Nearly 40% of consumers surveyed last year said they use hospital ratings to choose a health care facility, but there's little agreement between the lists, raising questions about their value.
Consumers pore over reviews and ratings of everything from cars to washing machines, but it's doctor and hospital rankings that may be the most confusing and controversial. At least 15 different groups rank health care organizations, but no two judge them the same way, which leads to widely divergent results, says Brent James, a medical doctor who is chief quality officer at Intermountain Healthcare in Salt Lake City.
"On some of those, we look pretty bad and on others we're golden; the best in the nation," James says. "All of us publish newspaper ads that say we're the best on one or another."
U.S. News & World Report, which has been ranking hospitals for 20 years, met with dozens of hospital leaders Thursday to discuss ways to improve its own list, which some doctors who head hospitals say is the best. Still, participants grappled with issues including how and whether to rate a hospital's "reputation," if a hospital's lower-income patient population should be factored into the rankings and whether a hospital's more advanced technology or even its ranking really relates to what a patient will actually experience there.
What's a consumer to make of it all?
The survey of consumers' views on hospitals, by the Robert Wood Johnson Foundation and Harvard School of Public Health, found Americans evenly split on whether they think there are big or small differences in the quality of care among their local hospitals. And while 38% said they rely on rankings to choose a hospital, 57% said they'd more likely go to a hospital they were familiar with than they would go to one because it had a high ranking.
The U.S. News rankings are "as comprehensive a picture as possible of the quality of hospitals in this country," says Peter Slavin, an internal medicine doctor and president of Massachusetts General Hospital, which ranked first.
When Consumer Reports came out with its best hospitals list in July, however, Mass. General was in about "the middle of the pack," in his own state, much less the country, says Slavin. Consumer Reports ranks based only on safety, which some argue is too narrow a focus.
"Different people care about different things," says Slavin. "Some are focused on safety, others on service and convenience, or are looking for the most innovative places where they are helping to write the textbooks â?? not just read them."
Safety in a hospital generally refers to avoiding harm caused by the doctor or facility, such as a result of infection or post-operative complications.
While the magazine ultimately gave NYC hospitals, overall, low marks, Consumer Reports did change its methodology to reflect some suggestions it received from hospitals in the city, says John Santa, an internal medicine doctor who heads the magazine's health ratings center. Its ratings, started in 2010, have also been expanded to include a composite safety score and several new elements, such as the likelihood a hospital would expose patients to the radiation in two CAT scans rather than just one.
Other discrepancies between lists: