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Good, better, best? Evaluating hospital rankings

An article in the current issue of Archives of Surgery asks the question: Are the “top” hospitals really better than all the others? The answer is yes. . . and no.

The authors compared risk-adjusted mortality rates at highly-ranked hospitals by U.S. News & World Report and HealthGrades–two of the most popular commercially available hospital ratings web sites–with other U.S. hospitals for specific types of cancer surgery. The U.S. News top-rated hospitals out-performed others in all three surgical categories and the HealthGrades hospitals out-performed in one of the three; however, after accounting for surgical volume, only one category stood out: the U. S. News hospitals performing colon surgery.

According to the authors, “Our findings show that both ratings fail to identify equally wellperforming hospitals of similar volume. Mortality rates between best hospitals and hospitals of similar volume were not significantly different. . . While we found a mortality rate benefit to choosing these highly rated hospitals, patients may equally benefit from going to a similarly high-volume hospital closer to their home.”

For details on the study, see:

Osborne, N. H., and others. Evaluating popular media and Internet-based hospital quality ratings for cancer surgey.  Archives of Surgery. 146(5):600-604, May, 2011. http://archsurg.ama-assn.org/cgi/content/abstract/146/5/600


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