How good is your hospital? Here’s how to find out

After years of planning, the federal government has finally published its first set of hospital quality ratings. You can see how many stars, from one to five, your hospital earned. (To access the ratings and search for a hospital, click here.)

The ratings use a complex formula to determine quality, and the results are controversial. Many top teaching hospitals in the Philadelphia area didn't do very well. The Hospital of the University of Pennsylvania earned only three stars, while Thomas Jefferson University Hospital and Temple University Hospital earned only two. Some smaller community hospitals did better. Main Line Hospital Paoli earned a full five stars, while Main Line Hospital Lankenau, Main Line Hospital Bryn Mawr, and Riddle Memorial Hospital earned four.

The formula for assigning stars includes measures of clinical outcomes and patient experience. It is possible that teaching hospitals have poorer outcomes because they tend to treat sicker patients and their patients may report worse experiences because the hospitals are larger.

After checking the government ratings, you can also consult the U.S. News & World Report list of Best Hospitals, which was released this week for 2016. This is one you're likely to see heavily advertised by hospitals that scored well.
It uses a different methodology that considers patient volume and hospital staffing and has produced different results, with major teaching hospitals coming out on top. Penn came out best in Philadelphia and ninth-best nationally. Jefferson was number two in the region, followed by Christiana Care Health System.
U.S. News examined 12 specialties in detail, and the rankings consider the results for each. Patients can see how well their hospital performed for specific procedures and conditions. Here are the ratings for Philadelphia.

To round out your research, additional ratings are available from a few other sources, including Healthgrades, which focuses on clinical outcomes, Consumer Reports, which focuses on safety, and the Leapfrog Group, which focuses on measures of overall quality.

The government ratings add an important new source of information to the mix. However, as this is the first set of ratings it has published, watch for changes in future results, as the methodology is refined.
It's not surprising that the different ratings come up with such variable results, because they each emphasize different factors. Critics have noted that some hospitals are able to "game" some surveys that focus on process measures, but not outcomes.

It all can add up to considerable confusion for patients. But even when the surveys conflict, the ratings can still serve as a guide for asking questions when choosing a hospital. Ask why your hospital didn't do well in the areas where it received low marks. You should get a specific answer and an explanation of how the hospital plans to improve.
Also keep in mind that the ratings look at how hospitals do in specific services. You want to look for the hospital that is outstanding for the procedure you need.
It is encouraging that the government is giving patients another tool for cutting through the competing claims in deciding which hospital is best for them. Consumers can already do this for most goods and services. It is time to be able to do it for health care.

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