U.S. News & World Report's best hospital list may mislead consumers about the hospitals' quality of care, according to a Comparion Medical Analytics study that points out what it thinks are flaws in the criteria.
Comparion argues that there are flaws in the rankings' criteria, mainly based on reputation, survival rates and patient safety indicators across major academic medical centers.
Thane Forthman, president and CEO of Comparion, takes issue with three "shortcomings" in the study: "The small number of quality indicators used to assess 75 percent of the specialties, the use of subjective, reputation-based data to rank the other 25 percent of specialties, and assumption that comparing academic medical centers to less than 10 percent of U.S. hospitals nationally provides reliable information regarding their quality of care."
Comparion based its research on its own pending composite quality scoring methodology--its evaluation looks at care measures, outcome measures and patient satisfaction scores. Forthman says its study indicates that when objective quality measures are used, the U.S. News rankings have no correlation to his company's quality rankings.
U.S. News' 1-5 rankings included Massachusetts General Hospital, Johns Hopkins, Mayo Clinic, Cleveland Clinic and UCLA. Differing greatly, Comparion's rankings had Indiana University, Mayo Clinic, Duke University, University of Michigan and Northwestern rounding out their top five.
Forthman noted in the announcement, "In order to provide reliable comparisons among hospitals, the study removed unusually difficult cases (i.e., outliers) and adjusted for differences in patient risk factors (i.e., clinical and demographic characteristics). Otherwise, differences in quality performance could be attributed to differences in the complexity of cases treated. Additionally, all performance indicators were tested for statistical significance so a hospital's relative rank and percentile score could be accurately determined."
Comparion concludes that people shouldn't necessarily assume the academic medical centers ranked by U.S. News and World Report provide the best care. The group cites both FierceHealthcare and Becker's Hospital Review research from November 2010 in arguing that hospitals not affiliated with universities perform equal or better care.
Another ranking the industry can turn to features new hospital safety report cards that show incremental progress on keeping patients safe from infections, injuries and errors, released yesterday by Leapfrog.
To learn more:
- read the Comparion announcement
Quality of care low at notable university hospitals
Hospitals making minimal but sustained headway on patient safety
Plethora of hospital ratings confusing, 'flawed'
Texas County Memorial Hospital, Leapfrog Group clash over safety score data
When it comes to quality improvement, hospitals just can't win for losing