Exploring relationships between medical college rankings and performance with big data

Abstract

Background: It is important to examine the cost-effectiveness of medical education. The public wants to know how government spending is being utilized to train doctors. There are very few studies that examine national data to understand the relationships between medical education and outcomes. We used Big Data analytics with open health data to explore answers. We joined physician data and hospital total performance score data reported by Center for Medicare and Medicaid Services (CMS), containing information for nearly 600,000 practitioners and performance scores from three thousand hospitals in the United States. We combined this data medical college costs from the American Association of Medical Colleges and medical school rankings. We used Mullan's social mission to compare medical schools. We also computed the correlation between the rankings of 4-year baccalaureate colleges in the US published by the Wall Street Journal, and the in-state tuition at these colleges in the Integrated Post-secondary Education System database. Results: We found a statistically significant but negligible correlation (Spearman rank correlation − 0.04, p-value < 0.0001) between the rank of a medical school and the total performance score of the hospitals that their graduates practiced in. We found a statistically significant and high correlation (Spearman rank correlation of − 0.903, p-value = 0.003) between the averaged rank of medical schools and average number of graduates produced by these schools associated with CMS hospitals. Similar results were obtained for the social mission score. In contrast, the correlation between the ranking of 4-year colleges and (a) their tuition was − 0.34 and (b) their outcomes was − 0.86 (p-value < 10 − 5). Conclusions: Our results suggest that US medical education is robust and produces satisfactory performance outcomes. Higher tuition is not correlated with higher ranks or better outcomes. Hence, the public needs to question what they are getting in return for higher tuition. We also suggest that it may be better to produce more graduates from existing medical schools than opening new schools.