COVID-19 Hospital Encounters by Urban-rural Location of the Hospital by Week From Selected Hospitals

COVID-19 Hospital Data

The National Hospital Care Survey (NHCS), conducted by the National Center for Health Statistics (NCHS), collects data on patient care in hospital-based settings to describe patterns of health care delivery and utilization in the United States. Settings currently include inpatient facilities and emergency departments (ED). The survey collects electronic data, Uniform Bill (UB–04) administrative claims or electronic health records, for all encounters in a calendar year from a nationally representative sample of 601 hospitals. Information collected includes diagnoses, procedures, demographics, discharge status, and patient identifiers (e.g., name and date of birth). Eligible hospitals are in the 50 states and the District of Columbia and include noninstitutional and nonfederal hospitals with six or more staffed inpatient beds. Hospitals are currently being received into the survey.

NHCS results provided on COVID-19 hospital use are from UB–04 administrative claims data from March 18, 2020 through May 23, 2023 from 25 hospitals that submitted inpatient data and 25 hospitals that submitted ED data. The data used in these figures are considered preliminary, and the results may change with subsequent releases. There will be updates every two months to the data file. The data are not nationally representative. Even though the data are not nationally representative, they can provide insight on the impact of COVID-19 on various types of hospitals throughout the country.

Results on this page show the percentage of confirmed COVID-19 encounters over time among all ED or inpatient encounters, by urban-rural location of the hospital. Data are presented for each setting (inpatient and ED), by week.

  • A confirmed COVID-19 hospital encounter is defined as an any listed International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) diagnosis code of B97.29 and/or U07.1. Prior to April 1, 2020, CDC guidance stated to code a confirmed COVID-19 hospital encounter as B97.29. On April 1, 2020, the guidance changed to code confirmed COVID-19 hospital encounters as U07.1.
  • The hospital urban-rural classification is based on the NCHS urban-rural classification scheme for counties. There are three categories of urban-rural shown in the figure:
    • Large central and fringe metropolitan areas: Metropolitan statistical area (MSA) with a population of 1 million or more people.
    • Medium and small metropolitan areas: MSA with a population less than 1 million people.
    • Rural areas: Micropolitan (urban clusters with a population of at least 10,000 but less than 50,000) and noncore (everything else considered non-micropolitan) areas.

  • 3,541,170 ED encounters and 1,180,340 inpatient discharges.
  • For weeks where there are less than 30 encounters in the denominator, data are suppressed. In the figure, weeks with suppressed data do not have a corresponding data point on the indicator line.

Technical Notes

  • Data are not nationally representative.
  • Less than 1% of all encounters were excluded due to missing diagnosis.
  • 9.2% of inpatient discharges were for newborn (ICD–10–CM: Z38) encounters and are excluded.
  • Data represent encounters, not patients.
  • Weeks with less than 30 encounters in the denominator are suppressed.


Data Source

The data presented are from the 2020, 2021, 2022 and 2023 NHCS. The data in these figures are considered preliminary and are not nationally representative. All estimates shown meet the NHCS Data Presentation Standards for Proportions.

The goal of NHCS is to produce national estimates on hospital care and utilization. The survey is designed to produce objective and timely data to assess the health and well-being of the population and the performance and functioning of the health care system. For more details about NHCS, visit the National Hospital Care Survey website.


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