‘TOP’ HOSPITALS: More Relevant to HMOs than to Patients?
Hospitals making the annual "100 Top Hospitals" ranking produced by HCIA Inc. and William M. Mercer Inc. (not to be confused with the annual U.S. News & World Report list, which hits news stands today) do not necessarily provide higher-quality care than their lower-ranked peers, according to a study published today in Health Affairs (release, 7/12). An analysis of nearly 150,000 Medicare patients with acute myocardial infarction found that "while the ranked hospitals showed significantly shorter lengths of stay, lower in- hospital costs and lower rates of readmission within 180 days than for AMI patients treated in unranked hospitals, there was no significant difference in quality of care as shown by treatment therapies and their 30-day mortality rates." The report noted that "the rankings would be useful for managed care providers looking for facilities that provide equivalent quality care at a lower cost," but could prove misleading to consumers, as hospitals that make the list view their inclusion a "public relations bonanza" and market it heavily. Lead investigator Jersey Chen noted that although the study identified no sacrifice of care among the top 100 hospitals, "[t]op-ranked hospitals are mistakenly marketing this report as evidence of their superior quality and disseminating it widely to the media." HCIA Senior Vice President Jean Chenoweth said, "It's never been proved that excellence in management means excellence in clinical care, but I expect they go hand in hand" (Fawcett, Wall Street Journal, 7/12). Dr. Paul Berger of Mercer noted, "It was intended for them to help them prioritize their initiatives. We are in the consulting business. We really are trying to help hospitals look at their performance" (Julien, Hartford Courant, 7/12). In contrast to the HCIA and William M. Mercer ranking, U.S. News & World Report's "America's Best Hospitals," released today, ranks hospitals according to patient care and reputation. The two lists have only two hospitals, Brigham and Women's Hospital in Boston and Ohio's Cleveland Clinic, in common (Wall Street Journal, 7/12).
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