Patients who seek surgery for cancer at one of the top 50-ranked hospitals (according to US News and World Report [USNWR]) ranked hospitals had better outcomes compared with non–top-ranked hospitals. However, the scores within those top 50 outcomes were comparable, according to a recent study.1
Using data from the Medicare Inpatient Standard Analytic Files from 2013 to 2015, researchers looked at the relationship of postoperative outcomes and Medicare expenditures among patients who underwent surgery for colorectal, lung, esophageal, pancreatic, and liver cancer at hospitals ranked within the top 50 on the USNWR list, and those that ranked below 50.
The study included outcomes for 94,599 patients, of whom 13,217 underwent surgery at a top-50 hospital. The odds of postoperative complications were lower at top-ranked hospitals compared with non–top-ranked hospitals for:
- Lung cancer (OR, 0.81; 95% CI, 0.61-0.87)
- Esophageal cancer (OR, 0.70; 95% CI, 0.52-0.94)
- Pancreatic cancer (OR, 0.81; 95% CI, 0.70-0.94)
- Liver cancer (OR, 0.85; 95% CI, 0.69-1.04)
However, this was not found to be true for colorectal cancer surgery (OR, 1.46; 95% CI, 1.28-1.65). Those patients who had surgery at a top-ranked hospital did have lower odds of experiencing a failure-to-rescue after developing a complication following colorectal surgery (OR, .57; 95% CI, 0.41-0.80) compared with non–top-ranked hospitals.
Looking at outcomes for these 5 surgery types within the top 50 hospitals, there was no difference in odds of developing a complication or experiencing failure-to-rescue, 90-day readmission, or 90-day mortality, except when it came to pancreatic resection. Among patients who underwent pancreatic resection, there was a 37% lower odds of mortality at honor-roll hospitals — or hospitals ranked within the top 20 — compared with non–honor-roll-ranked hospitals (OR, 0.63; 95% CI, 0.44-0.89).
“Patients undergoing surgery for lung, esophageal, liver, pancreatic, and colorectal cancer at the top 50 USNWR hospitals had lower odds of experiencing mortality compared with non–top-ranked hospitals,” the researchers wrote. “However, rank within the top 50 USNWR was not associated with quality, suggesting that the USNWR was a crude tool to differentiate hospitals relative to patient outcomes.”
Mehta R, Merath K, Farooq A, et al. U.S. News and World Report hospital ranking and surgical outcomes among patients undergoing surgery for cancer [published online November 3, 2019]. J Surg Oncol. doi: 10.1002/jso.25751