Duke University Hospital has again emerged as the top hospital in North Carolina for complex medical conditions, and one of only two in the Southeast in the national top 20, according to the latest national hospital ranking by U.S. News & World Report.
The Triangle is the only region of the state with two top-rated hospitals. UNC Hospitals in Chapel Hll ranked third in the state, according to U.S. News & World Report, after second-ranked Wake Forest Baptist Medical Center in Winston-Salem.
All three are flagship hospitals within prestigious medical schools and part of large networks with regional hospitals, medical practices and diagnostic labs. U.S. News said the other top hospitals in North Carolina for treating complex medical conditions are: Vidant Medical Center in Greenville, Carolinas Medical Center in Charlotte, Mission Hospital in Asheville, Moses H. Cone Memorial Hospital in Greensboro and FirstHealth Moore Regional Hospital in Pinehurst.
The nation’s most widely-used hospital ranking survey, U.S. News started ranking hospitals in 1990 based on professional reputation and subsequently added quantifiable data on patient death and other outcomes. Since 2005, the ranking methodology and analysis has been done by RTI International, the nonprofit research organization in Research Triangle Park.
This year’s hospital rankings were winnowed down from 4,655 medical facilities. U.S. News said its rankings are not intended for routine procedures and conditions, but to help patients assess where they can get the best care for complicated diagnoses, such as pancreatic cancer or a heart valve replacement for an elderly patient with other complex health conditions.
The media organization said its rankings should never be the sole basis for a medical decision but only one factor among many considerations.
“Patients still have to do their own research and talk with their doctor,” U.S. News said in its explanation of the annual rankings. “We also understand that families have to consider such factors as the stress and expense of travel and lodging in another city and their insurer’s willingness to pay for care if a hospital is out of network.”
U.S. News assess hospitals in 25 different areas — 16 areas of complex care and nine standard procedures and conditions.
Duke University Hospital, which ranked 19th nationwide overall in U.S. News’ 2018-2019 rankings, was nationally ranked in 11 adult specialties, including cardiology, ophthalmology, orthopedics, pulmonology and urology. Duke rated “high performing” in one adult specialty (diabetes/endocrinology) and eight procedures and conditions: colon and lung cancer surgery, aortic valve and heart bypass surgery, abdominal aortic aneurysm repair, heart failure treatment, and hip and knee replacement,
Duke has consistently rated among the nation’s top hospitals by U.S. News, coming in 17th place last year and ranking as high as 8th place in 2012.
UNC Hospitals is nationally ranked in five adult specialties, including ear, nose and throat, and gastroenterology. UNC is rated “high performing” in five adult specialties, like geriatrics and rheumatology, and in four procedures and conditions: colon cancer surgery, heart bypass surgery, lung cancer surgery and heart failure.
Because the rankings focus on challenging medical conditions, U.S. News said, hospitals had to have a minimum level of patient volume in those specialties to be ranked. As a result, only 158 hospitals were ranked nationally in at least one of the 16 specialties.
U.S. News used weighted criteria, putting the greatest emphasis on survival and safety, but also considered patient volume and nursing ratio to patients.
For diagnoses that don’t typically result in death and are treated in outpatient facilities, such as ophthalmology, psychiatry, rheumatology and rehabilitation, hospitals were based on professional reputations rather than mortality and safety.
U.S. News has also changed its methodology over time, which affects how hospitals rank over time, said Ben Harder, who oversees the rankings for U.S. News.
He said the measures that have been added include hospitals readmission rates, surgical infection rates, rates of prolonged hospitalizations, and the rate at which patients get discharged straight home as opposed to a nursing home or rehabilitation facility.
“All those outcomes are adjusted for patient-level risk factors and at least partially for socioeconomic status,” Harder said. “Some hospitals are exceptionally good at preventing mortality, but may stand out less on other outcomes that also matter to patients.”