New CareChex Studies Rank Quality of U.S. Hospital Care and Patient Satisfaction with Hospital Stay

GREENVILLE, South Carolina--(BUSINESS WIRE)--CareChex, a division of The Delta Group specializing in rating the quality of hospital and physician care, today released two new studies that reveal broad disparities between quality of U.S. healthcare by state and metro area and surprising regional differences in patient satisfaction with the care they are getting.

"2010 CareChex Quality of Care by U.S. Geographic Area"

The studies are paired with a third piece of analysis that highlights a startling trend: that technical quality of care in the U.S. is a poor proxy for patient satisfaction with their hospital stay. In fact, some of the states with the most dissatisfied patients are the most highly ranked for quality of care.

The first study, "2010 CareChex Quality of Care by U.S. Geographic Area," provides insight into the relative quality of care and the broad disparities in care delivered across different states and major metropolitan areas. The data also helps explain the growing trend toward U.S. "medical tourism," where patients travel outside their local market to receive higher quality care at a better price.

The second study, "2010 CareChex Patient Satisfaction by U.S. Geographic Area," identifies the relative patient satisfaction with hospital care among states and major metropolitan areas and gives a "macro" view of which locations offer the best customer-centric care. With the rise of "consumerism" in healthcare, the hospital industry has realized that cost and quality alone are insufficient competitive differentiators in the minds of customers - service excellence also plays a vital role in determining value. The absence of "customer-oriented" care can often lead to patient dissatisfaction despite excellence in clinical quality.

"This finding underscores the need for hospitals to engage in regular patient satisfaction surveys rather than assume patients are satisfied with their medical care simply because a hospital meets a particular standard of clinical quality," says Andrew Webber, President & CEO, National Business Coalition on Health (NBCH), a national membership organization of purchaser-led health care coalitions representing over 7,000 employers and approximately 25 million employees and their dependents. "From the perspective of employers and purchaser-based coalitions, employee satisfaction with the care they receive is an important part of the hospital's overall value equation - there's simply no reason why we shouldn't expect quality care to be provided along with a positive patient experience."



#1 Ohio (98.0)         #1 District of Columbia (0.1)
#2 Michigan (96.1)         #2 Nevada (2.0)
#3 Delaware (94.1)         #3 Hawaii (3.9)
#4 Massachusetts (92.2)         #4 New Mexico (5.9)
#5 Connecticut (90.2)         #5 New York (7.8)
#6 Indiana (88.2)         #6 Alaska (9.8)
#7 Wisconsin (86.3)         #7 Wyoming (11.8)
#8 Florida (84.3)         #8 Mississippi (13.7)
#9 North Dakota (82.4)         #9 California (15.7)
#10 Iowa (80.4)         #10 West Virginia (17.7)
#1 Vermont (98.0)         #1 District of Columbia (0.1)
#2 Maine (96.1)         #2 Nevada (2.0)
#3 New Hampshire (94.1)         #3 Florida (3.9)
#4 Alabama (92.2)         #4 California (5.9)
#5 Louisiana (90.2)         #5 Hawaii (7.8)
#6 Wisconsin (88.2)         #6 New Jersey (9.8)
#7 South Dakota (86.3)         #7 New York (11.8)
#8 North Carolina (84.3)         #8 Maryland (13.7)
#9 Nebraska (82.4)         #9 Arizona (15.7)
#10 Iowa (80.4)         #10 New Mexico (17.7)

Overall Hospital



Ohio         #1 (98.0)         #34 (33.3)
Delaware         #3 (94.1)         #41 (19.6)
Connecticut         #5 (90.2)         #37 (27.5)
Florida         #8 (84.3)         #49 (3.9)
Illinois         #11 (78.4)         #39 (23.5)
Arizona         #15 (70.6)         #43 (15.7)
Vermont         #30 (41.2)         #1 (98.0)
Louisiana         #36 (29.4)         #5 (90.2)
Mississippi         #44 (13.7)         #14 (72.6)
Wyoming         #45 (11.8)         #15 (70.6)

Other key survey findings:

  • The nation's capital (District of Columbia) has the "lowest quality" of overall hospital care and the "lowest patient satisfaction score" when compared to the rest of the country.
  • With one of the highest levels of HMO managed care penetration in the country, California had one of the lowest "quality of care" scores. While more research is needed to determine why this may be, a link to aggressive ancillary cost reduction and shorter hospital stays may be adversely affecting quality of care.
  • The three states with the "highest patient satisfaction scores" are all from the "Northeast region" of the U.S. (i.e., Vermont, Maine, and New Hampshire)
  • 5 of 10 states with the "highest quality" of overall hospital care are in the "Midwest region" of the U.S. (i.e., Ohio, Michigan, Indiana, Wisconsin, and North Dakota)
  • 6 of 10 states with the "lowest quality" of overall hospital care are in the "Western region" of the U.S. (i.e., California, Wyoming, New Mexico, Nevada, Hawaii, and Alaska)
  • There are puzzling disparities in some locations between quality of care and patient satisfaction. For example, the Raleigh/Durham, NC area has relatively low quality of care rankings and high patient satisfaction. Ohio, Delaware and Connecticut have very high quality rankings but unusually low patient satisfaction. Mississippi, while ranked 44th among states for care quality, has a relatively high patient satisfaction score.

Full quality rankings and percentile scores by state and metropolitan areas for overall hospital care and for patient satisfaction are available here: Also available are quality rankings and percentile scores for the 50 largest metro areas by select clinical categories (e.g., cardiac care, cancer care, orthopedic care, etc.).

Maps available for reprinting showing state by state comparisons on quality of care, patient satisfaction with hospital care and disparities between quality and satisfaction are available at:

About The Delta Group and CareChex

As the nation's largest privately‐held healthcare information services company, The Delta Group provides an extensive array of products and services designed to measure, manage, and monitor the clinical, financial, and market performance of healthcare organizations.

CareChex, a division of The Delta Group, specializes in rating and ranking the quality of hospital and physician care using both public and proprietary measures of performance including process of care, outcomes of care, and patient satisfaction.

Study Design, Data Sources and Methods

In September 2010, CareChex released three (3) significant research studies relating to the quality of U.S. healthcare and patient satisfaction findings by state and major metropolitan area.

These and all research projects conducted by CareChex were designed as longitudinal studies spanning the most recent three (3) years of federal fiscal year data using all Medicare inpatient discharges from the Center for Medicare and Medicaid Studies (CMS) Medicare Provider Assessment and Review (MedPAR) file as well as the Department of Health and Human Services (DHHS) Hospital Compare database. All CareChex studies utilized both public and proprietary methods validated by third‐party organizations for evaluating hospital quality performance.

These methods include process of care measures developed by The Joint Commission (TJC) for national accreditation of healthcare organizations, inpatient quality and patient safety measures developed by Stanford University under sub‐contract with the federal government's Agency for Health Research and Quality (AHRQ), patient satisfaction measures developed by CMS using a standardized national hospital survey, and proprietary outcome measures developed by The Delta Group for evaluating rates of hospital inpatient mortality, post‐surgical complications, and global patient safety events. For more information regarding the construction and validation of the aforementioned methods, please access the following web links:

Additionally, specific statistical methods used in each of the three (3) independent studies include statistical significance testing, distribution standardization, and correlation analysis.


Schwartz Communications
Douglas Russell, 781-684-0770
[email protected]
The Delta Group, Inc.
Dr. Thane Forthman, D.H.A.
Managing Principal
[email protected]