Ranking hospitals and providers is a complex procedure with serious pitfalls.
Four popular hospital rating websites vary widely about which facilities are the best and which are the worst, according to a study published on Monday in Health Affairs, Modern Healthcare reports (Rice, Modern Healthcare, 3/2).
Study Details
The researchers evaluated four rating sites that rank or grade hospitals across the country:
Findings
The researchers found that no hospital earned top ratings from all of the sites. Out of 844 hospitals that received a high rating from one site, just 10% earned top marks from another site. Meanwhile, 27 hospitals that received top ratings from one site received low marks from another.
The researchers noted that the variation in definitions of quality could confuse consumers, who increasingly are comparison shopping for medical services. In addition, the researchers said the different definitions could complicate hospitals' efforts to focus improvements.
Reaction
UCLA Health System Chief Medical Officer and Chief Quality Officer Robert Cherry said, "Unfortunately, we can attest as an institution that has come out on both sides of these 'report cards' that there is a lack of clarity, consistency and understanding between the various methodologies and in some cases [this] may be misleading the public" (Beck, Wall Street Journal, 3/2).
The ratings services said that their systems serve different purposes that consumers understand. "They're not measuring the same thing," Healthgrades Chief Strategy Officer Evan Marks said (New York Times, 3/2).
For example, Leapfrog uses a letter grade to reflect how well a hospital keeps patients from "preventable harm and medical errors," while Healthgrades compiles a list of top hospitals using mortality and complication rate data.
Doris Peter, director of Consumer Reports' health-ratings center, said the findings are "not a surprise to us -- we're rating different aspects of hospital quality," adding, "we are all hampered by needing better data" (Wall Street Journal, 3/2).
The researchers said the ratings are useful, but study author Matthew Austin, an assistant professor at the Johns Hopkins University School of Medicine, emphasized that consumers needed to understand the ratings systems' different focuses and their limitations. He added it is necessary for the systems to increase efforts to communicate their ratings' goals. Austin also said that the challenge for a ratings system is finding a grade or category that is easily understood but still represents an institution's nuances (New York Times, 3/2).
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