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Lown Institute rankings ask what hospitals owe their communities in return for tax exempt status and ranks Cleveland Clinic worst in U.S.

When examining 3,641 private nonprofit hospitals for its rankings, Lown looked beyond the usual metrics used to evaluate hospitals. It sought to encourage these organizations to be more responsible and accountable to the communities they serve, said Dr. Vikas Saini, president of Lown Institute. “The reason our rankings matter is because, as citizens, all of us have a huge stake in how high quality, how affordable and how just our health care system is,” Saini said. “We’re reporting measures that do all of that.” More

Spines ’R’ Us: The evidence and business behind spinal fusions

In Modern Healthcare, Lisa Gillespie reviews the evidence and incentives that drive some hospitals to overuse spinal fusion procedures. She cites research from the Lown Institute in collaboration with Australian academics published this year, which shows that spinal fusions for stenosis and other conditions not backed by strong evidence of effectiveness are associated with poor outcomes. Out of seven low-value procedures, inpatient spinal fusions were affiliated the most with hospital-acquired conditions, adverse patient safety indicators and unplanned hospital admissions after outpatient procedures, their review of Medicare claims from 2016 to 2018 found. “If, on average, this thing doesn’t work, the burden is on you to tell me why for this particular patient, it’s going to work, beyond just a faith-based argument,” said Dr. Vikas Saini, president of the Lown Institute.

“The public expects their doctors to make care decisions, but I will also say the public expects doctors to make their medical decisions on the basis of the best interest of the patient,” Saini said. “It is now going to become more relevant for hospital administrators to do their homework on appropriateness and inappropriateness.”

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How socially responsible are Sacramento region’s hospitals? Check out their report cards

Only one California hospital ranked among the 10 most socially responsible hospitals in the United States: Tiny Oroville Hospital, which landed at No. 4 this year on the Lown Institute Hospitals Index. The hospital serves a large number of Medi-Cal beneficiaries and patients with low education levels, according to the report released Tuesday by the Lown Institute, while also excelling at preventing patient errors and re-admissions, keeping mortality rates low and quality clinical outcomes and running an efficient operation. More

Hospitals with top clinical outcomes often don’t score well in equity metrics, rankings find

"We think that hospitals represent really kind of probably the central part, certainly the most visible and the most active part, of all of American healthcare," Lown Institute President Vikas Saini said. "And to get a better healthcare system, hospitals absolutely have to be part of the solution." Saini noted that the individual hospitals on the honor roll were not particularly well-known names. "That was the goal of our whole exercise was to really begin to shine a spotlight on hospitals that might be doing things in a way that hadn't yet been really discovered or recognized," he said. More

Should regulatory authorities approve drugs based on surrogate endpoints?

When the FDA approved new Alzheimer's drug Aduhelm based on little clinical evidence, experts protested. Yet the Aduhelm controversy is just the latest in a pattern of regulators approving new drugs based on surrogate endpoints rather than clinical outcomes that matter to patients. In The BMJ, Jeanne Lenzer and Shannon Brownlee argue that surrogate endpoints provide no guarantee of clinical benefit and should be used only as a last resort in drug trials. More