Hospital rankings, mortality rates based on chance, study says

Although more prominent around the time new top-hospitals lists come out, skeptics about hospital rankings again rear their heads. A new study published this week in Pediatrics finds that reported mortality rates used for hospital rankings are statistically imprecise with limited measures to compare quality of care.

Researchers looked at 42 children's hospitals and found that the rankings are not as precise as people might think they are. Comparing the rankings to randomly shuffling a stack of cards, Dr. Chris Feudtner of The Children's Hospital of Philadelphia told Reuters Health that the rankings can depend on chance.

"You are chasing after something that is being buffeted around by chance," he told Reuters.

Each estimate of a mortality rates comes with some uncertainty, called a confidence interval, reports Reuters Health. In the study, half of the confidence intervals overlapped at least 22 of the 42 possible ranking positions, meaning that if a hospital ranked number 15 on a list, it could have just as easily been named number 37, according to the article.

The often cited U.S. News & World Report "Best Hospitals" list factors patient survival for 32.5 percent of the hospital score. Although it includes mortality rates within its rankings, it also includes other factors, such as patient safety and nursing and patient services, as well as--not without some public criticism--reputation, which accounts for 32.5 percent of the hospital's score.

Another recent study in the Archives of Surgery indicated that hospital rankings are often misleading and incomplete, failing to recognize high-volume hospitals of equal quality.

For more information:
- read the Reuters article
- check out the study abstract

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