In the “Best Hospitals” 2023 rankings by U.S. News & World Report released Tuesday, four Delaware hospitals were rated as “high performing” in specific treatment areas with one ranked in the top 50 nationally.
The publication evaluated more than 4,300 hospitals in 21 procedures and conditions. More than 1,900 were rated high performing in at least one area, but none were rated high performing in all areas.
Hospitals were also ranked from 1 to 50 nationally in each of 15 specialties, with hospitals not in the top 50 but still in the top 10% of all rated hospitals receiving a designation of “high performing.”
Best general hospitals in Delaware
ChristianaCare, Newark, was ranked #1 in Delaware and tied at #4 in the Philadelphia metro area with Temple University Hospital.
“High performing” ratings were achieved in 13 procedures/conditions: leukemia/lymphoma/myeloma, lung cancer surgery, prostate cancer surgery, abdominal aortic aneurysm repair, heart attack, heart bypass surgery, congestive heart failure, stroke, diabetes, maternity care (uncomplicated pregnancy), hip replacement, knee replacement, chronic obstructive pulmonary disease (COPD).
The report said the hospital was also high performing in two specialties, but didn’t list which of the above procedures were specialties.
Beebe Healthcare, Lewes, was ranked #2 in Delaware.
“High performing” ratings were achieved in seven procedures/conditions: colon cancer surgery, lung cancer surgery, pneumonia, heart attack, diabetes, hip replacement, knee replacement.
Bayhealth Hospital, Kent Campus, Dover, did not receive a state ranking from U.S. News & World Report, but it was the only other general hospital in Delaware to receive “high performing” marks.
“High performing” ratings were achieved in three procedures/conditions: congestive heart failure, stroke, diabetes.
Best children’s hospitals
Nemours Children’s Hospital, Wilmington, was ranked #1 in Delaware and #9 in the Mid-Atlantic region.
Nemours was nationally ranked in the top 50 in five children’s specialties: pediatric orthopedics #31; pediatric cardiology and heart surgery #33; pediatric cancer #37; pediatric diabetes and endocrinology #38; pediatric gastroenterology and GI surgery #47.
What statistics were used in the ratings?
The Best Hospitals ratings evaluate almost every hospital in the U.S. that admits patients in any of 21 common procedures and conditions and 15 specialties.
U.S. News said data came from the federal Centers for Medicare and Medicaid Services’ standard analytical file database and from the American Hospital Association and professional organizations.
No veterans or military hospitals were included.
“Claims data for VA and military hospitals are unavailable in Medicare claims data and are largely unavailable. If these data become publicly available, we will consider evaluating them,” U.S. News said. “Claims data from the Medicare database are the most comprehensive source data available.”
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The report used files of every hospital admission paid by traditional Medicare for inpatients age 65 and older treated from 2017-2021 to assess each hospital’s risk-adjusted mortality rates, readmissions and other outcomes.
“How well older patients are treated is generally considered a good test of a hospital’s capabilities,” U.S. News said. “Such patients have a greater chance of being admitted with one or more conditions, such as diabetes or high blood pressure, that put them in a higher-risk category.”
The analysis included publicly-available data from the Centers for Medicare and Medicaid Services including federally mandated patient-satisfaction surveys.
“We put the heaviest reliance on outcomes because of the self-evident connection between a patient’s outcomes, including survival and the quality of their care,” the report said.
The outcomes included 30-day mortality rate, 30-day readmission rate and length of stay.
“These measure how well the hospital performed the procedure at the time of care and also was able to prevent an unplanned re-visit to the hospital due to the same condition. A shorter length of stay is indicative of a lower complication rate,” U.S. News said.
Other data included the number of patients, the ratio of nurses to patients and the physician survey.
What if my hospital is rated average or below average?
About 50% to 70% of the hospitals in each procedure or condition were rated as average.
U.S. News & World Report said some hospitals were rated below average “partly because of low patient volume, not necessarily because of a high number of deaths or other adverse events. No firm conclusion can be reached about an unrated hospital; these hospitals did not treat enough patients to be evaluated thoroughly.”
Based on your health situation, the report said it could make more sense to go to an average hospital closer to you or within your insurance network than a high-performing hospital that is farther away and out-of-network.
“As always, these ratings should be taken as a starting point. All care decisions should be made in conjunction with medical professionals,” the report said.
Debate about the validity of the rankings
This year for the nationally-rated hospitals, U.S. News & World Report changed from ordinal rankings in favor of an “Honor Roll” in no particular order, according to a report in USA TODAY.
The change came after recent user surveys found a growing need to highlight ratings based on specialties, conditions, procedures and region instead of national rankings, “because in most cases patients should consider a provider near where they live,” said Ben Harder, U.S. News chief analyst and managing editor.
The hospital rankings emerge amid a national conversation debating the value, transparency and methodology of such rating systems, USA TODAY reported.
In June, the San Francisco city attorney’s office announced it was launching an investigation into U.S. News, alleging bias, questionable methodology and undisclosed financing.
Not long after, the University of Pennsylvania Health System declared it was no longer actively participating in the annual U.S. News & World Report “Best Hospitals” rankings, underscoring the need for greater transparency.
Although U.S. News later announced changes to its methodology in July, emphasizing health equity and outpatient outcomes, University of Pennsylvania Health System CEO Kevin Mahoney was not assuaged.
“Overall, rankings systems are an oversimplified, dated way to measure 21st century health care,” he said in a statement to USA TODAY.
However, hospital rankings are one of the only sources of up-to-date data that patients have to compare hospitals in a comprehensible and transparent way, Michael Millenson, an expert on quality care and patient safety, said in a July USA TODAY interview.
Hospital rankings “are not perfect – sometimes they mislead and we have to ask questions – but it’s the best we have,” he said.
USA TODAY is part of the Gannett company with The News Journal/delawareonline.
Reach reporter Ben Mace at rmace@gannett.com.
