How Healthgrades Rates Hospitals
HOW H E A LT H G R A D E S R AT E S H O S P I TA L S
SINCE 1998
Healthgrades brings transparency to healthcare. Our hospital ratings help consumers evaluate and compare hospital performance to ind the best care.
But what goes into rating a hospital for quality?
If you're a scienti ic type, and want to read all the details of why our methodology is the most rigorous (and impartial), you can read the full document here. But if you'd like an overview of how the process works, read on.
By The Numbers
Let's start by looking at the numbers:
More than 20 years, longer than any other hospital ratings organization.
Our analysis is based on 45+ million Medicare medical
claims for the most recent three-year period available.
We receive our data from nearly 4,500 hospitals nationwide.
Ratings are independent and impartial. Hospitals can neither opt-in or opt-out, nor can they submit their own data.
Healthgrades has comprehensive healthcare expertise
and rates hospitals across 31 conditions and procedures -- that's a lot of specialties!
Hospital quality is not a popularity contest.
We don't consider the reputation of the institution or any inancial information. Our scienti ic and transparent methodology focus on what matters most to patients: clinical outcomes.
Methodology Simpli ied
Our methodology works like this:
1 Identify and group patients by ICD-10-CM codes. It's the system used by healthcare providers to classify and code all diagnoses, symptoms, and procedures, everything from headaches to hypertension.
This stands for International Classi ication of Diseases, Tenth Revision, Clinical Modi ication
2 Determine the most appropriate measure for the procedure: mortality or complication rates.
3 Develop a list of potential risk factors. These include comorbid conditions.
Existing conditions like heart disease, demographic information such as age, gender, and procedure type can all impact the chance of a negative outcome
4 Use logistic regression to determine which risk factors correlate with negative outcomes (and the strength of that correlation).
A fancy term for a predictive analysis
5
Apply the logistic regression model to individual hospital data sets to derive the predictedoutcome by hospital.
6 Compare the actual outcome to the predicted outcome.
7 Assign star ratings.
Why Hospital Quality Matters
Clinical outcomes differ dramatically between hospitals in the top and bottom of the Healthgrades hospital performance categories. Patients treated at a hospital receiving a 5-star rating have, on average, a lower risk of a complication or mortality than if treated at a hospital receiving a 1-star rating in that procedure or condition.
For Example
From 2018-2020, patients treated at hospitals receiving the America's 100 Best Hospitals for Joint Replacement Award have, on average:
64.9% lower risk of experiencing a
complication while in the hospital than if they were treated in hospitals that did not receive the award.*
From 2018-2020, patients treated at hospitals receiving the America's 100 Best Hospitals for Cardiac Care Award have, on average:
27.8% lower risk of dying while in the
hospital than if they were treated in hospitals that did not receive the award.*
From 2018-2020, patients treated at hospitals receiving the America's 100 Best Hospitals for Critical Care Award have, on average:
30.1% lower risk of experiencing a
complication or dying while in the hospital than if they were treated in hospitals that did not receive the award.*
As a result:
According to the Healthgrades 2022 Specialty Excellence Ratings Analysis (using data from 2018 through 2020), the report found:
If all hospitals, as a group, performed similarly to 5-star rated hospitals
218,141
lives potentially could have been saved.
156,050
patients potentially could have avoided complications.
For more information about how Healthgrades rates hospitals, contact us at quality@ or view our full methodology here.
* Statistics are based on Healthgrades analysis of MedPAR data for years 2018 through 2020 and represent three-year estimates for Medicare patients only. For appendectomy and bariatric surgery, Healthgrades used inpatient data from 16 states that provide all-payer data for years 2017 through 2019. Due to the highly variable impact of the pandemic on hospital outcomes, Healthgrades made the decision to exclude cases with a COVID-19 diagnosis from the 2020 data in order to preserve the statistical integrity of our models and fairly evaluate clinical outcomes at all hospitals.
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