The best hospitals…in the world?

It seems like every day there’s a new hospital ranking, and this week is no different. As we’ve noted on this blog, hospital rankings differ in what they prioritize and how they evaluate hospitals. The US News and World Report “Best Hospitals” ranking, for example, relies fairly heavily on specialty care and expert opinion, and only recently started incorporating measures of equity and overuse. On the other hand, the Lown Hospitals Index seeks to measure hospital social responsibility, including not only traditional outcomes metrics but novel measures of equity and value.

Newsweek recently released their ranking of the “World’s Best Hospitals” for 2022. Let’s see how this ranking measures up…

The Newsweek ranking measures hospital performance across over 2,200 hospitals in 27 countries. Their ranking is based on three sources: An online survey of 80,000 doctors and other medical professionals, results from patient experience surveys, and “key performance measures” on quality of care and patient safety.

The weighting of these three elements is heavily skewed toward reputation. More than half of hospitals’ total score for the ranking is based on the survey results, in which participants were asked to recommend the best hospital (50% of the score is based on national recommendations from peers from the respective country and 5% is based on international recommendations from peers from other countries).

According to Newsweek’s methodology, the surveys are assigned the highest weights “because medical experts are best suited to assess the quality of a hospital.” The high weight of the survey may also be due to lack of data for the other two metrics in many countries. There were no patient experience scores for hospitals in 19 of the 27 countries included in the ranking; in these countries evaluations from Google were used as a substitute and weighted lower. Hospitals in 13 countries did not have quality of care or patient safety measures available.

Because data sources were different for each country, the Newsweek ranking cannot be used to compare hospitals across countries, only rank them within each country. This makes their “World’s Best Hospitals” ranking slightly confusion — can the Mayo Clinic still consider themselves the “best hospital in the world” if the rankings aren’t meant to be compared cross-country?

Lastly, the Newsweek ranking unfortunately doesn’t include any metrics for social responsibility in its ranking. Many of the hospitals at the top of their list (Mayo Clinic, Cleveland Clinic, Massachusetts General) have also been at the top of national hospital rankings for clinical outcomes. However, the Lown Index shows that these hospitals tend to fall short when it comes to their metrics on equity, like hospital CEO pay and racial inclusivity.

As hospital rankings continue to sweep the globe, we should ensure that our rankings measure not just reputation, but outcomes, value of care, and equity as well.