Consider the data
Next, to truly assess healthcare quality, these systems must be based on comprehensive, reliable data. However, some of the most visible systems rely on facility self-reporting, patient anecdotal comments and even proprietary measures of hospital reputation.

Certain well-known ranking systems also exclude facilities that are not members of major hospital associations, or they focus predominantly on academic medical centers. The result is that high performing local facilities offering excellent value for a particular medical condition may be overlooked.
Another important consideration is how performance data are segmented, analyzed and presented. Extensive research conducted at Harvard proves that significant intra-hospital quality score variability exists across patient populations, specialties and disease states. Yet some systems simply provide an overall facility ranking that may have little or no relevance for a patient’s particular problem.

Other systems do break down hospital performance by condition but indications are often too broad to be truly useful to a particular individual. Some systems provide quality ratings for departments or medical specialties only, which likewise is not specific enough to help with an individual case.

Physician ratings important
Finally, be aware that a hospital with a top quality rating for a particular condition can still have a surgeon ranking in the lowest percentile treating relevant patients. In fact, numerous studies have shown that the dispersion of physician practice patterns is highly variable in a specific institution. It should go without saying that one of the most important factors in patient care is the specific physician standing over the patient, scalpel in hand, ready to cut and heal.

As a result, an unwitting patient, for example, could conduct extensive research to identify a facility recognized for high quality joint replacement care and still have an extremely poor outcome thanks to an individual surgeon whose track record is rife with failure. But not one major consumer ranking program breaks down data by physician. It is no exaggeration to say that the consumer quality of rating systems for cars far overshadow those for healthcare.

Examine the methods
Naturally, along with rich data, sophisticated analytic methodologies are imperative to make care rankings useful and accurate tools. For example, the number and objectivity of quality indicators and outcome measures is vitally important. Does the analysis look truly compare apples to apples? Does it include a variety of risk-adjusted outcome indicators? Does it juxtapose quality with cost for a true sense of value?

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