National hospital ratings systems share few common scores and may generate confusion instead of clarity.
Attempts to assess the quality and safety of hospitals have proliferated, including a growing number of consumer-directed hospital rating systems. However, relatively little is known about what these rating systems reveal. To better understand differences in hospital ratings, we compared four national rating systems. We designated "high" and "low" performers for each rating system and examined the overlap among rating systems and how hospital characteristics corresponded with performance on each. No hospital was rated as a high performer by all four national rating systems. Only 10 percent of the 844 hospitals rated as a high performer by one rating system were rated as a high performer by any of the other rating systems. The lack of agreement among the national hospital rating systems is likely explained by the fact that each system uses its own rating methods, has a different focus to its ratings, and stresses different measures of performance.
J. Matthew Austin (jausti17@jhmi.edu) is an assistant professor at the Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, in Baltimore, Maryland.
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Ashish K. Jha is a professor of health policy and management at the Harvard T.H. Chan School of Public Health, in Boston, Massachusetts.
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Patrick S. Romano is a professor of medicine and pediatrics in the Division of General Medicine at the University of California, Davis, School of Medicine, in Sacramento.
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Sara J. Singer is an associate professor of health care management and policy in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health.
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Timothy J. Vogus is an associate professor at the Owen Graduate School of Management at Vanderbilt University, in Nashville, Tennessee.
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Robert M. Wachter is a professor and associate chair in the Department of Medicine at the University of California, San Francisco, where he holds the Benioff Endowed Chair in Hospital Medicine.
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Peter J. Pronovost is a professor of anesthesiology and critical care medicine, surgery, and health policy and management at the Johns Hopkins University, in Baltimore, Maryland. He is also the director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine.
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D006761:Hospitals / Q000592:standards* / Q000639:trends; D006801:Humans; D017063:Outcome Assessment, Health Care; D010358:Patient Participation / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000592:standards* / Q000639:trends; D020379:Risk Adjustment; D017751:Safety Management / Q000458:organization & administration; D014481:United States
Hospitals; Quality Of Care