A scoring system that counts patient mortality rates as long as 180 days after discharge as well as dozens of complications from common hospital procedures shows 262 hospitals as the best in the country, out of about 1,500 eligible for consideration.
That's according to the 2013 Distinguished Hospitals for Clinical Excellence report from Healthgrades, which says that if all hospitals in the nation had mortality rates as low as in these 262 hospitals between 2009 and 2011, 164,414 lives would be saved. That translates to 30.9% fewer deaths.
The report gives five stars to those hospitals whose risk-adjusted mortality rates or complication rates from procedures in 27 lines of service—from abdominal aortic aneurysm repair to cardiac valve repair or replacement—were lower than other hospitals'.
See how 3 hospital rating systems stacked up in 2012 >>> |
"Consumers should use Healthgrades because of its detailed information," Evan Marks emphasizes. "For example, just because a particular hospital is among the 262, that doesn't mean you should go there. The first thing you need to ask is what you need as a patient, and are they doing a good job in that area. If I'm having a hip replacement and the hospital is not doing a good job in that, I don't want to go there. I want to go to the hospital that's got five stars in hip replacement."
Noticeably not on the list are some big name hospitals, such as the Cleveland Clinic, the Mayo Clinic's Methodist Hospital in Rochester, MN (although the Mayo's Saint Mary's Hospital in Rochester made the list), Johns Hopkins Medical Center in Baltimore, San Francisco General, Massachusetts General Hospital and Beth Israel Deaconess.
Among hospitals that made the list, however, are many relatively unknown facilities, some in small towns, such as Lodi Memorial Hospital in Lodi, CA and French Hospital in San Luis Obispo, CA; Allen Memorial Hospital in Waterloo, Iowa; Munroe Regional Medical Center in Ocala, FL; and Exeter Hospital in NH.
To be eligible for consideration, hospitals had to be evaluated in at least 19 of 27 service lines or procedures included in the Healthgrades formula.
Hospitals with poor performance receive one star, average performance nets three stars, and best performance five stars, says Marks, Healthgrades' executive vice president for informatics and strategy. Patient experience scores collected by the federal government on Hospital Compare are also included on the company's website.
The Healthgrades scoring system also uses 12 National Quality Forum endorsed safety measures. Each hospital is scored as worse than average, average, or better than average on such measures as pressure ulcers, collapsed lung after a procedure or surgery near the chest, catheter-associated bloodstream infections acquired in the hospital, hip fracture following surgery, or excessive bruising or bleeding as a result of a procedure.
"The data on Healthgrades is more granular and rich than the data on Hospital Compare," Marks says.
But consumers may be getting confused by the flurry of recent hospital rating systems, for example Leapfrog Group, Consumers Union, U.S. News & World Report, and Truven (formerly Thomson Reuters) all have released rankings of hospitals and in many cases with much different results for the same hospital.
Marks agrees.
"Yes, I believe they are confused, because some people want to go to U.S. News & World Report, or they want to go to a doctor they see in a magazine that has been listed as America's best orthopedic surgeon just because a bunch of other doctors think that's the case," Marks says.
"But that's not objective. And it's important for consumers to know what objective measures are, process measures, outcome measures, clinical quality and safety issues, to familiarize themselves with those to help inform their decision about which doctors and hospitals to utilize."
Asked what she thought of the Healthgrades ranking, a spokeswoman for the American Hospital Association said in an e-mail response, “Hospitals support providing information on quality and patient safety so that consumers can make an informed choice with their health care. Patients should use all available tools at their disposal to identify which health care decisions are right for them, such as talking with friends and family and consulting with doctors, nurses and other health care providers. The new Healthgrades rating system is merely one tool of many patients can use when making healthcare decisions."
Even Healthgrades has several types of products. For example, in addition to this 2013 edition of Healthgrades Distinguished Hospital Award for Clinical Excellence, Healthgrades also publishes annual lists of America's 50 Best Hospitals, and America's 100 Best Hospitals, which may include many of the 262 hospitals if they have been distinguished award winners consistently over the last two or four years.
This year, Healthgrades further divided its Distinguished Hospitals List by state. For example, Delaware and Montana, followed by Colorado, South Dakota, California, Iowa, Minnesota, Michigan, and New Hampshire have the largest percentage of hospitals nabbing the award.
Half the hospitals in Delaware and Montana and between 30% and 40% of hospitals in the other states, made the cut on based on 27 procedures or conditions, from abdominal aortic aneurysm repairs, to valve repair or replacement surgeries.
No hospital in Alabama, Alaska, the District of Columbia, Maine, Mississippi, Nevada, Rhode Island, Vermont, West Virginia, or Wyoming made the cut.