Scripps La Jolla hospitals nab top local spot in annual hospital rankings – The San Diego Union-Tribune
In its annual “best hospitals” edition, U.S. News & World Report lists Scripps in the No. 1 spot for its San Diego County regional rankings, pushing UCSD’s hospitals in La Jolla and Hillcrest to No. 2.
Though neither organization made the publication’s honor roll, reserved for the 20 hospitals judged the best in the nation, the top spot in town is still a very valuable honor capable of driving marketing campaigns in a region where a handful of big health systems compete for well-insured patients.
Nationally, the Mayo Clinic in Rochester, Minn., Cleveland Clinic and Johns Hopkins Hospital in Baltimore topped the honor roll. In California, UC San Francisco, Ronald Reagan UCLA Medical Center Stanford Health Care and Cedars-Sinai Medical Center in Los Angeles made it into the top 20.
In addition to choosing the top five hospitals in 46 different metro markets, U.S. News also lists the top 50 hospitals nationwide in 16 different specialties from cancer to rheumatology. This year, Scripps and UC San Diego tied with eight national rankings each.
Scripps Memorial Hospital La Jolla and Scripps Green Hospital, whose performance is combined into one set of rankings in the report, climbed further up the rankings while the university’s scores, which include UC San Diego Medical Center in Hillcrest and Thornton Hospital in La Jolla, slipped a bit in several areas.
U.S. News also changed the way it ranks hospitals in specific geographic regions. Quality calculations used five years, instead of three years, of data on a range of conditions. The local horse race also leaned more heavily on how well hospitals did treating more commonly-performed procedures such as aortic valve surgery, chronic obstructive pulmonary disease, colon cancer and heart failure.
Ben Harder, chief of health analysis at U.S. News, said in an email that the decision to emphasize less complex procedures is a pragmatic attempt to make the rankings more relevant for the average consumer.
“The shift reflects our judgment that patients looking for a hospital within their communities are more likely to need the sort of care evaluated in the procedures and conditions ratings than they are the higher-complexity, higher-acuity care evaluated in the specialty rankings,” Harder said in an email.
Chris Van Gorder, Scripps chief executive, said Monday that the organization’s two La Jolla hospitals maxed out their scores in these more bread-and-butter types of care which probably pushed them into first place. But he noted that UC San Diego was only eight points lower out of a possible 108. So, at the end of the day, he said, San Diegans should be happy that both organizations did well as have others, especially Sharp Memorial and Sharp Grossmont hospitals, which have consistently had better-than-average results even with fewer national rankings.
“We’re proud of the score, but I think the message to the community is that there is really great health care in San Diego, and you don’t have to leave to get great care,” Van Gorder said.
Patty Maysent, UC San Diego Health’s chief executive, sounded a similar note.
“To have two organizations each nationally ranked in eight different specialties … what a great market we have in San Diego,” Maysent said.
As to why UC San Diego lost the No. 1 spot, Maysent cited the report’s increased emphasis on the volume of procedures performed, and also the university’s tendency to treat the most severe and complicated patients, as possible reasons why scores decreased.
“When you get the Hail Mary types of patients, you may tend ot have a little bit higher mortality rate, and if you have a slightly lower volume than others that may hurt you a little more,” Maysent said.
U.S. News uses statistical methods to adjust scores for the severity of patient illness before hospitalization to try and make sure that hospitals serving the sickest don’t end up at a disadvantage. Maysent acknowledged this adjustment, but said it is not a panacea.
“That adjustment is never perfect,” Maysent said.
UC San Diego Hospitals have also recently suffered criticism for hospital-acquired infection rates. According to a petition filed with the state in February by the advocacy group Consumer’s Union, UC San Diego’s hospitals led their peers in California with higher-than-predicted levels of three different types of infections. Other well-known hospitals on the list included Ronald Reagan UCLA Medical Center and Stanford Health Care.
It’s not clear exactly how much, if at all, the infection rate data affected the ratings. But what is clear, said Dr. Bruce Spurlock, president and chief executive of Cynosure Health, a consulting company that works on health care ratings for the California Health Care Foundation, is that hospitals tend to care more than patients.
“Hospitals use these rankings the most, especially their marketing departments,” Spurlock said. “Patients, from what the evidence suggests, are loyal more to a physician than they are to a hospital.”
Van Gorder agreed. While this kind of recognition is nice, he said, he is under no illusions about what’s on patients’ minds.
“I don’t think they really care that much about what list we happen to be on. They just hope that the individual care they receive is going to be of high quality,” he said.
For many years, U.S. News has been criticized by experts who have questioned the publication’s long-standing use of doctor opinion surveys to help determine rankings. This year, 27.5 percent of most specialty ranking scores were determined by an opinion survey of more than 125,000 doctors nationwide.