Few Upsets in U.S. News Top Kids' Hospitals List

By Robert Lowes
WebMD Health News

June 27, 2017 -- For the third straight year, Boston Children's Hospital took first place in the annual ranking of the best pediatric hospitals by U.S. News & World Report.

The 11th annual ranking, released today, held few surprises. As in the previous two years, Boston Children's was trailed by Children's Hospital of Philadelphia, Cincinnati Children's Hospital Medical Center, and Texas Children's Hospital, Houston, in that order. Four other hospitals were repeats from last year, while Johns Hopkins Children's Center of Baltimore and the Children's National Medical Center in Washington, D.C., made the honor roll again after brief absences.

Here are the rankings:

  1. Boston Children's Hospital
  2. Children's Hospital of Philadelphia
  3. Cincinnati Children's Hospital Medical Center
  4. Texas Children's Hospital, Houston
  5. Johns Hopkins Children's Center
  6. Children's Hospital Los Angeles
  7. Ann and Robert H. Lurie Children's Hospital of Chicago
  8. Nationwide Children's Hospital, Columbus, Ohio
  9. Children's Hospital of Pittsburgh of UPMC
  10. Children's National Medical Center

U.S. News bases its honor roll on how pediatric hospitals rank in each of 10 specialties, with points assigned to their positions -- 25 points for first place in a given specialty, 24 points for second, etc. The 10 hospitals with the most points across the 10 specialties appear in the honor roll.

The methodology is a departure from last year's, when a hospital had to score in the top 10% of at least three specialties to qualify for the honor roll. Last year's rankings also used a different point system.

The top children's hospitals in the 10 specialties are as follows:

  • Cancer: St. Jude Children's Research Hospital, Memphis, TN
  • Cardiology and heart surgery: Texas Children's Hospital, Houston
  • Diabetes and endocrinology: Children's Hospital of Philadelphia
  • Gastroenterology and gastrointestinal surgery: Boston Children's Hospital
  • Neonatology: Children's National Medical Center, Washington, D.C.
  • Nephrology: Boston Children's Hospital
  • Neurology and neurosurgery: Boston Children's Hospital
  • Orthopedics: Boston Children's Hospital
  • Pulmonology: Children's Hospital of Philadelphia
  • Urology: Boston Children's Hospital

The rankings within the 10 specialties mostly reflect objective quality measures, such as clinical outcomes, patient volume, infection control, adequate staffing of nurses, efficiency and coordination of care, and compliance with best practices. A hospital's reputation within a specialty, as gleaned from physician surveys, accounts for 15% of its score.

So Long, Reputation?

Hospital rankings by some other organizations do not give any weight to reputation, which is seen as an unreliable measure of quality. For its 2016-2017 rankings, U.S. News lowered the weight of the reputation score from 16.7% to 15%. And this year, reputation was dropped to 8.5% in the specialty of pediatric cardiology and heart surgery. U.S. News said in a release that it made this change to help accommodate a new quality measure in this specialty -- adjusted mortality rate after pediatric heart surgery.

Ben Harder, the managing editor and chief of health analysis at U.S. News, told Medscape Medical News in an email that comparable data are not available for other specialties, so the weight of reputation remains at 15% in its scoring.

The magazine is meeting with hospital representatives and other stakeholders in November to discuss the future role of reputation in the ranking, Harder said. Participants will discuss the possibility of cutting the weight assigned to reputation more, or replacing it with new, objective quality measures, an announcement posted on the magazine's website says.

See more information on the U.S. News rankings of pediatric hospitals on the magazine's website.

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References
SOURCES: U.S. News & World Report: " U.S. News Best Children's Hospitals 2017-18." Ben Harder, managing editor, chief of health analysis, U.S. News & World Report.

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