Reputation and the Best Hospital Rankings: What Does It Really Mean?

Cua, Santino; Moffatt-Bruce, Susan D.; White, Susan

doi:10.1177/1062860617691843

Cited by 34 publications

(33 citation statements)

References 15 publications

(25 reference statements)

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“…Specifically, hospital reputation accounts for 27.5% of the process domain's weight, which relies entirely on physician survey data regarding the reputation of the hospital. As such, the USNWR ranking position can be marked affected by this metric without any consideration of clinical outcomes . Indeed, Cua et al noted that the ranking of the top 50 hospitals in the 2015 Best Hospital rankings for cancer, cardiology, gastroenterology, neurology, and orthopedics was more influenced by reputation on the total U.S. News score than objective metrics.…”

Section: Discussionmentioning

confidence: 99%

“…As such, the USNWR ranking position can be marked affected by this metric without any consideration of clinical outcomes . Indeed, Cua et al noted that the ranking of the top 50 hospitals in the 2015 Best Hospital rankings for cancer, cardiology, gastroenterology, neurology, and orthopedics was more influenced by reputation on the total U.S. News score than objective metrics. Collectively, these data have important potential implications as the relative position within the top 50 – while frequently used in advertising campaigns – had little impact on actual patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The U.S. News and World Report (USNWR) best hospital rankings is one of the most utilized hospital rankings in the United States . The USNWR rankings are divided by specialty and the final ranking of a hospital takes into consideration objective structure, process, outcomes, and patient safety measures, in addition to subjective hospital reputation . The USNWR seeks to measure hospital quality of care for high acuity patients, so as to inform the public which hospital might better suit their needs.…”

Section: Introductionmentioning

confidence: 99%

“…As such, the USNWR ranking position can be marked affected by this metric without any consideration of clinical outcomes [21][22][23]. Indeed, Cua et al 2 noted that the ranking of the top 50 hospitals in the 2015 Best Hospital rankings for cancer, cardiology, gastroenterology, neurology, and orthopedics was more influenced by reputation on the total U.S. News score than objective metrics.…”

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confidence: 99%

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U.S. News and World Report hospital ranking and surgical outcomes among patients undergoing surgery for cancer

Mehta

Merath

Farooq

et al. 2019

Journal of Surgical Oncology

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Background Despite the popularity of the U.S. News and World Report (USNWR) hospital rankings among the general public, the relationship between hospital rankings and actual patient outcomes for major cancers remains poorly investigated. Methods Medicare Inpatient Standard Analytic Files were queried from 2013–2015 to assess the relationship of postoperative outcomes and Medicare expenditures among patients undergoing surgery for colorectal, lung, esophageal, pancreatic, and liver cancer at hospitals ranked in the top‐50 USNWR vs hospitals ranked below 50. Results Among 94 599 patients, 13 217 vs 81 382 patients underwent surgery at a top‐50 hospital versus a non‐top 50 ranked hospital. Other than among patients who underwent colorectal surgery, the odds of postoperative complications were lower at top ranked vs non‐top ranked hospitals (colorectal: OR, 1.46, 95% CI, 1.28‐1.65; lung: OR, 0.73, 95% CI, 0.61‐0.87; esophagus: OR, 0.70, 95% CI, 0.52‐0.94; pancreas: OR, 0.81, 95% CI, 0.70‐0.94; liver: OR, 0.85, 95% CI, 0.69‐1.04). Moreover, the odds of 90‐day mortality were lower at top ranked hospitals vs non‐top ranked hospitals (colorectal: OR, 0.59, 95% CI, 0.48‐74; lung: OR, 0.66, 95% CI, 0.53‐0.82; esophagus: OR, 0.56, 95% CI, 0.40‐0.80; pancreas: OR, 0.51, 95% CI, 0.40‐0.65; liver: OR, 0.61, 95% CI, 0.44‐0.84). Outcomes were comparable among hospitals within the top‐50 rank. Conclusion Mortality rates were lower at hospitals in the top‐50 USNWR versus non‐top ranked, yet hospitals within the top‐50 USNWR rankings had comparable outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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U.S. News and World Report hospital ranking and surgical outcomes among patients undergoing surgery for cancer

Mehta

Merath

Farooq

et al. 2019

Journal of Surgical Oncology

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“…However, there has been some criticism of the utility of Doximity, as given rankings are based on reputation as defined by survey-eligible physicians or based on research productivity [6,7]. Furthermore, the quality of residency programs can be expressed in many outcome measurements and a variety of factors may be required to fully capture program quality.…”

