Hospitals across five North Bay counties generate at least $4.9 billion in annual spending and support more than 35,400 jobs, according to a report by the Hospital Council of Northern and Central California.

The report covers a total of 18 hospitals, along with related construction projects and health care jobs, across Marin, Sonoma, Napa, Lake and Mendocino counties. It does not include Solano County, which was counted in a separate report in late 2012.

While the report takes into account ancillary jobs and economic benefits, it does not include the additional impact of vast network of nonprofit health centers or independent physician and medical specialty groups, meaning the nearly $5 billion in annual spending is likely a conservative estimate.

According to the report, direct spending across North Bay and North Coast hospitals totals $2.8 billion. Of that total, $1.6 billion represents labor income. In addition, indirect and induced economic effects amount to roughly $767 million and $1.2 billion, respectively, according to the report, which notes that hospital spending generates jobs and economic activity outside of the facilities themselves.

"Without this spending, other economic sectors of the North Bay would shrink," the report states.

The report also said employment in the hospital industry is "more stable and less cyclical" than other sectors, and that during recessions, fewer jobs are eliminated. Such jobs also support a variety of education levels, "not just those intended for white-collar professionals," the report said.

Mean hourly wages and annual salaries at hospital jobs are higher than average compared to other employment sectors, particularly in the outer reaches of the North Bay, according to the report. For example, health care salaries are 14 percent higher in the Santa Rosa--Petaluma market than other jobs, 17 percent higher in Napa County and 20 percent higher in Marin County and the interior Bay Area.

But in rural Mendocino and Lake counties, such salaries are 49 percent higher than the average wage, according to the report, which attributes the differences to more high-wage professions in San Francisco and its immediate proximity.

Hospital and health care jobs will also grow at a faster clip in the North Bay than other industries, according to the report, citing figures from the state Employment Development Department.  In the Santa Rosa-Petaluma region, all occupations will grow employment by 9 percent, while health care practitioners will grow by 17 percent and health care support occupations will grow by 23 percent.

In addition to employment and spending figures, the report also noted that hospitals from Marin to the Mendocino coast provided $374.6 million in unreimbursed and charity care in 2010, the most recent year for available statics from the Office of Statewide Health Planning and Development.

Leading the way among all hospitals, Marin General provided nearly $85 million in charity and uncompensated care. Not far behind is St. Joseph Health-owned Santa Rosa Memorial, which provided a total of nearly $74.6 million. Adventist Health-owned St. Helena Hospital came in at third, with a total of $57.5 million, followed by Sutter Medical Center of Santa Rosa at more than $35.5 million.

Those numbers will likely be "much higher" in 2013, according to the report.

Hospital construction projects also account for a significant economic boost, to the tune of $500 million over the next five years, according to the report.

The following hospitals were included in the report: Vibra-owned Kentfield Rehabilitation Hospital; Marin General Hospital;  Kaiser Permanente Medical Centers in San Rafael and Santa Rosa; St. Joseph Health-operated Petaluma Valley Hospital; St. Joseph Health-owned Santa Rosa Memorial and Queen of the Valley Medical Center in Napa; Sutter Health-affiliated Novato Community Hospital, Sutter Medical Center of Santa Rosa and Sutter Lakeside Hospital; Adventist Health-operated St. Helena Hospital Napa Valley, St. Helena Hospital Clear Lake, Ukiah Valley Medical Center and Frank R. Howard Memorial Hospital in Willits; Sonoma Valley Hospital; Palm Drive Hospital; Healdsburg District Hospital; , Mendocino Coast District Hospital.