National study raises concern about U.S. News & World Report's hospital rankings

CLEVELAND - A MetroHealth/Case physician says his research shows US News & World Report's hospital rankings are a poor indicator of hospital quality.

Dr. Ashwini Sehgal's findings are published in the April 20 issue of the Annals of Internal Medicine.

He said he did the analysis to find out what role reputation played in the magazine's hospital rankings.

Dr. Sehgal's research suggests that the rankings don't reflect quality of care provided. He said the main problem is that reputation is "totally subjective."

Of the top 50 hospitals, he said 75 percent of the ranking is based on reputation, not objective quality of care.

The top five in each specialty are chosen by reputation nearly 100 percent of the time.

"If we did the same thing with professional football teams, we would decide let's just give the Super Bowl trophy to the Dallas Cowboys, without making them play any games because they have a national reputation for being a good team," he said.

Avery Comarow, the magazine's Health Rankings Editor e-mailed us this response:

Ask yourself: Shouldn't an elderly patient who needs heart surgery go to a hospital that successfully performs many heart operations on older people, not only on patients who are younger and relatively healthy? Shouldn't someone with an breathing problem that is hard to diagnose be referred to a hospital where lung specialists see the toughest cases? That is why we make a hospital's reputation with specialists part of the America's Best Hospitals rankings. The 600 physicians surveyed (not 250, as the study implies) are asked to name up to five hospitals that in their opinion "provide the best care for patients with the most serious or difficult medical problems." We also ask them not to consider location or expense.

What the physicians we survey tell us, through their responses, is that they would want their patients who need high levels of care to be treated only to certain medical centers. The survey is a form of medical "peer review." It is subjective, as all surveys are. But the results do not change dramatically from year to year, which we think means that doctors generally agree on the hospitals that are the best in their specialty.

Cleveland-area hospitals were not quick to dismiss or judge the research, but the Cleveland Clinic's Chief Medical Operations Officer, Dr. Marc Harrison supported the criterion of reputation.

"Reputations don't just happen, hopefully, good or bad, they're earned," he said.

The Cleveland Clinic's Heart Center is world renowned for its number one ranking in the magazine year after year and also receives accolades in other specialties.

University Hospitals and Rainbow Babies and Children's Hospital also advertises its US News rankings to attract patients. The hospital released this statement about the study:

We acknowledge the value of US News & World Report’s rankings in helping patients assess hospital quality. University Hospitals Case Medical Center and Rainbow Babies & Children’s Hospital have been highly ranked in many specialties. We strongly believe, however, that the true measure of a health care institution is based on solid quality measures and outcomes such as Medicare, Thomson Reuters and Leapfrog who utilize scientific based evidence to indicate quality.

Dr. Sehgal recommends patients should keep four things in mind when choosing a hospital.

1.) Get information from multiple sources

2.) Remember the quality of care is most important

3.) Choose hospitals with the most experience in your area of need

4.) Visit the hospitals and don't be afraid to ask questions

The Cleveland Clinic also recommends this website for information on their performance.

If you'd like to read the entire study, you can find it on the Annals of Internal Medicine's website when it posts the April 20 issue.