What most hospital ranking systems are missing

Hospitals have been nationally ranked by popular media sources such as U.S. World News & Report for decades, but the quality measures used to determine these lists may be missing one key domain––health equity.

That’s according to experts from U.S. News & World Report, who recently published an opinion in JAMA arguing that hospital rankings need to start considering equity as a key quality measure. Other domains that are typically considered in national rankings include safety, efficacy, efficiency, timeliness and patient-centeredness.

U.S. News & World Report published new and updated health equity measures for hospitals featured in its rankings this July, developed under a framework comprising 3 domains: access, outcomes, and social determinants of health. The outlet says that, possibly by 2023, a composite index will combine these into a summary score. The composite index may serve as a standalone ranking or may be incorporated into existing U.S. News & World Report rankings.

Measurements of health equity are important because two hospitals in the same community could have vastly different demographic characteristics, and the extent to which hospitals’ own policies and practices play a role in causing or perpetuating segregation of patient choice should be investigated.

U.S. News & World Report analysts evaluated the match up between each hospital’s Medicare beneficiary population in its surrounding community with its patients with Medicare undergoing typically elective procedures. Previous studies have shown Black patients were more likely to experience higher readmission rates compared with White patients after certain procedures, such as coronary artery bypass graft surgery or lumbar spinal fusion surgery. 

“Limitations notwithstanding, public reporting of these measures may bring awareness and resources to areas where improvements can be made to achieve health equity,” wrote first author Tavia Binger, MSPH, health data analyst at U.S. News & World Report, et al. “Like other elements of US News & World Report’s public reporting program, the health equity measure portfolio could be expected to expand and evolve.”

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

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