title: Evaluating popular media and internet-based hospital quality ratings for cancer surgery.
abstract: OBJECTIVE
  We sought to determine whether "best hospitals," as defined by the US News & World Report or HealthGrades, have lower mortality rates than all other American hospitals for cancer surgery.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  Medicare database (2005-2006).
  
  
  METHODS
  All patients with a diagnosis of malignancy who underwent pancreatectomy, esophagectomy, and colectomy (n = 82,724).
  
  
  METHODS
  Risk-adjusted mortality rates at best hospitals according to both the US News & World Report and HealthGrades, was compared with all other US hospitals, adjusting for differences in patient factors and surgical acuity. Risk-adjusted mortality rates between best hospitals and all other hospitals was compared after controlling for differences in hospital volume.
  
  
  RESULTS
  Risk-adjusted mortality was significantly lower in US News & World Report best hospitals for all 3 procedures: pancreatectomy (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.30-0.58), esophagectomy (OR, 0.48; 95% CI, 0.37-0.62), and colectomy (OR, 0.69; 95% CI, 0.55-0.86). Risk-adjusted mortality was significantly lower in HealthGrades best hospitals for colectomy (OR, 0.79; 95% CI, 0.65-0.95). However, after accounting for hospital volume, risk-adjusted mortality was only significantly lower at the US News & World Report best hospitals for colectomy (OR, 0.79; 95% CI, 0.62-0.99) and was not significantly lower at HealthGrades best hospitals for any of the 3 oncologic procedures.
  
  
  CONCLUSIONS
  Publicly marketed hospital rating systems of surgical quality such as the US News & World Report "America's Best Hospitals" and HealthGrades "Best Hospitals" may identify high-quality hospitals for some oncologic surgeries. However, these ratings fail to identify other high-volume hospitals of equal quality.
authors.affiliation: Michigan Surgical Collaborative for Outcomes Research and Evaluation, Department of Surgery, University of Michigan, Ann Arbor, USA. nichosbo@umich.edu
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Osborne
authors.forename: Amir A
authors.initials: AA
authors.lastname: Ghaferi
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Nicholas
authors.forename: Justin B
authors.initials: JB
authors.lastname: Dimick
authors.forename: Md
authors.initials: M
authors.lastname: Mph
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000592:standards*; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009524:Newspapers as Topic / Q000706:statistics & numerical data*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010180:Pancreatectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D011639:Public Opinion; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000706:statistics & numerical data*; D014481:United States