Best and worst hospital rankings often conflict, confuse consumers

Four of the most popular ratings systems for hospital quality are often at odds, potentially confusing patients, according to an analysis published in Health Affairs.

Researchers, led by J. Matthew Austin of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality, analyzed the ratings systems used by U.S. News & World Report, Healthgrades, the Leapfrog Group and Consumer Reports.

No hospitals were assessed as high performers by all four systems between mid-2012 and mid-2013. Most hospitals ranked as top performers by one system weren't ranked as top performers by any of the other three. In fact, the study found that in several cases, hospitals that were named as high performers under one system were considered low performers under another. Variations this broad are likely to cause confusion among consumers, the opposite of the ratings' intended purpose, the researchers wrote.

The institutions behind the ratings argue the public should expect contradictions because the systems assess different measures. Expecting uniformity would be akin to expecting the ratings from Car & Driver to align perfectly with car safety ratings, Healthgrades Chief Strategy Officer Evan Marks told the New York Times.

U.S. News offered the Times a similar defense, saying it focuses on determining the best hospitals within specific specialties, while Healthgrades emphasizes clinical information and the Consumer Reports and Leapfrog ratings are focused on patient safety, according to the article. This array of different approaches reflects what consumers want, Leapfrog Group CEO Leah Binder said. "There's room for many voices," she told the Times. "We can all look at that information and judge it for ourselves."

This is not the first time hospital ratings have come under scrutiny. In 2013, several hospitals noted they received a lower ranking from the Leapfrog Group after declining to participate, FierceHealthcare previously reported. Similarly, U.S. News, which critics have said overemphasized hospital reputations in the past, last year changed its methodology and doubled the weight of patient safety in a hospital's overall score.

To learn more:
- read the Health Affairs abstract
- here's the Times article