Hospitals that scored near the top in six or more specialties. They are ranked by points. They received 2 points per specialty for scoring at least 3 standard deviations (a statistical yardstick) above the mean and 1 point for scoring below 3 but higher than 2 standard deviations above the mean.
Calculated for hospitals in 12 specialties to summarize overall quality of inpatient care. One third of each hospital's score is based on reputation, one third on mortality, and one third on a mix of other factors that varies by specialty, such as number of discharges, nursing care, and technology. A score of 100 is assigned to each specialty's top-ranked hospital. In four other specialties (Ophthalmology, Psychiatry, Rehabilitation, and Rheumatology), ranking is determined by reputation.
Reputation (%)
Percentage of board-certified physicians responding to U.S. News surveys in 2005, 2006, and 2007 who listed the hospital among the best in their specialty for especially difficult conditions and procedures.
Mortality index
Compares the number of deaths with the number predicted (after adjusting for severity of condition), based on Medicare inpatients treated at the hospital in 2003, 2004, and 2005. If the number was equal to the number predicted, the mortality index is 1.00. Above 1.00 means worse than predicted; below 1.00 means better. Deaths counted occurred within 30 days from the date of admission except in Cancer, in which deaths are from admission to discharge.
Discharges
Total number of Medicare inpatients who received specified medical and surgical care during 2003, 2004, and 2005.
Nursing index
Indicates relative balance of nurses to patients; higher is better. Nurses must be on-staff R.N.'s, not temps or from agencies. Nurses are counted in "full-time equivalents"—two half-time nurses, for example, equal one full-time equivalent. Patients are an adjusted daily average of inpatients and outpatients, giving more weight to inpatients.
Nurse Magnet hospital
Indicates whether as of April 1, 2007, the hospital satisfied standards set by the American Nurses Credentialing Center for nursing excellence.
Advanced services
Hospitals that are neither members of the Council of Teaching Hospitals nor affiliated with a member must offer at least 6 from a list of 14 key technologies and other capabilities to be considered eligible for any of the specialty rankings. Within individual rankings, the numbers indicate how many services are offered from a list that varies by specialty—7 in Cancer and 2 in Geriatrics, for example. The full list: bone marrow transplant, cardiac intensive care unit, computer-assisted orthopedic surgery, diagnostic radioisotope services, full-field digital mammography, image-guided radiation therapy, infection isolation room, kidney transplant, multislice spiral computed tomography, positron emission tomography scanner, robotic surgery, shaped beam radiation, single photon emission computerized tomography, and stereotactic radiosurgery. One point is awarded for on-site availability, half a point if nearby but off-site.
Patient services
Indicates how many key services related to the overall quality of a patient's stay are offered. There are 12 altogether; the maximum number varies from a high of 9 in Geriatrics to a low of 6 in several specialties. The full list: Alzheimer's center, arthritis treatment center, cardiac rehabilitation, fertility clinic, genetic testing/counseling, geriatric psychiatry, hospice, pain management program, palliative care, patient-controlled analgesia, rehabilitation care, and translators. One point is awarded for on-site availability, half a point if off-site but nearby.
Trauma center
Indicates state certification as a Level 1 or 2 trauma center that can provide advanced care for severely injured patients. This capability has been shown to be related to a hospital's overall quality.
NCI Cancer Center
In Cancer, indicates certification by the National Cancer Institute as of April 1, 2007, as a "clinical" or "comprehensive" cancer center, denoting high-quality research and clinical care.
FACT credit
In Cancer, indicates whether as of April 1, 2007, the hospital met standards set by the Foundation for the Accreditation of Cellular Therapy for transplanting cells to treat cancer. Half a point is given if accreditation is only for autologous transplants, in which a patient's own cells are removed and then returned following radiation therapy. A full point is given if accreditation is for allogeneic transplants, in which cells are donated by another person (allowing a greater number and more kinds of cell transplants), or for both autologous and allogeneic transplantation.
NIA Alzheimer's center
In Geriatrics, indicates certification by the National Institute on Aging as of April 1, 2007, as an Alzheimer's Disease Center, denoting high-quality research and clinical care.
Epilepsy center
In Neurology and Neurosurgery, indicates whether as of April 1, 2007, the hospital met voluntary Level 4 standards set by the National Association of Epilepsy Centers for staffing, technology, and training. Level 4 is the highest degree of recognition, signifying a regional or national referral facility.
