Criteria for Evaluating Ophthalmology Departments Based on the U.S. News & World Report Ranking System

Abstract

Purpose To propose a methodology for ranking U.S. clinical ophthalmology programs which utilizes an existing framework of both objective structural (or resource) information and outcome data as well as subjective reputational scores currently used by U.S. News & World Report for most clinical specialties.

Design Evidence-based manuscript.

Topic The U.S. News & World Report annual “Best Hospital Rankings by Specialty” provides the public with information regarding the relative strengths of U.S. medical and surgical departments in providing care and treatments for patients with complex diseases. For most medical and surgical specialties, these rankings are determined by considering a combination of objective structural (or resource) information and outcome data along with subjective reputational scores.

Clinical Relevance In ophthalmology, U.S. News & World Report annual rankings are currently generated only from subjective reputational scores submitted by a small number of voting ophthalmologists. No objective clinical or outcome data are considered.

Literature Reviewed Methodology for determining “Best Hospital Rankings by Specialty” utilized by RTI International on behalf of U.S. News & World Report.

Results The ranking system of U.S. departments of ophthalmology presently employed by U.S. News & World Report presents an incomplete picture of the relative strengths and weaknesses of the departments listed.

Conclusion With the changes in health insurance that increasingly shift decision-making responsibility and cost to consumers, providing mechanisms to allow the public to make informed decisions is an emerging imperative for ophthalmology and other specialties. Revision of the current “reputation-only” ranking system used for ophthalmology to also include objective clinical and outcome data would benefit patients by providing more accurate and impartial information on which to base their eye care decisions.

Keywords

ophthalmology - ranking system - U.S. News & World Report

• References

• 1 Joynt KE, Orav EJ, Jha AK. The association between hospital volume and processes, outcomes, and costs of care for congestive heart failure. Ann Intern Med 2011; 154 (2) 94-102
• 2 Magid DJ, Calonge BN, Rumsfeld JS , et al; National Registry of Myocardial Infarction 2 and 3 Investigators. Relation between hospital primary angioplasty volume and mortality for patients with acute MI treated with primary angioplasty vs thrombolytic therapy. JAMA 2000; 284 (24) 3131-3138
• 3 McGrath PD, Wennberg DE, Dickens Jr JD , et al. Relation between operator and hospital volume and outcomes following percutaneous coronary interventions in the era of the coronary stent. JAMA 2000; 284 (24) 3139-3144
• 4 Dudley RA, Johansen KL, Brand R, Rennie DJ, Milstein A. Selective referral to high-volume hospitals: estimating potentially avoidable deaths. JAMA 2000; 283 (9) 1159-1166
• 5 Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med 2002; 137 (6) 511-520
• 6 Nguyen NT, Paya M, Stevens CM, Mavandadi S, Zainabadi K, Wilson SE. The relationship between hospital volume and outcome in bariatric surgery at academic medical centers. Ann Surg 2004; 240 (4) 586-593 , discussion 593–594
• 7 Pope DG. Reacting to rankings: evidence from “America's best hospitals and colleges.” 2006. Available at: opimweb.wharton.upenn.edu/documents/JobMarketPaper-Pope.pdf
• 8 Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff (Millwood) 2005; 24 (4) 1150-1160
• 9 Murphy J, McFarlane E, Olmsted MG, Severance J, Drozd EM, Morley M, Hill C. U.S. News & World Report 2010/11 Best Hospitals Rankings Methodology. Washington, DC: U.S. News & World Report; 2010
• 10 Sehgal AR. The role of reputation in U.S. News & World Report's rankings of the top 50 American hospitals. Ann Intern Med 2010; 152 (8) 521-525
• 11 Teasley III CE. Where's the best medicine? The hospital rating game. Eval Rev 1996; 20 (5) 568-579
• 12 McGaghie WC, Thompson JA. America's best medical schools: a critique of the U.S. News & World Report rankings. Acad Med 2001; 76 (10) 985-992
• 13 Bartels LM. Presidential Primaries and the Dynamics of Public Choice. Princeton, NJ: Princeton University Press; 1988
• 14 Bikhchandani S, Hirshleifer D, Welch I. A theory of fads, fashion, custom and cultural change as informational cascades. J Polit Econ 1992; 100 (5) 992-1026
• 15 Callander S. Bandwagons and momentum in sequential voting. Rev Econ Stud 2007; 74: 653-684
• 16 Green J, Wintfeld N, Krasner M, Wells C. In search of America's best hospitals. The promise and reality of quality assessment. JAMA 1997; 277 (14) 1152-1155
• 17 Johns KJ, Feder RS, Hamill MB, Miller-Meeks MJ, Rosenfeld SI, Perry PE eds. Lens and Cataract: Section 11, Basic and Clinical Science Course. San Francisco, CA: American Academy of Ophthalmology; 2003. –2004: 171
• 18 Ta CN. Minimizing the risk of endophthalmitis following intravitreous injections. Retina 2004; 24 (5) 699-705
• 19 Ng JQ, Morlet N, Bremner AP, Bulsara MK, Morton AP, Semmens JB. Techniques to monitor for endophthalmitis and other cataract surgery complications. Ophthalmology 2008; 115 (1) 3-10
• 20 Seiden SC, Barach P. Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?. Arch Surg 2006; 141 (9) 931-939
• 21 Pennsylvania Patient Safety Reporting System (PAPSRS). Focusing on eye surgery. PAPSRS Patient Saf Advis 2005; 2 (1) 12-14
• 22 Beebe J. Wrong side surgery position paper. 2009 . Available at: www.doh.state.fl.us/MQA/medical/info_wrong.doc