Varying national hospital ratings systems may cause confusion, study finds

National hospital ratings systems are varied in their foci, measures, methods and transparency and may generate confusion rather than clarity, according to a recent study published in Health Affairs.

The study compared hospital performance on four national hospital rating systems — U.S. News & World Report's Best Hospitals, Healthgrades' America's 100 Best Hospitals, Leapfrog's Hospital Safety Score, andConsumer Reports'Health Safety Score. It designated high performers for all four rating systems and low performers for all rating systems but Healthgrades, as that system lists only top hospitals. Researchers then looked at where, if at all, hospitals overlapped on the rating systems.

The release date of the ratings used in the analyses covered the time period from July 2012 to July 2013.

Here are eight findings from the study:

1. Just 83 hospitals were rated by all four systems, but none were rated as a high performer by all four.

2. Only three hospitals were rated as high performers by three of the four systems.

3. In aggregate, only 10 percent of the 844 hospitals rated as high performers by one of the rating systems were rated as high performers by any of the other systems.

4. Of the 88 hospitals rated as high performers on more than one rating system, Leapfrog and HealthGrades agreed most frequently (48 hospitals, 55 percent); Consumer Reports and U.S. News agreed on none of the hospitals they rated as high performers.

5. No one hospital was rated as a low performer on all three of the rating systems that rated low performance.

6. Fifteen hospitals were rated as low performers on two of the three systems.

7. Of the 15 hospitals rated as low performers on more than one rating system, Leapfrog and Consumer Reports agreed most frequently (seven hospitals, 47 percent). The weakest agreement for low performers was between Consumer Reports and U.S. News, which agreed on only three hospitals (20 percent). 

8. There were 27 instances of what the study calls "extreme cross-rating disagreement" in which hospitals that were high performers on one system were low performers in another. For instance, 14 hospitals were Leapfrog high performers butlow performers on U.S. News. Another seven were rated as high performers by Leapfrog and low by Consumer Reports.


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