Highlights
- •Hospital rankings are often used to guide a patient’s decision on which hospital may be best equipped to manage their care.
- •Hospital’s honor roll position was not associated with differences in patient outcomes following surgical intervention.
- •Caution should be used when attempting to associate rank-position and clinical outcomes or quality of care.
Abstract
Background
Hospital ranking systems are often used by individuals to inform choice around which
healthcare system may be best equipped to manage their care.
Methods
The 2013–2015 100% Medicare Inpatient and Outpatient SAFs was utilized to identify
patients who underwent surgery (AAA repair, CABG, THA, TKA and lung resection) at
one of the top-20 hospitals ranked by USNWR.
Results
On multivariable linear regression analysis, after controlling for clinical and hospital
level factors, rank position among the top 20 USNWR hospitals was not associated with
the proportion of patients who experienced a complication (β = 0.167), failure-to-rescue
(β = 0.277), 90-day readmission (β = 0.186) and 90-day mortality (β = 0.033)(all p > 0.05).
Similar trends were observed among each surgical procedure type, as well as even among
all top 50 USNWR ranked hospitals (all p > 0.05).
Conclusion
Rank position among hospitals within the USNWR "honor roll" was not associated with
differences in patient outcomes following surgical intervention. Patients and hospitals
need to exercise caution when placing weight on rank-position among hospitals as a
means to discriminate clinical outcomes and quality of actual patient care.
Keywords
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References
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Article info
Publication history
Published online: November 26, 2019
Accepted:
November 20,
2019
Received:
November 17,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
