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Why hospital rating tools should allow patients to customize rankings

It's possible to move beyond a one-size-fits-all approach to hospital ratings and toward one that takes into account individual needs and preferences

Jeff Lagasse, Editor

2018-19 US News Best hospital rankings

Publicly available hospital ratings and rankings should be modified to allow quality measures to be prioritized according to the needs and preferences of individual patients, according to a new RAND Corporation analysis.

The team of researchers proposed a new way of rating hospitals by creating tools that allow patients to decide which performance measures to prioritize. 

For example, they showed how the different priorities of a pregnant woman and a middle-aged man needing knee surgery might change which of their local hospitals has the highest overall rating.

The team created a web tool that demonstrates a way to create customized rankings. The tool, which allows users to create custom rankings of most hospitals in the nation, is based on the 2016 version of the federal government's Hospital Compare star ratings.

What the tool showed researchers is that it's possible to move beyond a one-size-fits-all approach to hospital ratings, especially in an era defined in part by the internet, which allows for such things to be tweaked and refined based on each individual patient's needs and preferences.

The underlying philosophy is that if the ratings inform patient choice, then patients should be asked for their input. This has reimbursement implications, as hospital reimbursement is now based in part on how they perform on various rating measures.

The findings demonstrate that a hospital quality report tailored to the "average" patient is likely not a good fit for most patients with individual needs.

In one scenario modeled by the team, customizing hospital report cards to the needs of a pregnant woman who lives in the suburbs of Boston drives down the ranking of a large downtown medical center and boosts the ratings of two community hospitals that are closer to her home. 

In another scenario, the ranking of two hospitals in the Los Angeles suburbs reverses when a man needing elective knee surgery customizes rankings to reflect his own needs.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com