New research suggests that when searching for top-performing hospitals with a wide range of services, consumers may be led astray if they narrow the list to hospitals with a five-star patient experience. Many five-star hospitals offer fewer services than those without five stars, according to a new study by Johns Hopkins researchers recently published in JAMA Internal Medicine.
The U.S. Centers for Medicare & Medicaid Services (CMS) publicly reports data on more than 4,000 hospitals across the country. In the past, raw numbers — reflecting measures such as patient satisfaction, complication rates and timeliness of care — were published on the CMS website. In 2016, however, the agency debuted a system in which hospitals are assigned a star rating in several categories, including “patient experiences.”
Although data on how the public uses the ratings isn’t available, researchers assume that people use them when choosing a facility for their medical care. For this study, the researchers linked CMS patient experience star ratings with information from the American Hospital Association on the clinical services a hospital offers. Among 2,798 hospitals with patient experience star ratings, 150 hospitals (5.4%) received five stars. The team compared those hospitals to ones that received one through four stars in patient experience.
While 95.3% of most hospitals have emergency departments and 90.6% have intensive care units, only 77.3% of five-star hospitals have emergency departments and only 42.0% have intensive care units. Similarly, five-star hospitals are less likely to have neurology, cardiology, obstetrics and oncology units, among other services. Only 1.7% of five-star hospitals have neonatal intensive care units, compared to 31.5% of other hospitals. The five-star hospitals are also less likely to be teaching hospitals or research hospitals. Even when the team removed specialty hospitals — such as cardiac and orthopaedic hospitals — from the analysis, the results were similar: Five-star-rated general medical hospitals offered fewer services than general medical hospitals with lower ratings.
- Comparison of Services Available in 5-Star and Non–5-Star Patient Experience Hospitals. JAMA Internal Medicine. June 10 2019