Sept. 15, 2026: NJHA Report: Severity of Illness Increased Dramatically in N.J. Over Last Decade

Individuals admitted to the hospital in New Jersey are arriving with more severe levels of illness, with nearly half of all patients classified at the highest levels of patient severity, according to a new analysis from the New Jersey Hospital Association.

All told, 47% of hospital patients in 2025 arrived at the hospital with "major" or "extreme" illness - the highest level in a decade.

"The data confirms what our hospitals and their healthcare teams observe every day: Patients are sicker, requiring higher levels of care and expertise than ever before," said NJHA President and CEO Cathy Bennett.

In a new report, More Severe Illness, Increasingly Complex Needs: A 10-Year View on New Jersey's Patient Population, NJHA and its Center for Health Analytics, Research and Transformation (CHART) examined de-identified patient data captured in the New Jersey Hospital Discharge dataset for 2016 to 2025. The review included tracking the severity of illness levels as assigned in the All-Patient Refined Diagnosis Related Group (APR-DRGs), a metric commonly used by healthcare providers, payers and researchers to understand illness levels, healthcare quality and utilization of healthcare services. APR-DRGs establish severity of illness scores ranging from 1 to 4 where 1 = Minor severity, 2 = Moderate severity, 3 = Major severity, or 4 = Extreme severity.

NJHA first began tracking this trend in 2023 as the COVID-19 public health emergency was coming to an end. This analysis, now spanning a full decade of data, shows the impact of an aging population, more people with chronic conditions and - a new finding - the ongoing presence of COVID-19 as an endemic condition creating added challenges, especially in older patients.

The data shows a clear shift toward higher-severity levels: While severity scores of Minor and Moderate declined, the percent of patients with Major illness increased from 23.5% to 32.6% and those classified as Extreme more than doubled, from 7.0% to 14.4% between 2016 and 2025.

Taken together, the combined share of discharges with a severity of illness of either Major or Extreme grew from 30.5% in 2016 to 47.0% in 2025 - an increase of roughly 54.2%.

Data also provides insight into some of the factors driving the rise in severity:

Aging Population. The proportion of New Jersey residents aged 65 and older increased 33% between 2010 and 2024, while the number of residents in that age group grew 43% over the same span, according to State Health Assessment Data. In 2024 data, adults 65 and older numbered about 1.7 million in New Jersey, representing roughly 18% of the state's population. New Jersey's median age (40.1 years) now exceeds the national median (39.2 years).

Chronic Disease Prevalence. Rates of major chronic conditions among New Jersey adults have also climbed over the past decade. Prevalence of obesity, diabetes and hypertension (high blood pressure) have all increased over the past decade, according to N.J.'s Behavioral Risk Factor Survey.

COVID-19's Impact: NJHA's analysis reveals that the share of patients with Major and Extreme severity illness scores remain substantially higher among COVID-19 patients than among non-COVID-19 patients. In 2025, 43.2% of patients with a COVID-19 diagnosis had a severity level of Major, compared with 32.5% of non-COVID patients. For Extreme severity, the disparity in 2025 was even more pronounced: 14% of non-COVID-19 patients were classified as Extreme severity compared with 46.8% of COVID-19 patients.

"We can't afford to ignore the trend in rising patient severity," said Bennett. "Sicker patients require skilled staff to care for them, sufficient hospital resources to support their needs and continued access to care at all levels. These are challenges our healthcare system and policymakers are grappling with - and for the sake of New Jersey patients, we must get it right."

Find more at www.njha.com/CHART.