Researchers question rankings’ validity
Using reputation as measure of quality
When the influential US News & World Report published its seventh annual "America’s Best Hospitals," a list identifying outstanding hospitals in 16 medical specialties, an article in the Journal of the American Medical Association (JAMA) disputed the list’s accuracy, based on the fact that national data sources for components are limited.1 Because there are no national data on process of care, the report states, a reputation survey was used to measure this component of quality.
"One consequence of reliance on reputation," warn the JAMA authors, "is that a small group of prominent hospitals in each specialty receives such high scores that they automatically rise to the top of the rankings, regardless of structure or outcome score. Adequate surveillance and protection of quality in an era of managed care requires measurement systems beyond the scope of existing data and methods."
Reference
1. Green J, Wintfeld N, Krasner M, et al. In search of America’s best hospitals: The promise and reality of quality assessment. JAMA 1997; 277:1152-1155.
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