Hospital Ratings Miss Many High Performers, Study Says





Are the nation’s best hospitals really better than all the rest?

Yes, and no, according to new study printed in the current issue of Archives of Surgery

The study’s authors compared risk-adjusted mortality rates at highly-ranked hospitals by U.S. News & World Report and HealthGrades – two of the most popular hospital ratings web sites – with other U.S. hospitals for specific types of cancer surgery.

Researchers sought to determine whether "best hospitals," as defined by the US News & World Report or HealthGrades, have lower mortality rates than all other American hospitals for cancer surgery. They looked at the Medicare database from 2005-2006 at all patients with a diagnosis of malignancy who underwent pancreatectomy, esophagectomy and colostomy.

The study shows that for the three types of cancer surgery, "America's 50 Best Hospitals" as ranked by internet-based HealthGrades are no better than the other hospitals once the number of patients they treat is taken into account.

Based on the U.S. News & World Report ratings, the top-50 hospitals trumped the rest on just one of the surgeries - removal of the colon or part of it.

"Our findings show that both ratings fail to identify equally well-performing hospitals of similar volume," Dr. Nicholas Osborne, of the University of Michigan in Ann Arbor, and colleagues write in the Archives of Surgery.

"Because these ratings list only a selected number of best hospitals," the researchers said, "these consumer aids may dissuade patients from seeking care at closer high-volume, equal-quality hospitals."

In response, the folks at HealthGrades say the findings are fundamentally flawed and could undermine patients ability to find high quality hospital care. They say the study methodology tries to compare two different treatment time frames and different outcome measures.

"While we're encouraged by the study authors' attempts to help patients find accurate quality information, in this case this study may have the opposite effect and might actually discourage patients from getting the information they need to make critically important health care decisions," said Dr. Rick May, HealthGrades Vice President, Accelerated Clinical Excellence, in a press release. "We stand firmly behind the accuracy of our hospital ratings.”

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