It is liking comparing apples and oranges as the article states, so those hospitals who take care of patients based on an older and perhaps less healthy demographics base did not come out as well.  Patient mix I think should be included, otherwise you can’t really get an accurate feel for how the hospital is really doing.  Physicians see this all the time when they are ranked with demographic groups and the percentages of items they should be hitting as a percentage for their focus, and some have a heavier group of seniors versus patients under 40, so again, everything is not equal there as well.  BD 

They found that the hospitals with the lowest crude composite scores tended to be smaller, non-academic institutions that treated a higher percentage of older, sicker and minority patients than those in the top group. While there was general agreement on performance between the two ranking systems, researchers found that when taking into account patient characteristics and treatment opportunity, 16.5 percent, or 74 of the hospitals would fall into a different financial status category.

So why doesn't Medicare consider patient mix in tallying rankings? "On the surface, it may well seem to be the right thing to do, but some feel such a move would 'legitimize' less-than-optimal care," says Peterson. "At the same time, not taking these factors into consideration is like comparing apples to oranges."

Hospital rankings: More than meets the eye


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