AHA Annual Survey Database (licensed)

Licensed: not exercised here

The AHA Annual Survey is a paid licensed product (American Hospital Association), so it carries no provenance badge: the access path below was not run in this session. Treat it as unverified until someone exercises it through an AHA data licence. This is the honest grade under the institute’s Verified discipline.

The AHA Annual Survey Database is the standard census of U.S. hospitals: an annual organization-level record of services offered, bed counts, admissions, staffing, ownership type, control (nonprofit, for-profit, government), and system or network affiliation. It is the standard source for the hospital denominator in health-economics and hospital-finance research, usually joined to financial filings (IRS Form 990, Medicare cost reports) on a hospital identifier. A paper we distill uses it: Lewellen uses the AHA Annual Survey (2000 to 2018) for hospital services, operations, and system affiliation alongside IRS Form 990 financials in a study of female hospital CEOs.

• Cost: licensed, subscription. No free tier; academic licences are available, often through a data distributor.
• Vendor: American Hospital Association (AHA Data). Academic copies are frequently obtained via the Dartmouth Institute or a university library.
• Coverage: annual, organization-level, all U.S. registered hospitals (community, federal, specialty), going back decades; affiliation and system fields make it a standard source for tracking consolidation.

Access (when licensed)

• Through an AHA data licence. Extracts are delivered as annual flat files (one record per hospital per year) under a use agreement; many researchers receive them through an institutional subscription rather than directly.
• Stable hospital identifier. The AHA ID is the linking key to Medicare cost reports (via a crosswalk) and other hospital data; build joins on it rather than on hospital name.
• Credentials or a signed agreement are required. Keep any credentials in .env, never hard-coded.

Gotchas (the ones that bite pipelines)

These are the failure modes to expect; they are documented, not verified here.

• It is a survey, so response and item completeness vary. Not every hospital responds every year, and individual fields can be blank or imputed by the AHA. A field present in one year may be missing in the next for the same hospital. Check the completeness flags before treating a series as a panel.
• The unit is the hospital, not the system. A multi-hospital system appears as several records; system affiliation is a field, not the row grain. Studies of consolidation must aggregate carefully and watch for re-affiliation across years.
• Definitions and questionnaire fields change over time. Service categories, bed-type breakdowns, and ownership codes have been revised across survey vintages; a variable name can refer to different things in different years. Reconcile against the year-specific documentation before pooling.
• Linking to financial filings is many-to-one and lossy. One IRS Form 990 or cost-report entity can span several AHA hospitals (and vice versa); the crosswalk is approximate. The citing paper joins AHA operational data to Form 990 financials, exactly the kind of merge where mismatches drop observations.
• No patient-level or clinical-outcome data. The survey is organizational (capacity, services, ownership), not clinical; quality and outcome measures come from separate sources (CMS metrics, HCRIS). Do not expect mortality or readmission fields here.

Citation

Cite the source and product, e.g.: AHA Annual Survey Database (American Hospital Association), [year(s)], accessed YYYY-MM-DD. State the survey years used, how missing or imputed fields were handled, and the identifier used to link to financial or outcome data.