This is Year 20 for America's Best Hospitals, a tool for patients who need medical sophistication that most facilities are unable to provide. We don't grade hospitals, as other ratings and rankings do, on routine procedures like outpatient hernia repair or manageable conditions like low-grade heart failure. We look instead at how well these institutions do in complex and demanding situations—replacing an 85-year-old's heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples. High-stakes medicine calls for more than the usual brand of doctoring.
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We ranked hospitals in 16 specialties, from cancer and heart disease to respiratory disorders and urology. A total of 4,861 hospitals were put through the statistical wringer. (Certain facilities, such as prison hospitals and military installations, were excluded because of unavailable data, a very small number of beds, or other factors that made evaluation difficult or pointless.)
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Only 174 hospitals scored high enough to be ranked in even one of the 16 specialties. And of these, just 21 qualified for our Honor Roll by ranking at or near the top in at least six specialties.
Hard data, such as death rates and numbers of nurses, largely determined 12 of the 16 specialty rankings. To be a candidate for these specialties, a hospital first had to meet any one of three criteria: be a teaching hospital, have at least 200 beds, or have at least 100 beds and at least four out of eight important medical technologies, such as current-generation CT scanners and precision radiation therapies. This year, 44 percent of all hospitals met that test.
Hospitals that passed that test next had to show a minimum number of Medicare inpatient discharges for certain procedures and conditions in 2005, 2006, and 2007. The number varied by specialty—325 in cancer, for example. Or they had to have been nominated by at least one physician in U.S. News surveys in 2007, 2008, and 2009.
The 1,859 hospitals left received a U.S. News Score from 0 to 100, based on reputation, death rate, patient safety, and care-related factors such as nursing and patient services. The 50 highest scorers are ranked. (Scores and complete data for the rest are also provided.) The details:
Reputation counted as 32.5 percent of the score. Each year we draw a random sample of 200 physicians from a national database for each of 12 specialties. They are asked to list five hospitals they consider among the best in their specialty for difficult cases, without taking into account cost or location. The figure shown for "reputation" in the rankings is the total percentage of the specialists in 2007, 2008, and 2009 who named the hospital in their response.
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