Healthgrades on Tuesday released its annual clinical quality scores for U.S. hospitals and debuted its National Health Index, which ranks care quality in 25 U.S. cities.
Methodology for clinical quality scores
To score hospitals, Healthgrades analyzed Medicare inpatient data for nearly 4,500 short-term, acute care hospitals across the United States between 2014 and 2016, covering clinical outcomes for 34 conditions and procedures. For two procedures—appendectomy and bariatric surgery—Healthgrades also used 2013-2015 all-payer state data.
The organization adjusted the mortality and complications outcomes for clinical risk factors and patient demographics. Healthgrades assessed hospitals' performance on clinical quality outcomes based on in-hospital complications, in-hospital mortality, and 30-day post-admission mortality.
Healthgrades then assigned hospitals ratings of one, three, or five stars—for "worse than expected," "as expected," or " better than expected," respectively, for each of the 34 conditions and procedures.
Clinical quality report findings
In its Report to the Nation, Healthgrades said the clinical quality scores "underscore[e] a theme Healthgrades has observed for years: significant variation in health outcomes exists among hospitals nationwide."
For instance, the report found that between 2014 and 2016, patients treated for pancreatitis at hospital with a five-star ranking for in-hospital mortality for that condition had a 93 percent lower risk of death than those treated at a one star-ranked hospital. Similarly, patients who received a total knee replacement at a hospital that had a five-star rating for that procedure were nearly 68 percent less likely to experience a complication than those treated at a one star-ranked hospital.
Overall, Healthgrades estimated that if all hospitals performed similarly to those that received five stars for clinical quality, an average of 219,568 patient lives may have been saved, and 164,454 complications avoided, between 2014 and 2016.
National Health Index
Healthgrades on Tuesday also released the first annual National Health Index, which spotlights the 25 healthiest cities in the country.
For the rankings, Healthgrades assessed the state of health and health care in 43 metropolitan areas across the country based on data from three sources, including:
- The Association of American Medical Colleges' 2015 report on the percent of primary care providers per every 100,000 population;
- CDC's Behavioral Risk Factor Surveillance System 2015 survey; and
- Healthgrades' 2018 hospital quality star rankings.
Healthgrades used the data to evaluate cities on four factors—access to care, availability of high-quality hospitals, high-risk health behavior, and population health—for a maximum overall score of 100.
According to Healthgrades, the top five cities based on overall score are:
- Twin Cities, Minnesota, with a ranking of 100 out of 100;
- Denver, with a ranking of 99.4 out of 100;
- Sacramento, with a ranking of 98.8 out of 100;
- Cincinnati, with a ranking of 98.7 out of 100; and
- Portland, with a ranking of 98.5 out of 100.
Based on the four individual factors, the leading cities are:
- Denver, taking the top spot for population health;
- Charleston, West Virginia taking the top spots for access to high-quality hospitals and healthy behaviors; and
- Boston, taking the top spot for access to care (Healthgrades Report to the Nation, 10/17; Healthgrades hospital quality ratings release, 10/17; Healthgrades clinical quality methodology, accessed 10/17; Healthgrades National Health Index release, 10/17; Healthgrades National Health Index methodology, accessed 10/17; Healthgrades National Health Index, accessed 10/17).
Get the cheat sheets: How hospital quality ratings programs work
Download our one page sheets for summaries on the methodology and metric categories used in five hospital quality rating programs:
- US News and World Report Best Hospital Rankings
- CMS Star Ratings
- Leapfrog Group Hospital Safety Grade
- Truven Analytics’ Top 15 Health Systems
- Truven Analytics’ Top 100 Hospitals