Evaluating Popular Media and Internet-Based Hospital Quality Ratings for Cancer Surgery

Archived Abstract of Former PSC Researcher

Osborne, Nicholas H., Amir A. A. Ghaferi, Lauren Nicholas, and Justin B. Dimick. 2011. "Evaluating Popular Media and Internet-Based Hospital Quality Ratings for Cancer Surgery." Archives of Surgery, 146(5): 600-604.

Objective: We sought to determine whether "best hospitals," as defined by the US News & World Report or HealthGrades, have lower mortality rates than all other American hospitals for cancer surgery.

Design: Retrospective cross-sectional study.

Setting: Medicare database (2005-2006).

Patients: All patients with a diagnosis of malignancy who underwent pancreatectomy, esophagectomy, and colectomy (n=82 724).

Main Outcomes Measures: Risk-adjusted mortality rates at best hospitals according to both the US News & World Report and HealthGrades, was compared with all other US hospitals, adjusting for differences in patient factors and surgical acuity. Risk-adjusted mortality rates between best hospitals and all other hospitals was compared after controlling for differences in hospital volume.

Results: Risk-adjusted mortality was significantly lower in US News & World Report best hospitals for all 3 procedures: pancreatectomy (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.30-0.58), esophagectomy (OR, 0.48; 95% CI, 0.37-0.62), and colectomy (OR, 0.69; 95% CI, 0.55-0.86). Risk-adjusted mortality was significantly lower in HealthGrades best hospitals for colectomy (OR, 0.79; 95% CI, 0.65-0.95). However, after accounting for hospital volume, risk-adjusted mortality was only significantly lower at the US News & World Report best hospitals for colectomy (OR, 0.79; 95% CI, 0.62-0.99) and was not significantly lower at HealthGrades best hospitals for any of the 3 oncologic procedures.

Conclusions: Publicly marketed hospital rating systems of surgical quality such as the US News & World Report " America's Best Hospitals" and HealthGrades " Best Hospitals" may identify high-quality hospitals for some oncologic surgeries. However, these ratings fail to identify other high-volume hospitals of equal quality.

PMCID: PMC3332047. (Pub Med Central)

Country of focus: United States of America.

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