Best hospital lists: Rating the rankers

Hospital ranking systems have been getting more attention in recent years as the number of rankings has proliferated, and as patients, purchasers, health plans  and the government have taken a greater interest. USA Today (A Healthy Disagreement) looks at the rankings, noting that some hospitals do well on certain lists but not others. Of course the main reason for this is differences in methodology.US News tries to be comprehensive. Consumer Reports emphasizes  patient safety. The Joint Commission compiles its list of top performers on "accountability measures." H&HN has a "most wired" survey. This information is all interesting enough in its own right, but it will be a long while before the surveys evolve to the point where they are very useful for patients. For now, the rankings serve as a spur for hospitals to improve their performance.One critical omission from these rankings is any ranking by cost or efficiency. Considering that the US hospital industry consumes close to $1 trillion of resources per year and that patients are increasingly responsible for paying hospital fees themselves, there should be plenty of interest in such rankings. A big challenge is data gathering and analysis, which is a lot more involved when dealing with cost and efficiency topics. Some states, like Massachusetts, do publish summary level information on cost, but the results are limited.It's unreasonable (and actually not all that useful) to do such rankings nationally. But I do look forward to seeing individual states or regions move forward with systematic approaches to mine all payer claims databases and other data feeds to produce information that helps the buyers and users of hospital services and assists hospitals themselves in making improvements.