How and Why: A 2013-14 Best Children's Hospitals FAQ

The facts and methodology behind our current pediatric rankings.

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Why should anyone care about the Best Children's Hospitals rankings? When should they be consulted? How are they created? The following FAQ addresses these and other Best Children's Hospitals questions.

FOR PARENTS AND OTHER CAREGIVERS

Why does U.S. News rank children's hospitals?

Few children face life-threatening or rare conditions or have to go through complicated operations. But some do, and those kids need expertise that most hospitals, where nearly all inpatients are adults, simply cannot provide. Even hospitals with busy pediatric departments are not necessarily equipped to deal with a newborn that weighs a few pounds or has a defective heart. Relatively few hospitals see sizable numbers of children with a wide range of cancers or respiratory illnesses or kidney conditions. And among hospitals that do treat large volumes of children with serious health problems, the reality, as it is for adult patients, is that some places are better than others. That is why U.S. News in 2007 began using data to rank medical centers on their ability to help children who most need it.

How are the rankings organized and updated?

The rankings list the 50 best-performing hospitals in 10 pediatric specialties. They're updated annually in June. In addition, the Best Children's Hospitals Honor Roll recognizes hospitals that ranked very high in at least three specialties. (See "What is the significance of the Honor Roll?" below for more detail.)

What are the 10 specialties?

Cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal (GI) surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology.

Are the highest-ranked hospitals in a specialty the best choice for all families?

No. In each set of specialty rankings, hospitals are judged by their performance across a wide range of conditions and procedures in that specialty. In the pulmonology rankings, to take that specialty as an example, one hospital might rank lower than another but outperform it in treating children with a particular condition such as cystic fibrosis.

So the rankings are just a starting point.

Yes. We understand that families also have to consider the stress and expense of traveling to another city with a sick child, as well as the willingness of an insurer to pay for care at a hospital outside its network.

How many hospitals were evaluated for these rankings?

For the 2013-14 rankings, U.S. News requested medical data and other information from 179 facilities; 110 turned in enough data to be evaluated; 87 were ranked in at least one specialty.

There's an awful lot of information on usnews.com about each of the ranked hospitals. What should I focus on?

All of the elements play a role in determining how well a hospital treats children in that specialty. Hospital reputation, based on a survey of pediatric specialists and subspecialists in each of the 10 ranked specialties, gets heavy weight (25 percent of a hospital's score) because in the rarefied world of very sick kids, we consider the opinions of these physicians informed and important. Many of the non-reputational factors displayed on usnews.com relate to survival, infections, surgical complications and other medical outcomes that together make up one-third of the score. Still other factors evaluate a hospital's commitment to safety, excellence and respect for patients. A few examples of these might include a count of specific ways in which a hospital minimizes infections, the number of fellowship programs offered and the extent to which families are involved in a child's care.

Each family has to decide how much emphasis to put on the various categories of information.

FOR MEDIA AND PROFESSIONALS

What do the rankings mean? Who are they for?

They are a tool for families and others in search of an unusually high caliber of care because of a child's challenging medical needs.

How are the rankings organized?

Into 10 specialty areas, as listed above. The 50 top-scoring hospitals are displayed in each specialty. Many of the measures that went into hospital scores, such as reputation, are common to all of the specialties, while others, such as accreditation for bone marrow transplant, are specialty-specific.