Source provenance and access

Source files and access

Each source file is listed with its resource ID, extract date, SHA-256 hash, access terms and cost.

Primary 2024 source

2024 Pivot Table - Hospital Annual Selected File (April 2026 Extract)

Resource ID: bd8a9580-0d34-4f70-bb9e-7feb56a43eff
Last modified: 2026-05-04T19:14:47.611878
File size: 1,334,461 bytes
SHA-256: 161e6ba3f84f7f92a232fcf30081e3f0f5383b56dac99be6587c3ade9fd5f461
Runtime use: Versioned static snapshot; no live CKAN dependency
DataStore boundary: 152 Profile-sheet aggregate rows; not used for facility records

Historical registry

Calendar-year files, 2012–2024

Each file is downloaded and hashed when the site is built. A trend measure is published for a year only when the file has the fields it needs.

Cross-domain registry

37 public files, cached and hashed

All were downloaded from public agency or publisher sites with no account or license fee. The site uses validated snapshots of these files.

Validated analytical outputs

Derived data files

Each file states its population, period, denominator, aggregation rule and caveat.

14 Health Service Area cross-domain rollupsCapacity, utilization, finance, payer mix, quality, spending proxies, liquidity, and provider-footprint system HHIregional_rollups.csv7 national hospital-context rowsCapacity, inpatient volume, ownership, system affiliation, and spending with explicit comparison classesnational_hospital_benchmarks.csv5 peer-reviewed California price studiesFree full text; findings kept separate by price concept and research designprice_variation_evidence.csvFederal Medi-Cal payer-revenue sensitivityMedi-Cal is 30.3% of cohort net patient revenue. The 1%, 3% and 5% figures are illustrative sensitivities.federal_medi_cal_exposure.csvDated policy and subsidy timelineEach event labeled with the status its source givespolicy_timeline.csv

California vs. United States

5 matched CMS comparisons

Each comparison uses the same Centers for Medicare & Medicaid Services (CMS) measure and hospital population in both geographies. U.S. values include California.

CMS matched

CMS hospital overall rating

California 3.06 · U.S. 3.16

stars, unweighted mean among rated acute-care hospitals. The U.S. value includes California. Ratings are composites with CMS suppression and eligibility rules, not risk-free rankings.

CMS matched

Acute-care hospitals reporting emergency services

California 81.2% · U.S. 90.9%

share of acute-care hospitals. Presence of an emergency service does not measure service level, capacity, travel time, access, or outcomes.

CMS matched

Patients who definitely recommend the hospital

California 67.76% · U.S. 69.01%

percent. Describes the average reporting hospital, not the average patient. Suppressed/unavailable results are excluded. The published CMS national statistic is retained separately for context and is not used as the comparator. No case-mix or sampling uncertainty comparison is inferred.

CMS matched

Appropriate care for severe sepsis and septic shock

California 68.76% · U.S. 63.59%

percent, unweighted mean among reporting acute-care hospitals. Unweighted hospital summaries do not adjust for hospital volume, case mix, or missingness. The U.S. value includes California.

CMS matched

ED median minutes before leaving, excluding transfers and psychiatric/mental-health patients

California 183 · U.S. 170

minutes, median across reporting acute-care hospitals. Unweighted hospital summaries do not adjust for hospital volume, case mix, or missingness. The U.S. value includes California.

Expanded national context

7 capacity, utilization, ownership, system, and spending rows

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.

aligned concept; different hospital populations

Staffed beds per reporting hospital

California 156.61 · U.S. 151.4

beds per hospital. 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.

contextual only

Annual inpatient admissions or discharges per hospital

California 9,283.31 · U.S. 6,552.18

events per hospital. HCAI reports discharges while AHA reports admissions, and the hospital populations differ. The row is workload context, not a performance ranking.

aligned ownership grouping; different hospital populations

Nonprofit hospital share

California 56.9% · U.S. 58.3%

share of hospitals. California uses HCAI control categories for comparable GAC hospitals; the U.S. uses AHA community-hospital ownership categories.

aligned ownership grouping; different hospital populations

Investor-owned hospital share

California 26.4% · U.S. 23.9%

share of hospitals. California uses HCAI control categories for comparable GAC hospitals; the U.S. uses AHA community-hospital ownership categories.

aligned ownership grouping; different hospital populations

State or local public hospital share

California 16.7% · U.S. 17.8%

share of hospitals. California combines HCAI district and city/county control; federal hospitals are outside both comparison denominators.

contextual only

Hospitals linked to a health system

California 76.3% · U.S. 69.7%

share of hospitals. 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.

contextual only

2023-2024 hospital spending or operating-revenue growth

California 7.9% · U.S. 8.9%

annual percent change. 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.

Domain coverage

Source coverage by topic

Every topic below uses public sources that need no account or fee.

implemented

Finance, supply, capacity, utilization

HCAI annual selected + complete files; 2026 Q1 report

Account: No
Cost: $0

Hospital-submitted financial periods and definitions require reconciliation.

implemented

Market concentration

HCAI 2024 Patient Origin and Market Share + HCAI CCN link + AHRQ 2023 system linkage

Account: No
Cost: $0

County patient flows are a descriptive screen, not an antitrust market definition; unmatched facilities remain independently identified.

implemented_with_evidence_boundary

Hospital spending / pricing

OHCA Hospital Measurement 2022–2023 + RAND Round 5.1 + five free peer-reviewed California studies

Account: No
Cost: $0

OHCA net patient revenue measures are spending proxies. Peer-reviewed studies use different payers, periods, services, and designs and are not pooled into a current price index.

implemented

Quality outcomes

HCAI IMI 2016–2024 + CMS Care Compare HCAHPS, Timely and Effective Care, and HRRP

Account: No
Cost: $0

CMS quality linkage is CCN-only. HCAHPS, SEP-1, ED time, and condition-specific HRRP ratios remain separate; no composite is invented.

implemented

Health equity

HCAI 2024 Hospital Equity Measures

Account: No
Cost: $0

First-year hospital-reported fields contain substantial missingness and varying denominators.

implemented_with_denominators

California vs. national

CMS quality files + AHA Fast Facts 2026 + CMS National Health Expenditure Accounts

Account: No
Cost: $0

Five CMS quality rows use matched definitions where available. Seven capacity, utilization, ownership, system, and spending rows retain separate denominators and are explicitly classified as aligned-with-caveats or contextual.

implemented_with_scenario_boundary

Policy and subsidies

HCAI awards; DHCS/LAO financing evidence; P.L. 119-21; current CMS rulemaking

Account: No
Cost: $0

Awards and loans are program evidence, not net benefit. Federal facility rows are payer-revenue sensitivities, not predictions or official allocations.

Optional acquisitions