Draft Almanac release · Independent analysis by CRWDHEALTH · Not endorsed by CHCF
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Market structure · 2024

Inpatient market shares by patient county

Choose a county to see which hospitals and health systems treated its residents in 2024. Every chart and table can be downloaded.

2024 · Inpatient + Inpatient from ED records · Agency for Healthcare Research and Quality (AHRQ) 2023 system linkage

System HHI1,594Herfindahl-Hirschman Index, 0 to 10,000
Top-four share70.5%Four largest systems or unclassified hospitals combined
Largest system26%Largest reported resident share
Resident discharges306,112152 reporting identities

2024 inpatient discharge destinations

San Diego County

Top ten systems or unclassified hospitals serving county residents. Shares use discharges at all reporting facilities as the denominator.

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Horizontal bars show the ten systems or unclassified hospitals receiving the largest shares of reported inpatient discharges for residents of San Diego County.1. Sharp Healthcare26%2. Scripps Health23.6%3. University of California Health11.5%4. Palomar Health9.4%5. Kaiser Permanente8.7%6. Rady Childrens Hospital San Diego5.2%7. SHARP MARY BIRCH HOSPITAL FOR WOMEN AND…4.7%8. KAISER FOUNDATION HOSPITAL - SAN MARCOS2.7%9. Prime Healthcare Services2.2%10. Tri City Healthcare District2%0%26%

Method: Within each California residence county, combine the disjoint Inpatient (not from ED) and Inpatient from ED settings; exclude ED Only and AS Only. Aggregate by stable facility ID, not name. Shares divide each facility's inpatient discharges by all included discharges for that county. HHI is the sum of squared percentage shares (0–10,000). System HHI groups only explicit AHRQ 2023 system IDs reached through documented HCAI-to-CCN links; all others remain separately identified and unclassified.

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Data behind the visual

Exact system shares

Hospitals without an AHRQ system link are listed individually as unclassified. They are not grouped by name.

RankSystem or hospitalDischargesShareLinkage
1Sharp Healthcareahrq:HSI0000097779,50426%AHRQ system
2Scripps Healthahrq:HSI0000096872,27623.6%AHRQ system
3University of California Healthahrq:HSI0000116835,31511.5%AHRQ system
4Palomar Healthahrq:HSI0000080928,6579.4%AHRQ system
5Kaiser Permanenteahrq:HSI0000053626,4898.7%AHRQ system
6Rady Childrens Hospital San Diegoahrq:HSI0000086415,9585.2%AHRQ system
7SHARP MARY BIRCH HOSPITAL FOR WOMEN AND NEWBORNSunclassified:10637069514,2784.7%Unclassified
8KAISER FOUNDATION HOSPITAL - SAN MARCOSunclassified:1063700288,2202.7%Unclassified
9Prime Healthcare Servicesahrq:HSI000008456,8132.2%AHRQ system
10Tri City Healthcare Districtahrq:HSI000015066,0002%AHRQ system
Reading these shares

The patient-origin population is broader than the 299-hospital comparable financial cohort; discharge totals are not interchangeable. Residence counties are descriptive screens, not antitrust markets. No adjustment for service, payer or travel time is made. Non-California and unknown residences are excluded and tabulated. AHRQ 2023 affiliations predate 2024 flows. Unclassified does not mean independent; incomplete system linkage may understate concentration. This raw workbook contains numeric counts; suppression rules from other HCAI products are not assumed. Shares in small counties can swing widely, so read HHI together with discharge volume.

Documented ownership changes · checked September 26, 2026

Ownership-change sensitivity: 9 hospitals regrouped

9 hospitals in four documented 2024 closings (UCI Health–Tenet, UCLA Health–West Hills, UCSF Health–Dignity San Francisco, Rady Children’s–CHOC) are regrouped with their acquiring AHRQ system for all 2024 flows as a year-end ownership sensitivity. Baseline 2023 affiliations remain unchanged. This is not transaction-date-adjusted or a causal merger effect.

