There are a lot of really good hospitals that didn’t make the list. I will tell you up front that I don’t know the majority of these hospitals and I haven’t read the methodology. But I would bet that the majority of these a smaller community hospitals that either do not take patients who are seriously ill or the seriously ill patients go to the bigger inner-city hospitals and teaching facilities. The other think I want to mention is that, for me, the key to quality care should be reflected in the hospital’s nosocomial infection rates. Nosocomial infections are those acquired AFTER the patient enters the hospital. Just my opinion.
That’s my impression upon first read too. Cancer specialists like Sloan Kettering and research hospitals like Johns Hopkins likely have higher mortality rates as their patients are of higher risk.
Unlike other hospital quality studies, HealthGrades evaluates hospitals solely on patients’ clinical outcomes: risk-adjusted mortality and inhospital complications. HealthGrades’ analysis is based on approximately 40 million Medicare patient discharges for the years 2007, 2008 and 2009.
I'm guessing that variations such as patient age and preexisting conditions (such as cancer) would be dealt with under the umbrella of "risk-adjusted mortality" and nosocomial infections would be factored in under "inhospital complications".