America’s Best Hospitals’ list comes under fire
US News & World Report’s annual ranking of America’s best hospitals is methodologically flawed and potentially misleading, according to an analysis published in the April 7 Journal of the American Medical Association.
Researchers at the New York University Medical Center in New York City analyzed the 1995 edition of the rankings, concluding that the list basically amounts to an opinion survey based largely on the relative prestige of each institution.
The list ranks hospitals according to structure, process, and outcomes. The process category consists of a "reputation score," which is compiled based on a national poll of physicians. According to the researchers, institutions with high name-recognition tend to score higher. Thus, the survey becomes "little more than a feedback loop that allows fame to be perceived as quality," according to the researchers.
The JAMA article also criticizes the outcomes rankings for taking into account mortality rates originally published by the Health Care Financing Administration (HCFA). In 1994, HCFA determined that the rates were probably inaccurate and stopped publishing them.
The researchers called on managed care plans and other organizations to make more data available for accurate comparison of U.S. hospitals.
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