Not long ago, a large up-and-coming hospital hired a friend of Expertscape as the chief of its Gastroenterology Division. The hospital executives assigned him just one mission: improve the division’s standing in the annual US News & World Report rankings.

You might react to this story with horror, approval, or cynical resignation. Is it not horrifying that a hospital cares more about an advertising victory than the humanitarian values that hospitals traditionally hold dear? Or is it a triumph of rational management, in which hospital leaders are driven to optimize a set of quantifiable characteristics said to benefit patient care? It may be reassuring – or unsettling – to know that research supports both views [1] [2].

No matter your perspective, the unavoidable fact is that hospital executives are increasingly adopting goals that lead to success in rankings, making it only a small exaggeration to say that hospitals are becoming ranking engines. Hospitals touch all of us (eventually), so whether you participate in the healthcare system as a patient or as a professional, you will be well served to understand the strengths and weakness of healthcare rankings.

Why We’re Here

Expertscape is therefore starting a series of blog posts that will analyze the strengths, weaknesses, and idiosyncrasies of various hospital and physician ranking systems. Most of our material will derive from research published in the medical literature, of which there is no shortage [3]. We are excited to share the insights of many smart researchers with you. But because this is a blog, and not an academic journal, our review won’t cover all corners. We are, however, a ranking system, too, so we won’t hesitate to discuss our strengths and weaknesses where appropriate.

Beyond patients and professionals, we think managers and marketers will be interested as well, given the significant cost of some of these systems [4].

The next post will start the series by discussing the simple and important fact that it does matter where you go for healthcare … which shows that cynical resignation could actually be hazardous to your health.

REFERENCES

[1] Rothberg2008 notes: “Public reporting has the potential to be a powerful agent for quality improvement. … Nevertheless, the existence of multiple and often conflicting reports can only further complicate the relationship between public reporting and consumer choice.” His references 3 and 12 discuss managing to the characteristics // Choosing The Best Hospital: The Limitations Of Public Quality Reporting // Health Affairs, 27, no.6 (2008):1680-1687 // PubMed // DOI

[2] Souba2008 tells a story of a hospital that played the rankings game and lost sight of its fundamental mission. // Rankings // Journal of Surgical Research. Volume 148, 109–113 (2008). // PubMed // DOI

[3] Philbert2009 found 187 studies published from 1975 to 2009 relevant to quality indicators in USNWR rankings. So in our blog series we’re going to mention only what catches our eye. At least we’re not limited to tweet length! // Can Hospital Rankings Measure Clinical and Educational Quality? // Academic Medicine: February 2009 - Volume 84 - Issue 2 - pp. 177-184. // PubMed // DOI – free full text

[4] Williams2014 says it cost one hospital $42K per year to use USNews branding. // How much does using the U.S. News “Best Hospitals” branding cost providers? // healthcaredrive.com // Website