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HospitalMedicare CCNBaseline system (2023)Sensitivity systemEffective dateEvidence
UCI HEALTH-FOUNTAIN VALLEYHCAI 106301175050570Tenet HealthcareUniversity of California HealthSource ↗
UCI HEALTH-LAKEWOODHCAI 106190240050581Tenet HealthcareUniversity of California HealthSource ↗
UCI HEALTH-LOS ALAMITOSHCAI 106301248050551Tenet HealthcareUniversity of California HealthSource ↗
UCI HEALTH-PLACENTIA LINDAHCAI 106301297050589Tenet HealthcareUniversity of California HealthSource ↗
UCLA WEST VALLEY MEDICAL CENTERHCAI 106190859050481HCA HealthcareUniversity of California HealthSource ↗
ST. FRANCIS MEMORIAL HOSPITALHCAI 106380960050152CommonSpirit HealthUniversity of California HealthSource ↗
ST. MARY'S MEDICAL CENTER - SAN FRANCISCOHCAI 106380965050457CommonSpirit HealthUniversity of California HealthSource ↗
CHILDREN'S HOSPITAL OF ORANGE COUNTYHCAI 106300032053304CHOC ChildrensRady Childrens Hospital San DiegoSource ↗
CHILDREN'S HOSPITAL AT MISSIONHCAI 106304113053306CHOC ChildrensRady Childrens Hospital San DiegoSource ↗

System HHI changes in 47 of 58 counties

System HHI of resident inpatient discharges under 2023 affiliations and under year-end 2024 ownership. Counties with no change are in the download.

Residence countyResident dischargesBaseline system HHIYear-end ownership HHIChange
San Francisco71,7071,687.01,978.2+291.2
Orange272,5841,037.61,175.3+137.7
Calaveras4,8921,894.21,873.5-20.7
Los Angeles960,700552.7569.3+16.6
Ventura82,0601,348.21,334.1-14.1
Santa Cruz22,3112,731.72,721.6-10.1
Marin20,8092,965.02,974.6+9.6
Nevada9,4463,732.23,726.1-6.1
Siskiyou2,9493,066.03,059.9-6.1
Tehama6,6733,669.33,663.4-5.9
Shasta22,3614,128.04,122.3-5.7
Merced28,1222,389.82,384.3-5.5
Trinity1,2722,205.12,199.8-5.3
San Luis Obispo23,2262,744.22,739.5-4.7
San Mateo54,0001,929.01,925.4-3.6
Mendocino9,5084,555.64,559.1+3.5
Mono4892,258.62,262.0+3.4
San Joaquin74,9731,636.81,633.4-3.4
Humboldt12,3355,078.15,080.7+2.6
Sonoma44,0062,442.42,444.9+2.5
Sutter10,4724,034.64,036.8+2.2
Plumas1,0341,579.01,581.1+2.1
Solano37,9962,424.42,426.3+1.9
Alameda127,9851,821.81,823.6+1.8
Lassen1,2704,572.34,573.9+1.6
Contra Costa98,4152,387.62,389.1+1.5
Napa11,2243,131.23,132.6+1.4
Yuba9,4423,302.03,303.4+1.4
Lake8,3952,215.62,216.9+1.3
Inyo1,1674,347.94,349.0+1.1
Sacramento155,7782,356.82,355.7-1.1
Madera15,3132,589.12,588.1-1.0
Riverside241,265929.2928.2-1.0
Amador4,6004,295.44,294.6-0.8
El Dorado16,3481,727.81,727.1-0.7
Yolo16,8692,615.22,614.5-0.7
San Diego306,1121,594.21,594.8+0.6
Butte30,5913,684.73,685.1+0.4
Del Norte2,6326,447.06,447.4+0.4
Santa Barbara40,6953,557.63,557.2-0.4
Placer39,2623,691.83,691.5-0.3
Tuolumne6,0253,532.03,532.3+0.3
Monterey42,5592,503.12,503.3+0.2
San Bernardino223,334870.3870.1-0.2
Fresno105,4843,435.73,435.8+0.1
Santa Clara147,8091,514.41,514.3-0.1
Tulare43,5573,474.43,474.5+0.1

Limitation: Focused search of documented 2023–2024 closings; not a comprehensive ownership refresh. Patient-flow data lack transaction-date splitting. AHRQ groups the UC system broadly; transactions without an AHRQ destination and unclassified affiliations remain unresolved.

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