Introduction
For families facing a serious or complex medical problem, finding the right hospital is daunting but critical. Decision tools beyond a doctor’s recommendation, however, were nonexistent until 1990, when U.S. News & World Report introduced “America’s Best Hospitals.” That initial assessment was modest, only short alphabetical lists of hospitals that were rated—not ranked—in 12 specialties. In 1991 and thereafter, hospitals were ordinally ranked.
The 2018-19 Best Hospitals rankings have been drawn from a universe of 4,656 facilities. The defined universe was the American Hospital Association’s (AHA’s) Annual Survey of Hospitals, which also provided some data for the rankings analysis. In a small number of cases, two or more AHA hospitals were combined for ranking purposes because they function as a single hospital in one or more specialties but report to AHA as separate facilities.
In 12 of the 16 adult specialty rankings, hospitals receive a composite score based on data from multiple sources. Unranked as well as ranked hospitals, accompanied by substantive data, are published online at www.usnews.com/besthospitals/rankings. A print edition publishes ranked hospitals, with somewhat less data displayed than online.
It is essential to use the Best Hospital rankings for their intended purpose—to help consumers determine which hospitals provide the best care for the most serious or complicated medical conditions and procedures, such as pancreatic cancer, or replacement of a heart valve in an elderly patient with multiple comorbidities. Relatively commonplace conditions and procedures, such as uncomplicated heart bypass surgery, knee replacement, and heart failure are the purview of a different analysis, Best Hospitals: Procedures and Conditions.
The underlying methodology for the Best Hospitals rankings was created by the National Opinion Research Center (NORC) at the University of Chicago in the early 1990s. NORC collected the data and compiled the rankings from 1993 to 2004. RTI International, Research Triangle Park, N.C., has produced the rankings from 2005 to the present. Over time, the methodology has been refined and extended—by incorporating patient safety data in 2009, for example, and a measure for voluntary data transparency in one specialty in 2016-17. Large-scale enhancements are always under consideration.
The roster of specialties has been revised over the years as well. AIDS care, for example, was included in 1990 but was dropped in 1998 because most AIDS care had shifted to the outpatient setting. Pediatrics was moved out of the Best Hospitals universe in 2007 when separate Best Children’s Hospitals rankings were created. Best Hospitals specialties were neither added nor removed for 2018-19.
The current 16 specialty rankings are:
• Cancer
• Neurology & Neurosurgery
• Cardiology & Heart Surgery
• Ophthalmology
• Diabetes & Endocrinology
• Orthopedics
• Ear, Nose & Throat
• Pulmonology
• Gastroenterology & GI Surgery
• Psychiatry
• Geriatrics
• Rehabilitation
• Gynecology
• Rheumatology
• Nephrology
• Urology
