Best Hospitals May Not Match Other Top Hospital Ratings

Different perspectives produce different results. That's fine—there's room for more than 1 approach.

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The America's Best Hospitals rankings are hardly the only hospital report card around, as I've noted before. Another one is published annually by HealthGrades, for instance. That one came out yesterday, and I was curious, as always, to see how well our approach and HealthGrades' match up. I took a look at a HealthGrades category called "distinguished hospitals for clinical excellence," defined as the top 5 percent in terms of deaths and complications across 26 procedures and illnesses such as heart attack and knee replacement. There are 270 hospitals included.

I compared the "clinical excellence" roster with our Honor Roll of 19 hospitals that scored at or near the top in at least six of the 16 Best Hospitals specialty rankings (such as cancer, heart disease, and orthopedics). Of the 19 Honor Roll hospitals, just four (and only two of the top 10) appear on the HealthGrades list.

That's explainable by the two different approaches used. HealthGrades casts a wide net. The procedures it considers are done in relatively high volume, and it is therefore logical that many of the hospitals that do well by HealthGrades are community hospitals, where such procedures tend to be performed. Best Hospitals, on the other hand, evaluates hospitals only on their ability to perform difficult procedures and treat patients who present a challenge because of age, existing medical conditions, or other factors. If someone close to me needed routine, uncomplicated bypass surgery, I very well might check out local hospitals at the HealthGrades site along with Best Hospitals. But when the bar is set higher, I'd keep my eyes on our rankings. Everyday competence wouldn't be good enough.