With over 6,000 hospitals in America, it is staggering to consider that the quality of healthcare differs significantly across states. Many areas are unable to provide necessities and support standard health services, and because of residential segregation, various states have higher quality care than others, which is especially concerning. With health systems ranking last amongst 11 other high-income countries, America faces tremendous barriers when it comes to supplying hospitals with the same level of healthcare.
With over 64 million Americans having access to Medicare insurance services, it is significant to focus on how hospital quality is determined through their system data. Medicare oversees practically all expenditure and treatment costs in the United States and is a major factor in the quality-of-care that patients receive. Understanding this data can assist people to evaluate their alternatives when it comes to determining which hospitals can give the best care and treatment.
Why is this important?
Access to healthcare is a fundamental human right, and it is important that America maintains equality across public healthcare services. The Commonwealth Fund identifies that across 71 measures in 5 categories of access to care, care process, administrative efficiency, equity, and health care outcomes, the U.S consistently ranked poorly in comparison to the health systems of other countries.
In the recent COVID-19 pandemic, the United States has upheld one of the highest death rates in the world, with disease burden also having higher rates than comparable countries. Recently, the disease rate within the U.S. was 37% higher than in comparable countries, with treatment outcomes being significantly poor. Using age and risk-standardized mortality rates, the HAQ Index indicates that the U.S ranked with a score of 88.7 out of 100, in comparison to the average of 93.7.
While this evidence indicates a strong demand for high-quality healthcare treatment that can ease these societal expenses, there is also evidence of high hospital admission rates. For instance, hospital admissions for various diseases (including diabetes, asthma, and heart failure amongst many others) demonstrate that the U.S. has higher admissions than comparable counties per 100,000 population. Hospitals are in significant use to meet rising health risks, and so it is important that they all supply sufficient care, knowledgeable staff, and equipment to treat illnesses and diseases.
Before we dive into the data, it is important to know how the data is ranked, and what constitutes America’s best and worst hospitals.
The Centers for Medicare and Medicaid Services (CMS) provides quality measure information on hospital care and releases public data concerning the Overall Hospital Quality Star Rating. Through a standardized holistic methodology, CMS is able to measure America’s hospital quality as an accumulation of the following categories:
6. Mortality (22%)
7. Safety (22%)
8. Readmission (22%)
9. Patient Experience (22%)
10. Timely and Effective Care (12%)
It is important to note that the weighting does not include cost, which you may notice when examining other rankings. However, to evaluate hospital care, it is important to maintain an objective lens in terms of the quality and efficacy of care as opposed to prices offered. The data may present differently if factoring in costs as criterion for the best and worst hospitals.
Places in America with the Best Hospitals
According to one of the most recent sets of Medicare data, the states that ranked in order from the highest in terms of average quality scores were:
- South Dakota
Many of these states can maintain high-quality hospital networks, and increasingly high numbers of private facilities. Various states, including Minnesota, are home to some of America’s number one hospitals, including several Mayo Clinics. Access to care is also significantly easier, with these states having lower costs comparatively to others.
In the number one spot, Wisconsin ranked with a score 3.9 out of 5 stars, with Colorado having the lowest ranking within the top 10 of a score of 3.6.
Places in America with the Worst Hospitals
When examining the most recent set of Medicare data, the states that ranked in order from the worst in terms of average quality scores were:
- New York
- New Jersey
- New Mexico
New York had the lowest score of 2.2 out of 5 stars, with Delaware having 2.8 out of 5 stars, which notably, is above average even whilst placing in the bottom 10.
Considerably, New York has a low 12.7% percentage of ‘A’ grade facilities in terms of hospital safety, with the state also having especially poor government and non-profit hospital rankings. Additionally, many of these states have high percentages of uninsured citizens, such as Mississippi and Florida, which can also contribute to lower quality treatment and care.
The United States provides compelling data highlighting inequalities in hospital care across the country, including varied accounts of safety, timeliness, and patient experience (amongst others). Given that the United States has among the greatest sickness and illness rates, as well as high hospitalizations, it is critical that all residents receive the same level of treatment, regardless of the facility used.
The United States is one of the greatest spenders on healthcare, accounting for 19.7% of GDP (or $12,530 per person at $4.1 trillion), but there is still a significant gap when it comes to ensuring equality for all. Using this data, America may better identify areas where it could invest, develop, and reinforce core health services to guarantee that all individuals have access to the resources they require. It is hoped that in the future, states with low hospital rankings would be able to improve their standing, and patients will be able to access high-quality care regardless of where they live.