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National hospital ratings systems generate confusion amongst patients

A recent Health Affairs study, led by J. Matthew Austin of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality, found that instead of helping patients choose safe, high-quality facilities, national hospital ratings systems tend to create confusion.

The study assessed four popular national rating systems used by consumers to judge hospitals. These ratings are published by U.S. News & World Report, Healthgrades, the Leapfrog Group and Consumer Reports.

Health Affairs found that between mid-2012 and mid-2013 the four ratings systems never reached a consensus regarding high performers. In several cases hospitals designated high performance ratings by one system received the lowest ratings by other systems. 

"The complexity and opacity of the ratings is likely to cause confusion instead of driving patients and purchasers to higher-quality, safer care," the authors said.

However, the institutions behind the ratings believe that the broad variations are not contradictions as much as they are indicators that each system measures different qualities. Evan Marks, the chief strategy officer for Healthgrades, told the New York Times that researchers shouldn't have expected an overlap, stating that expecting uniformity would be like asking ratings in Car & Driver, which reviews road test drives, to align perfectly with car safety ratings.

U.S. News & World Report, for example, told the New York Times that it helps patients find hospitals that excel within a given specialty, while Consumer Reports and Leapfrog focus on patient safety, and Healthgrades relies on clinical information to categorize facilities. 

The researchers acknowledged the different aims of the individual systems, but added that the large variations suggested there was a flaw in the system. "The challenge for any rating system," he said, "is to find an easy-to-understand grade or category that still captures the nuances of a single institution."

While national ratings systems may have a way to go before consumers can use them to accurately judge a hospital, services like Patient Approved can help individuals find doctors and hospitals that have received top reviews directly from the patients they treated.