This study describes trends in the number of administrators in Pennsylvania hospitals from 1991 to 2020, and in the proportion of administrators to other hospital staff. Data are from the Pennsylvania Department of Health and the American Hospital Association. We find that between 1991 and 2020, the average number of administrators increased by 102% (60% when adjusted for patient volume). RNs, all nurses, and total hospital staff did not increase to the same extent, so the proportion of administrators to these staff increased by 24%, 33%, and 70% respectively. Common policies for reducing administrative costs may or may not apply to reducing administrator growth. Other policies should be explored as we discover specifics about this growth. Future studies should include data from other states and lower-level administrative staff. Studies should also examine the relationship between the number and proportion of administrators and nurse staffing, costs and quality of care.
Keywords: administrative costs; growth hospital administrators; proportion hospital administrators to staff.