From the Journals

Tested: U.S. News & World Report hospital rankings



Do the U.S. News & World Report “Best Hospitals” rankings stand up to scrutiny? When it comes to cardiovascular care, the answer is yes … and no.

Do better rankings mean better cardiovascular care?

The hospitals that were ranked as the Top 50 for “cardiology and heart surgery” had lower 30-day mortality for acute MI, heart failure, and coronary artery bypass grafting (CABG), compared with 3,502 nonranked hospitals, when David E. Wang, MD, and his associates at Brigham and Women’s Hospital in Boston looked at the Centers for Medicare & Medicaid Services Hospital Compare website.

The Top 50 hospitals also had higher patient satisfaction scores (3.9 vs. 3.3 on a scale of 1-5), based on the CMS Hospital Consumer Assessment of Healthcare Providers and Systems star ratings, the investigators said Nov. 28 in JAMA Cardiology.

A clear endorsement for the rankings, it would seem, but another run through the Hospital Compare data – this time for 30-day readmission rates – managed to muddy things up. The nonranked hospitals equaled the ranked hospitals in readmission rates for acute MI and CABG and were actually lower for heart failure, Dr. Wang and his associates said.

“In recent years, financial incentives for hospitals to reduce readmissions … have been 10- to 15-fold greater than incentives to improve mortality rates and have resulted in significant declines in cardiovascular readmissions. Our finding that top-ranked hospitals have lower mortality rates than nonranked hospitals but have generally similar readmission rates might reflect these incentives,” they wrote.

SOURCE: Wang DE et al. JAMA Cardiol. 2018 Nov 28. doi: 10.1001/jamacardio.2018.3951.


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