CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

April 29th, 2010

Do Hospital Rankings Have Any Good Use?

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Hospital rankings now play an increasingly important role in the healthcare marketplace. In no field is the power of these rankings felt more than in cardiology. Ashwini Sehgal, the first author of a recent report in Annals of Internal Medicine, “The Role of Reputation in U.S. News & World Report‘s Rankings of the Top 50 American Hospitals,” agreed to answer questions from our editors about the rankings. We encourage you to add your own questions in the comments section.

We see a lot of ads for the U.S. News & World Report‘s top heart hospitals: Do the rankings convey any useful information?

Among the top ranked 50 hospitals in each specialty, the specific rankings have little correlation with objective measures of quality of care.  I think consumers should pay more attention to objective measures of quality of care rather than rankings that are determined primarily by subjective reputation.

You showed that the rankings were essentially the same if they only included reputation. How different was the ranking if it was done with everything but reputation? That is, is there variation in everything else measured, and is that correlated with reputation?

There is a modest amount of variation in the objective measures of quality of care — see Table 2 in the article.  However, the variation in reputation is much greater and, as a result, reputation dwarfs the objective measures in determining rankings of the top 50 hospitals.

Do you think there is any value in reputation?

I’m not sure what reputation is a measure of.  Well-known training programs?  Publicized research programs?  Marketing?  High U.S. News rankings in previous years?  It would be worth studying what factors physicians use in determining reputation.

Categories: General, Prevention


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