Hospital rankings by U.S. News & World Report rely on reputation rather than quality, safety

The highly touted "Best hospitals" list published annually by U.S. News & World Report places too much stock on a hospital's reputation and too little on such subjective criteria as quality of care and patient satisfaction, concludes a new study published in the Annals of Internal Medicine. Consider that all of the hospitals ranked at the top of 12 different specialties in last year's list achieved the status due to their reputation survey score, reports Bloomberg

To determine the reputation scores, U.S. News surveyors asked specialists nationwide to list up to five hospitals they considered to be the best in thier specialty. The specialties included diabetes and endocrine disorders; digestive disorders; ear, nose and throat; geriatric care; gynecology; heart and heart surgery; neurology; kidney disorders; orthopedics, respiratory disorders and urology.

"The relative standings of the top 50 hospitals largely reflects the subjective reputations of those hospitals," the study concluded. "Moreover, little relationship exists between subjective reputation and objective measures of hospital quality among the top 50 hospitals." 

Study author Ashwini Sehgal says the reputation score should be replaced with measures such as patient satisfaction. For the top 5 hospitals in each specialty, 97 percent corresponded with reputation rankings, while that number dipped to 91 percent for the top 10 in each specialty.

Avery Comorow, health rankings editor for U.S. News, disagrees.

"He doesn't look at reputation the same way we do," Comorow told the Cleveland Plain Dealer. "What we ask doctors to do is provide us with the names of hospitals [for patients] who need the absolute highest level of care for a complex condition or a complicated procedure....The bottom line is that we see reputation as a legitimate form of peer review for patients."

The 2010 U.S. News hospital rankings will be published in July.

To learn more:
- read this Bloomberg article
- read the Plain Dealer piece
- here's the report's abstract

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