Tom Hamm, a retired steelworker, underwent gallbladder surgery in 1991 at Citrus Memorial Hospital.
When Hamm returned to Citrus Memorial on Oct. 23, this time for a hernia operation, he noticed a significant change in surroundings.
"It's bigger now, so they've got more room to take on new patients," said Hamm, 76, who lives in the Highlands section of Inverness.
Hamm was right. The hospital has changed some since 1991. And there definitely are more patients.
Admissions at Citrus Memorial jumped 13 percent during the 1996-97 fiscal year that ended Sept. 30. That is by far the biggest one-year increase during the 1990s.
Hospital halls also are bustling across the county, where Seven Rivers Community Hospital's admissions are up 13 percent compared with last year.
The increases don't jibe with conventional wisdom.
More and more health services are delivered outside the hospital these days, because of improved technology and a desire to keep down costs.
Neither Citrus Memorial or Seven Rivers significantly expanded physically during the past year, so the increased admissions are not filling new beds.
Experts said the increase in admissions more likely is because of a growing population, with many senior citizens among the new residents.
Also, with more doctors serving the area, patients are more willing, and able, to stay closer to home for medical services.
"People are deciding not to leave Citrus County," said Dorothy Linton, spokeswoman at Seven Rivers. "They know that they have health care here in Citrus County, and that keeps them local, instead of bringing the admissions to a facility outside Citrus."
Officers at Citrus Memorial offered similar explanations.
Admissions have been up even during the traditionally slow summer, records show. The 171-bed hospital in Inverness ended its fiscal year with a healthy 68 percent occupancy rate _ 6 percent better than last year.
One of those summer patients was Georgia L'Hommedieu, a Bushnell woman who had surgery and stayed there June 24-30.
"The personnel were very fine, and the job they did was excellent," L'Hommedieu said. "The people were so good to me. I just want them to know that."
Did she notice an abundance of patients?
"I don't even know," she said. "I was in the room the whole time."
At Seven Rivers, just north of Crystal River, statistics are kept according to a fiscal year that runs June 1-May 31.
In 1994-95, the hospital, which has 128 beds, had 5,104 admissions. The next year, that number jumped 14 percent to 5,818.
In 1996-97, admissions dropped to 5,777. But that number might be misleading because it includes the 1996 summer months, which were slow.
A better number to study, spokeswoman Linton said, is the year-to-date comparison for the fiscal year. That figure shows admissions are up 13 percent from last year.
With those numbers, Citrus County is bucking the national trend. The American Hospital Association reported that in 1995 admissions to community hospitals nationwide increased less than 1 percent from 1994 numbers in non-metropolitan areas.
Before that, from 1991-95, admissions declined 2.5 percent at rural hospitals, the association said. It based those statistics on responses to an AHA survey.
In a county where 34 percent of the residents are 65 or older, one would expect much of the increase in admissions to come in that age range.
Statistics suggest that is correct.
At Citrus Memorial, Medicare admissions leaped 17 percent from 1995-96 to 1996-97. Medicare is the government health insurance program that mostly assists people 65 and older.
But the county's demographics have looked that way for a long time. Why the increase in admissions now?
"Nowadays, people are living longer, so the population over 65 more and more are those who are in the 85-90 range," said Marybeth Nayfield, director of the Citrus County Health Department.
Statistics show that 17 percent of the county's residents are 75 or older. The state average is 9 percent. "These are the frail elderly, those who are going to be in and out of the hospital before they die," Nayfield said.