is limited to 299 comparable general acute hospitals; the U.S. denominator is the broader AHA community-hospital population, including short-term specialty hospitals."
      },
      {
        "id": "annualInpatientVolumePerHospital",
        "domain": "utilization",
        "measure": "Annual inpatient admissions or discharges per hospital",
        "unit": "events per hospital",
        "california": 9283.31,
        "unitedStates": 6552.18,
        "californiaNumerator": 2775711.0,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 33553725,
        "unitedStatesDenominator": 5121,
        "period": "2024",
        "comparability": "contextual only",
        "source": "California HCAI HAFD 2024; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "HCAI reports discharges while AHA reports admissions, and the hospital populations differ. The row is workload context, not a performance ranking."
      },
      {
        "id": "nonprofitOwnershipShare",
        "domain": "ownership",
        "measure": "Nonprofit hospital share",
        "unit": "share of hospitals",
        "california": 0.568562,
        "unitedStates": 0.582699,
        "californiaNumerator": 170,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 2984,
        "unitedStatesDenominator": 5121,
        "period": "2024",
        "comparability": "aligned ownership grouping; different hospital populations",
        "source": "California HCAI HAFD 2024; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "California uses HCAI control categories for comparable GAC hospitals; the U.S. uses AHA community-hospital ownership categories."
      },
      {
        "id": "forProfitOwnershipShare",
        "domain": "ownership",
        "measure": "Investor-owned hospital share",
        "unit": "share of hospitals",
        "california": 0.264214,
        "unitedStates": 0.239016,
        "californiaNumerator": 79,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 1224,
        "unitedStatesDenominator": 5121,
        "period": "2024",
        "comparability": "aligned ownership grouping; different hospital populations",
        "source": "California HCAI HAFD 2024; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "California uses HCAI control categories for comparable GAC hospitals; the U.S. uses AHA community-hospital ownership categories."
      },
      {
        "id": "publicOwnershipShare",
        "domain": "ownership",
        "measure": "State or local public hospital share",
        "unit": "share of hospitals",
        "california": 0.167224,
        "unitedStates": 0.178285,
        "californiaNumerator": 50,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 913,
        "unitedStatesDenominator": 5121,
        "period": "2024",
        "comparability": "aligned ownership grouping; different hospital populations",
        "source": "California HCAI HAFD 2024; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "California combines HCAI district and city/county control; federal hospitals are outside both comparison denominators."
      },
      {
        "id": "systemAffiliationShare",
        "domain": "market_structure",
        "measure": "Hospitals linked to a health system",
        "unit": "share of hospitals",
        "california": 0.762542,
        "unitedStates": 0.696544,
        "californiaNumerator": 228,
        "californiaDenominator": 299,
        "unitedStatesNumerator": 3567,
        "unitedStatesDenominator": 5121,
        "period": "California linkage 2023; hospital activity 2024; U.S. 2024",
        "comparability": "contextual only",
        "source": "AHRQ Compendium hospital linkage 2023; AHA Fast Facts 2026 using the 2024 Annual Survey",
        "limitation": "California counts only identifier-linked records with a non-null AHRQ system ID, not every hospital present in the AHRQ linkage file. It is not an AHA Annual Survey classification; definitions and years differ."
      },
      {
        "id": "hospitalSpendingGrowth",
        "domain": "spending",
        "measure": "2023-2024 hospital spending or operating-revenue growth",
        "unit": "annual percent change",
        "california": 0.079048,
        "unitedStates": 0.089,
        "californiaNumerator": 150507928896.0,
        "californiaDenominator": 139482195195.0,
        "unitedStatesNumerator": 1634700000000,
        "unitedStatesDenominator": 1501101928374.66,
        "period": "2023-2024",
        "comparability": "contextual only",
        "source": "California HCAI HAFD calendar-year repeated cross-sections; CMS National Health Expenditure Accounts 2024",
        "limitation": "California is operating revenue for changing annual comparable-hospital cohorts; the U.S. is NHE hospital expenditures. The U.S. 2023 base is implied from the published 2024 level and 8.9% growth rate. The constructs and populations are not equivalent."
      }
    ],
    "nationalContext": [
      {
        "id": "usHospitalExpenditures",
        "label": "U.S. hospital expenditures",
        "value": 1634700000000,
        "unit": "dollars",
        "period": "2024",
        "source": "CMS National Health Expenditure Accounts"
      },
      {
        "id": "usHospitalExpenditureGrowth",
        "label": "U.S. hospital expenditure growth",
        "value": 0.089,
        "unit": "annual percent change",
        "period": "2023-2024",
        "source": "CMS National Health Expenditure Accounts"
      },
      {
        "id": "cmsHcrisLatestCompleteYear",
        "label": "Latest complete CMS hospital cost-report PUF year",
        "value": 2023,
        "unit": "year",
        "period": "CMS page modified January 8, 2026",
        "source": "CMS Hospital Provider Cost Report Public Use File"
      }
    ],
    "sources": [
      {
        "publisher": "American Hospital Association",
        "title": "Fast Facts on U.S. Hospitals, 2026",
        "url": "https://www.aha.org/statistics/fast-facts-us-hospitals",
        "period": "2024 Annual Survey"
      },
      {
        "publisher": "CMS",
        "title": "National Health Expenditure Fact Sheet",
        "url": "https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet",
        "period": "2024"
      },
      {
        "publisher": "CMS",
        "title": "Hospital Provider Cost Report Public Use File",
        "url": "https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report",
        "period": "Latest complete year 2023"
      }
    ],
    "method": "California results are computed from the validated 299-hospital HCAI cohort. U.S. results use published AHA 2024 aggregate counts or CMS NHEA. Every row retains its numerator, denominator, period, and comparability class.",
    "limitation": "Only staffed-bed and ownership concepts are reasonably aligned, and even those use different hospital populations. Admissions versus discharges, system affiliation, and spending growth are contextual rather than directly comparable."
  }
}