Section: Introductionmentioning

confidence: 99%

Is it a match? a novel method of evaluating medical school success

Chang

Nagler

Rudd

et al. 2018

Medical Education Online

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Background: Medical education program evaluation allows for curricular improvements to both Undergraduate (UME) and Graduate Medical Education (GME). UME programs are left with little more than match rates and self-report to evaluate success of graduates in The Match.Objective: This manuscript shares a novel method of program evaluation through a systematic assessment of Match outcomes.Design: Surveys were developed and distributed to Program Training Directors (PTDs) at our institution to classify residency programs into which our UME graduates matched using an ordinal response scale and open-ended responses. Outcomes-based measures for UME graduates were collected and analyzed. The relationship between PTD survey data and UME graduates’ outcomes were explored. Open-ended response data were qualitatively analyzed using iterative cycles of coding and identifying themes.Results: The PTD survey response rate was 100%. 71% of our graduates matched to programs ranked as ‘elite’ (36%) or ‘top’ (35%) tier. The mean total number of ‘Honors’ grades achieved by UME graduates was 2.6. Data showed that graduates entering elite and top GME programs did not consistently earn Honors in their associated clerkships. A positive correlation was identified between USMLE Step 1 score, number of honors, and residency program rankings for a majority of the programs. Qualitative analysis identified research, faculty, and clinical exposure as necessary characteristics of ‘elite’ programs:. Factors considered by PTDs in the rating of programs included reputation, faculty, research, national presence and quality of graduates.Conclusions: This study describes a novel outcomes-based method of evaluating the success of UME programs. Results provided useful feedback about the quality of our UME program and its ability to produce graduates who match in highly-regarded GME programs. The findings from this study can benefit Clerkship Directors, Student Affairs and Curriculam Deans, and residency PTDs as they help students determine their competitiveness forspecialties and specific residency programs.

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Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery

et al. 2019

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Importance Leading cancer hospitals have increasingly shared their brands with other hospitals through growing networks of affiliations. However, the brand of top-ranked cancer hospitals may evoke distinct reputations for safety and quality that do not extend to all hospitals within these networks. Objective To assess perioperative mortality of Medicare beneficiaries after complex cancer surgery across hospitals participating in networks with top-ranked cancer hospitals. Design, Setting, and Participants A cross-sectional study was performed of the Centers for Medicare & Medicaid Services 100% Medicare Provider and Analysis Review file from January 1, 2013, to December 31, 2016, for top-ranked cancer hospitals (as assessed by U.S. News and World Report ) and affiliated hospitals that share their brand. Participants were 29 228 Medicare beneficiaries older than 65 years who underwent complex cancer surgery (lobectomy, esophagectomy, gastrectomy, colectomy, and pancreaticoduodenectomy [Whipple procedure]) between January 1, 2013, and October 1, 2016. Exposures Undergoing complex cancer surgery at a top-ranked cancer hospital vs an affiliated hospital. Main Outcomes and Measures Risk-adjusted 90-day mortality estimated using hierarchical logistic regression and comparison of the relative safety of hospitals within each cancer network estimated using standardized mortality ratios. Results A total of 17 300 patients (59.2%; 8612 women and 8688 men; mean [SD] age, 74.7 [6.2] years) underwent complex cancer surgery at 59 top-ranked hospitals and 11 928 patients (40.8%; 6287 women and 5641 men; mean [SD] age, 76.2 [6.9] years) underwent complex cancer surgery at 343 affiliated hospitals. Overall, surgery performed at affiliated hospitals was associated with higher 90-day mortality (odds ratio, 1.40; 95% CI, 1.23-1.59; P < .001), with odds ratios that ranged from 1.32 (95% CI, 1.12-1.56; P = .001) for colectomy to 2.04 (95% CI, 1.41-2.95; P < .001) for gastrectomy. When the relative safety of each top-ranked cancer hospital was compared with its collective affiliates, the top-ranked hospital was safer than the affiliates in 41 of 49 studied networks (83.7%; 95% CI, 73.1%-93.3%). Conclusions and Relevance The likelihood of surviving complex cancer surgery appears to be greater at top-ranked cancer hospitals compared with the affiliated hospitals that share their brand. Further investigation of performance across trusted cancer networks could enhance informed decision making for complex cancer care.

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Reputation and the Best Hospital Rankings: What Does It Really Mean?

Cited by 34 publications

References 15 publications

U.S. News and World Report hospital ranking and surgical outcomes among patients undergoing surgery for cancer

U.S. News and World Report hospital ranking and surgical outcomes among patients undergoing surgery for cancer

Is it a match? a novel method of evaluating medical school success

Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery

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