On 7/21/15, the San Diego Union Tribune (
visit link) reportd the following story:
"UC San Diego, Scripps again top U.S. News list
Hospitals are ranked nationally in 20 specialties
By Paul Sisson | 10:06 p.m. July 20, 2015
SAN DIEGO — UC San Diego’s quality in a dozen hospital specialties ranks among the 50 best in the nation, according to the latest “Best Hospitals” evaluation by U.S. News & World Report.
Released today, the closely followed health care compendium also bestows eight national rankings to the combined programs of Scripps Memorial Hospital La Jolla and Scripps Green Hospital.
While health quality experts are quick to note that such rankings should not be consumers’ only factor in deciding where to receive care, the results do bring a certain cachet that can help influence doctor referral patterns and make it easier for top performers to recruit new talent.
Getting a national ranking in the U.S. News report is the best kind of validation, said Stewart Gandolf, chief executive of Healthcare Success, an Irvine-based health care marketing consultancy.
“It’s valuable because it’s coming from outside the organization, and it’s coming from a name that people recognize. A third-party endorsement is not just valuable, it’s gold,” Gandolf said.
Only 137 facilities nationwide, among nearly 5,000 that were considered, received at least one national specialty ranking. Sixteen of those medical centers were chosen for an honor roll that featured Massachusetts General Hospital in the top spot, followed by Minnesota-based Mayo Clinic and a tie between Johns Hopkins Hospital in Baltimore and UCLA Medical Center for third.
In addition, the UCSF Medical Center and Stanford Hospital in Northern California placed eighth and 15th, respectively. No local hospitals made the honor roll.
The 5,000 hospitals were ranked in 16 specialties, and U.S. News considered a range of health-care data for its assessment — from mortality and infection rates to service volume.
High-ranking hospitals routinely tout the rankings in their promotional campaigns, including TV commercials and brochures.
Gandolf said those commercials can impact both patients and physicians, bringing in millions of dollars in additional revenue.
“Just like consumers, doctors are influenced when they see on television that, wow, this particular hospital seems to be doing very well in this category or that category,” Gandolf said.
This year, UC San Diego saw its number of national rankings grow from 11 to 12 with the addition of gynecology, which placed 44th in the country. The total is twice what the university’s two hospitals — one in Hillcrest, the other in La Jolla — earned in 2011.
“We have worked to increase the visibility of our gynecology team, especially in the area of sophisticated gynecological oncology, where we have surgeons and staff that are handling some very complex cases,” said Paul Viviano, chief executive of the UC San Diego Health System.
He added that doing well in the rankings creates a kind of feedback loop, making it easier to recruit more top-level talent in the future.
“When you can say that they’re joining a team that’s recognized nationally, that makes it a more attractive opportunity,” Viviano said.
U.S. News is far from the only group that issues hospital rankings that target consumers.
In recent years, dozens of new lists have popped up, each with a different rubric and often different results. These include rankings from Healthgrades, the Leapfrog Group, Consumer Reports and the Centers for Medicare and Medicaid Services.
For example, Leapfrog, which publishes yearly letter grades for most hospitals in addition to in-depth looks at specific medical procedures, awarded Tri-City Medical Center in Oceanside an “A” in its most recent edition. But Tri-City does not make the U.S. News list in any specialty or even in the magazine’s regional rankings.
What should patients make of these disparities?
Dr. Ashish Jha, an internationally respected health-care-quality expert at Harvard University’s T.H. Chan School of Public Health, said the ratings vary because they focus on different goals.
Leapfrog’s reports, for instance, emphasize patient safety while the U.S. News rankings track individual specialties.
Jha said while these ratings systems can provide significant insight into important information, they should not be used in a vacuum. It is still important, he said, for people to seek out the opinions of their primary care physicians and others in the community who may have recently been admitted for hospital care.
“My take is that rankings like U.S. News and Leapfrog are a good place to start, but they’re not the whole picture,” Jha said.
And hospitals are only one half of the quality equation, he stressed. It is just as important to choose a surgeon with low complication rates, he advised.
“You can go to a high-quality hospital with a mediocre-quality surgeon, or you can go to a high-quality surgeon in a mediocre-quality hospital,” he said. “The idea is to find a high-quality surgeon at a high-quality hospital.”
But information on complication rates can be difficult to find.
ProPublica, a nonprofit investigative news service, recently released a database that lists complication rates by surgeon for nearly 17,000 doctors nationwide.
While the database has faced some criticism for the way it calculates complications and for the fact that it only uses Medicare data, Jha said he admires the effort. Like all other ratings systems, he said, it is not perfect but could be a good way to spur patients to raise the right questions.
“You can ask your primary care doctor, does he actually know the complication rates of the surgeon he’s sending you to?” Jha said."