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Hospital Rankings Failing to Account for Patient Socioeconomic Status, Lack Precision to Differentiate Higher Quality of Care

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Hospital rankings aimed at guiding patients to quality care don’t account for factors that affect the underlying health of patients, according to a trio of Duke medical experts.

U.S. News & World Report on Tuesday released its 2020-21 Best Hospitals Honor Roll. Duke Drs. Jonathan Bae and Adrian Hernandez, and Lesley Curtis, a professor of population health science and medicine, share their concerns with such rankings in a July 27 viewpoint article published in JAMA.

For one, they recommend a shift from rankings to ratings. “Because current ranking systems are unable to adequately account for the overall health of a population or differences in socioeconomic status, the rankings lack the precision to differentiate where care is of higher quality,” they write in JAMA. They outline several potential solutions which could contribute to hospital ranking systems that improve both patient decision-making and population health, including:

  • accounting for population differences between regions
  • shifting from rankings to ratings
  • bringing attention to measures that matter to patients
  • increasing transparency and reproducibility of results

They conclude hospital ratings can potentially provide useful information for patients if the ratings are clear and accurate and the methods used to generate the ratings are rigorous and transparent. By embracing thoughtful engagement and partnership with patients and clinicians, organizations that develop and report hospital ratings have an opportunity to reduce misinformation and provide information that could improve public understanding of health care delivery.

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