You will probably have no choice of hospitals in an emergency situation. Under other circumstances, it seems logical to choose the highest quality hospital, where you would expect to get the best possible care and a resolution of your health problems. But attempts to evaluate hospital quality are fraught with great problems.
Take the example of a recent report from HealthGrades, a for-profit rating service for health care quality. The company evaluated 5,000 hospitals and gave about 15 percent of them a five-star or stellar designation. This rating was based on each hospital's risk-adjusted mortality and complication rates over the past three years. Hospitals getting three stars were considered average, while those rated one star were considered the poorest. The evaluation also included ratings for treating individual conditions such as heart failure and pneumonia.
HealthGrades concluded that a patient treated at a five-star hospital last year had a 69 percent lower chance of dying than a similar patient treated at a one-star hospital, and a 49 percent lower chance of dying than one treated at an average, three-star hospital. Based on these findings, they estimated that more than 300,000 lives of Medicare patients would have been saved over the past three years if all the hospitals performed as well as the five-star hospitals. Half of all of these Medicare deaths occurred in patients diagnosed with heart failure, pneumonia, sepsis, and respiratory failure who were treated in hospitals with a low rating for treating these conditions.
These findings seem to support the notion of going to a five-star hospital. But most hospital ratings cannot appropriately take into account the severity of the patient's illnesses and accompanying complications. Although the HealthGrades rating system attempted to take these factors into consideration by adjusting the mortality rates for patients' risks, it is extremely hard to make these adjustments accurately.
Of course, I quickly looked up the ratings of various hospitals at http://www.healthgrades.com/. Their site lists the hospitals that receive overall five-star ratings by state as well as the scores given to a number of other hospitals for their treatment of many specific disorders.
I am obviously biased in my opinions, but I question the validity of their rating system because Johns Hopkins Hospital was rated an average hospital in Maryland, as was the Massachusetts General Hospital, which is part of Harvard University's hospital system, in Massachusetts.
They were also rated as average for their treatment of a number of specific medical conditions. These two hospital are generally considered among the very best in the country and are certainly places where I would take myself or a family member if hospitalization were needed.
Despite the problems with this and other hospital ratings, I still believe that patients are better served by going to the best possible hospital. But I don't recommend making your decision based on the ratings on the HealthGrades site.
