Association of Rankings with Cardiovascular Outcomes at Top-Ranked Hospitals vs Nonranked Hospitals in the United States

Abstract

Importance: The US News & World Report (USNWR) identifies the "Best Hospitals" for "Cardiology and Heart Surgery." These rankings may have significant influence on patients and hospitals. Objective: To determine whether USNWR top-ranked hospitals perform better than nonranked hospitals on mortality rates and readmission measures as well as patient satisfaction. Design, Setting, and Participants: This national retrospective study evaluated outcomes at 3552 US hospitals from 2014 to 2017. Exposures: US News & World Report 2018 to 2019 Cardiology and Heart Surgery rankings (top-ranked vs nonranked hospitals). Main Outcomes and Measures: Hospital-level 30-day risk-standardized mortality and readmission rates for Medicare fee-for-service beneficiaries age 65 years or older hospitalized for 3 cardiovascular conditions: acute myocardial infarction (AMI), heart failure (HF), and coronary artery bypass grafting (CABG) as well as Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction star ratings obtained from publicly available Centers for Medicaid and Medicare Services data. Results: Thirty-day mortality rates at top-ranked hospitals (n = 50), compared with nonranked hospitals (n = 3502), were lower for AMI (11.9% vs 13.2%, P