Hospital rankings may be skewed by transfer rates and treatment volumes.
With the ease of accessing the internet, people are relying on quality ratings more than ever before. Some may check websites to determine if a restaurant in town lives up to their reputation, and some may check a hospital’s rating online before receiving care.
A recent study, published by The Joint Commission Journal on Quality and Patient Safety, has found that false-positive event rates are the most common among high-transfer and high-volume hospitals.
Researchers at the Rush University Medical Center were surprised when their hospital ranked lower than expected in the US News & World Report’s hospital rankings of patient safety.
Their high mark of “A” in patient safety from the Leapfrog Group did not mesh well with their low score from a different ranking system. This caused them to analyze on their data to determine the accuracy of the US News’ ranking.
“When we compared the data that US News used for our hospital to our own internal data, we found big differences,” said researcher Bala Hota, MD. "US News showed many more patient safety events than our actual rates."
A majority of these reported patient safety events were present at the time the patient was admitted, and were not caused by the hospital. Data used in the US News report said that 25 patients developed pressure ulcers when only 1 actually developed the condition.
The researchers further explored data from other hospitals, and found similar discrepancies. False-positive event rates were common in hospitals that had a many transfers and those that treated many patients, according to the study.
These 2 characteristics are known to skew care ratings. Rush University Medical Center provides care for patients who are very sick and have complex conditions including those who were transferred from another hospital, the researchers said.
“Rush is the biggest transfer center in Illinois,” Dr Hota said. “If somebody is sick in a community hospital and not getting better, that hospital knows Rush is a reliable place to transfer the patient to.”
Hospital quality ratings are complex since care varies from patient to patient. Some elderly patients may be more prone to developing infections compared with younger patients despite the same quality of care being provided.
“People have argued and theorized that if you take care of a lot of very sick people or have a lot of transfers, then the data could be biased,” Dr Hota said. “This study proves that. It shows that data is not perfect, and misunderstandings in the data can negatively portray a hospital.”
Additional measures are needed to ensure accurate data and findings are being compiled for these rankings.
“The companies that are producing these ratings have to be more transparent,” Dr Hota said. “Their methodology should be reproducible and easily understood.”
Increased transparency and better quality ratings can help patients choose a hospital that is right for them. It can also show hospitals what areas they need to improve to provide better care for their patients.
“We consider quality to be the most important part of patient care,” concluded researcher Omar Lateef, DO. “We believe in being transparent about quality so we can continue marching towards improvement.”