The literature on deinstitutionalization (DI) and state hospitals is consistent in several areas: patient censuses at state facilities declined, staffing ratios increased, costs decreased with a net savings for state treasuries, and the number of state hospitals remained fairly constant or declined slightly. However, virtually all studies use data collected after DI had begun and span only a few years. This articles reports the results of data that spanned 39 years. Comparisons were made to examine the effects of DI on utilization, staffing and costs (inflation and population adjusted) at state hospitals. Newly opened hospitals greatly outnumbered closed facilities over the time frame, thus there were considerably more hospitals in 1988 than in 1949. The data also confirm that state hospitals have emerged from DI as different institutions with a new treatment emphasis refected in shorter stays and professionalized staff. However, this comes at a greatly increased cost.