Patients may think that when it comes to having surgery, the bigger and more renowned the hospital is, the better the treatment they are likely to receive. But a new US hospital ratings report has revealed that this is not necessarily the case.

The Consumers Union, the non-profit organization behind Consumer Reports magazine, has provided hospitals in the US with individual surgery ratings, in an attempt to guide patients to the right medical centers.

Lisa McGiffert, director of the Safe Patient Project at the Consumers Union, told the magazine:

Consumers have very little to go on when trying to select a hospital for surgery, not knowing which ones do a good job at keeping surgery patients safe and which ones don’t. They might as well just throw a scalpel at a dartboard.”

Using the same system that a hospital uses to monitor quality, Consumer Reports rated the hospitals by analyzing the percentage of Medicare patients undergoing surgery who died in hospital, or who stayed longer than expected.

Billing claims that hospitals submitted to Medicare for patients aged 65 and over were also used in developing the ratings. The claims, provided by Michael Pine and Associates, covered 2,463 hospitals in 50 states plus Washington D.C. and Puerto Rico between 2009 and 2011.

The magazine looked at the results of 27 different scheduled surgeries and combined these into an overall surgery rating.

All hospitals involved in the report were assessed in four different areas. These were:

  • Safety
  • Patient outcomes
  • Patient experience
  • Hospital practices.

Five of the surgeries were also given separate ratings, including back surgery, hip and knee replacements, angioplasty (removing blockages in the arteries of the heart), and carotid artery surgery (removing blockages of arteries in the neck).

The overall ratings revealed that well-known hospitals do not always live up to their expectations.

Consumer Reports gives an example of a variety of Mayo Clinic hospitals. Many of these performed well, but some only rated “average,” while the Mayo Clinic Health System in Austin, Minnesota, was awarded a “low” overall rating.

The renowned John Hopkins Hospital in Baltimore and The Cleveland Clinic also received surprising scores, with the report rating them as “worse than many small hospitals.”

Other results showed that specialty hospitals usually performed better compared with general hospitals, as the six top-performing hospitals in carotid artery surgery were heart hospitals.

The results also revealed that hospital choice was important depending on the particular type of surgery a patient needed. There was a wide variation of treatment found in hospitals when providing hip and knee replacement surgeries compared with colon surgeries and hysterectomies.

The ten most highly rated hospitals were narrowed down to those that regularly carried out a minimum of ten types of surgery and received a “high” rating in at least 30%, without getting a “low” rating for any type of surgery. The hospitals are as follows:

  • Anne Arundel Medical Center, Annapolis, MD
  • Christ Hospital, Cincinnati, OH
  • Enloe Medical Center, Chico, CA
  • Greater Baltimore Medical Center, Baltimore, MD
  • Memorial Health System, Colorado Springs, CO
  • Oklahoma Heart Hospital, Oklahoma City, OK
  • Penrose-St. Francis Health Services, Colorado Springs, CO
  • Scripps Green Hospital, La Jolla, CA
  • Trinity Rock Island, Rock Island, IL
  • Yavapai Regional Medical Center, Prescott, AZ.

Some experts have branded these ratings inaccurate, as many factors other than surgical complications may contribute to longer hospital stays.

David M. Shahian, vice president of the Lawrence Center for Quality and Safety at Massachusetts General Hospital, told Consumer Reports:

We are concerned that the methods used to generate these performance ratings have not been validated against gold-standard measures. They are based on claims data rather than clinical data from patient records.”

But John Santa, medical director for the magazine, said: “We wish we had access to more comprehensive, standardized information, but this is the best that is available.” He added:

“Our surgery ratings give patients more information so that they can make informed choices before surgery, and we hope that by highlighting performance differences, we can motivate hospitals to improve.”