Harvard Heart Letter

Online hospital ratings: Are they helpful?

A better understanding of these rating systems can help you know how and when to use them.

Many people make it a habit to check online reviews before purchasing products and services. But not everyone realizes that you can also find online ratings of many hospitals throughout the United States.

Granted, choosing your hospital isn’t always an option (in the event of a heart attack, for example). Location and insurance issues may also come into play. But if heart disease is a concern, do you know how your local hospital’s cardiac care stacks up? What if you need a non-emergency procedure? Where’s the best place to go?

Online hospital ratings can offer potentially helpful information, but recognize that there is no clear definition of “best” when it comes to hospital care, says Dr. Karen Joynt, a health policy researcher and a cardiologist at Harvard-affiliated Brigham and Women’s Hospital. “It’s an important topic, but there’s so much conflicting and confusing information online. It’s hard to know how to quantify all the different parameters that hospitals measure,” she says.

Doing the research

Hospitals report information to a variety of state and federal agencies. The most important one, Medicare, provides most of the raw data that goes into creating hospital rankings. So starting your research with the federal government’s Hospital Compare site (www.medicare.gov/hospitalcompare) makes sense. This site provides information on more than 3,600 Medicare-certified hospitals across the country. You can search by ZIP code, choose three hospitals, and then compare them on a variety of measures, such as how quickly people get treated for heart attack symptoms, or rates of infection or complications after surgery.

The site includes results from patient satisfaction surveys that include questions such as “Was your room quiet?” and “Was your pain treated appropriately?” Hospital Compare also features a rating system that summarizes up to 64 quality measures on common conditions (including heart attacks and heart failure) and rates the hospital on a scale of one to five stars.

However, there’s a fairly good chance that some of the hospitals in your area don’t show certain information or even have a star rating. For nearly one-third, there aren’t enough cases to provide an accurate assessment or Medicare doesn’t collect the information. Also, Hospital Compare doesn’t account for sociodemographic factors, which means hospitals that treat more low-income people—who are often sicker—tend to score lower than those that treat more affluent people. Yet these lower-scoring hospitals include some academic teaching hospitals, which are generally considered to provide above-average care.

Other sites prioritize and present information in different ways, which is why Dr. Joynt recommends reviewing several (see “Researching hospitals”). One of the best-known sites, from U.S. News & World Report, ranks hospitals by specialty, including cardiology and heart surgery.

When comparisons count

Hospital rating sites may be most useful in situations in which you’re unfamiliar with the available options—for example, if you’ve recently moved, if you’re traveling, or if you’re advising a loved one from afar, as was recently the case for one of Dr. Joynt’s friends. Her father was hospitalized in upstate New York after a dizzy spell and she wanted to know if she should have him transferred to a larger hospital. “I checked Hospital Compare and the state’s hospital reporting site and it looked like a good choice, with reasonable volumes for procedures, outcomes similar to national averages, and no red flags,” says Dr. Joynt.

But for many people, a hospital recommendation from a trusted physician will suffice. If you develop a heart problem, ask your doctor which hospitals in your area provide the best diagnostic testing and treatment for your situation. If any local teaching hospitals are conducting research on your condition, that facility might be the best place for cutting-edge therapies. If you need a procedure, ask your doctor which hospitals have the highest volumes of the procedure you need.

Researching hospitals

Comparing results from these websites—in addition to the government’s Hospital Compare site (www.medicare.gov/hospitalcompare)—can give you a broader perspective on how hospitals are assessed and ranked.

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