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Are "America's Best Hospitals" America's Best?

Arthur Hartz, MD, PhD; Evelyn M. Kuhn, PhD; Jose Pulido, MD
JAMA. 1997;278(6):473. doi:10.1001/jama.1997.03550060049021.
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To the Editor.  —Dr Green and colleagues1 found weaknesses in the methods used by US News & World Report to rate hospitals according to quality of care. Despite these weaknesses, it is possible that the rating could be of some use to patients desiring to choose an excellent hospital.We investigated the utility of the ratings using outcome data that were carefully adjusted for patient risk. Data for our analysis included the hospital's observed and predicted mortality rate for patients who had coronary artery bypass graft (CABG) surgery in New York and Pennsylvania from 1990 to 1992. We aggregated these data for the 8 hospitals in New York and Pennsylvania that were listed in US News & World Report as among the best 41 hospitals in cardiac care.2 The 10 909 patients in these 8 hospitals had an observed mortality rate of 3.45%, a predicted mortality rate of


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