Public Ranking Of Healthcare Providers Is Good, As Long As We Get It Right (Part 1)

In this era of consumerism I am all for the public having access to quality, safety, satisfaction and cost information about their hospital and physician. But along with that comes an obligation to get the information right. Not just reporting accurate data but also interpreting it correctly. Certain organizations have emerged as experts at rating hospitals and people tend to believe what they say. Is the hospital Joint Commission or HFAP accredited? How many stars does HealthGrades.com give each of its major services? Are they on the Thomson Reuters Top 100 Hospital List? How does it rank under Medicare for its Core Measures of Quality and HCAHPS scores for patient satisfaction? What is it's Press Ganey percentile ranking?

The organizations I have just mentioned use very objective criteria to assess hospital performance. It could be argued that they don't necessarily look at the factors that are the most important, but at least their conclusions are based on data and objectively compare one hospital with another. But these aren't the only measures out there.

Many consumers look with great interest at the highly touted "Best Hospitals" list published every year by U S News & World Reports. A recent study in the Annals of Internal Medicine has found that this list is determined by subjective reputation enjoyed from specialist physicians and not from any objective measures of quality and safety. To generate the list, the magazine asks specialists around the country to list the top five hospitals in their field that they would use for patients with very serious issues. This isn't necessarily a bad indicator, but the follow up study in Annals showed inconsistent correlation between objective measures of quality and the top 50 hospitals listed by U S News. It also doesn't consider that these hospitals may be the best for very serious and complex conditions, but may not provide the best care for far less serious issues that still require hospitalization.

More on this tomorrow.

Mark Brodeur