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Health Segment: Best Hospital Rankings

Avery Comarow, Health Rankings Editor at U-S News.

By Sam Baker, KERA Morning Edition Host

Dallas, TX –

You may have seen the billboards. Hospitals promoting their ranking in U-S News and World Report's annual evaluation of top American hospitals. They're ranked according to specialties - but also by region. In the Dallas-Fort Worth area, U.T. Southwestern, Baylor University Medical Center, and Parkland Hospital are in elite company. They all qualified as Best Hospitals, a standard met by fewer than three percent of all hospitals nationally, because of a high score in one or more of 16 specialties. 13 other hospitals in the metro area were one step down. They are what U.S. News calls "high performers." Avery Comarow, the Health Rankings Editor at U-S News, explained to KERA's Sam Baker what that designation means for consumers.

Avery Comarow: It means that judged by the same national standards as all hospitals are for the "Best Hospital" rankings, that hospital was in the top quartile, the top 25 percent. It's clearly a hospital that knows what it's doing in one or more specialties in which it's labeled high-performing.

Sam Baker: As I understand it, about 5000 hospitals were evaluated for this year's ranking. How did you go about doing that?

Comarow: There's a lot of data crunching involved. We used Medicare data to look at important numbers like surgical volume, mortality rates, and patient safety. We used the American Hospital Association for things that matter like whether a hospital has the kind of technology we think in different specialties are important to that specialty. We want to know if a hospital is what's called a "nurse magnet" hospital, meaning that it's very attractive to nurses, it's a good environment for them to work, and that makes it better for patients. And finally, in our 16 specialties, we survey a sample of specialists and ask them where they would send their sickest patients or their most difficult cases if they didn't have to think about geography or cost.

Sam: I would imagine when most people enter a hospital, it's at the directive of their primary physician, and whatever hospital they happened to be affiliated with, that's where the patient goes.

Comarow: Every year since 1990, I've made a couple of points to what you just said. One is that patients are not necessarily tied to the hospital your doctor recommends or refers you to. Even if a hospital isn't in your insurance provider's network. There's often a very good chance that the cost will be covered if your doctor makes a special case that you need to go to particular hospital. That's number one. Number two is what we want "Best Hospitals" to be is a first step on a journey that is fairly lengthy - one that will cause you ask a fair number of questions that you may not be used to asking, like: "How many of the procedure that I need have you done in the last year, and many of those were on people like me - my medical condition, roughly my age - and what were your outcomes?" People are not used to asking these questions. They are critical, critical questions.

Sam: So the basic point to all this is that we as health consumers need to be more proactive?

Comarow: And face the reality that we're talking about your life or your quality of life, and there will be homework involved in finding the place that can treat you most successfully.

Sam: Do the results give us an overall picture of the quality of health care in this country?

Comarow: There's been an interesting trend in "Best Hospitals". Back in the 1990s, the vast majority of hospitals in the rankings were teaching hospitals, and many of the teaching hospitals were academic medical centers that had their own medical schools. Over the years, a whole lot of health expertise has been trickling down to your average community hospital, and those hospitals are becoming more skilled at doing things that 10 or 20 years ago they would not have done. And as a result, we're seeing many more community hospitals - no teaching function at all - in the rankings. That means doctors doing what doctors should do. Doctors are learning at one place how to do something, and transferring that expertise to another place, and so, more people have it available to them.

Avery Comarow is the Health Rankings Editor for "U-S News and World Report".

To find more about the rankings: