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Ranking and Understanding U.S. Hospital Health Care: Part Three

The Midwest Region of the U.S. boasts high quality health care. For veterans, it's truly exceptional from a quality and reputation perspective.

We return from our brief foray into recruiting yesterday to the subject of hospitals and how VA hospitals stack up in various regions today, according to the Care Compare model endorsed by the U.S. government and developed by Yale’s Center for Outcomes Research and Evaluation (CORE). This is the third part in a running effort to use different ranking mechanisms to get a sense of a hospital or VA hospital’s “true” worth. Following our detailed examination of hospitals, we’ll be returning our gaze to colleges in an effort to develop a mechanism for honestly evaluating which colleges are in a holistic sense “the best” for veterans.

THE BIG STORY

Best In the Midwest

VA medical care tends to outperform similar hospitals. That goes double for the Midwest.

Midwesterners take their health care seriously. This, at least, is what one concludes from a full accounting of its two divisions in the midwestern region. The overall quality of healthcare is good, and there are more top-rated facilities both in absolute and in relative terms.

19.9% of hospitals in the Midwest Region (Region 2) were “top rated,” or received cumulative ratings of 9 or 10 stars, a reliable measurement of excellence.

Adding the "West North Central” group in with “East North Central” uncovered two new outliers: South Dakota, which at over 57% of its hospitals being “top rated” is the best state we’ve seen so far for health care, and Missouri, which at just 9% of its hospitals being “top rated” is the worst (worse by 3% than my home state of Connecticut).

Across the 648 fully-rated hospitals providing acute care service (rather than critical care) covering the Dakotas, Illinois, Indiana, Missouri, Michigan, Ohio, Wisconsin, Minnesota, Nebraska, Kansas, and Iowa, the average cumulative rating is a 6.94 — solidly above average.

Veterans can expect some of the best quality health care in the Midwest at their VA Medical Centers. The midwest itself boasts high quality health care. Photo via DVIDS, by Mark DePass

16 of these hospitals achieved “perfect” scores of 10, or 5 stars in each category. Of those 16, 6 were VA hospitals.

Out of 24 VA hospitals in the Midwest Region, 15 rated 9 or more cumulative stars (this includes the aforementioned hospitals that got perfect 10s), for 62.5%. Compared with the region’s already-impressive 19.9%, it’s clear that VA hospitals are centers of medical excellence. As important, these hospitals are seen as such by their patients.

We talked about that phenomenon some weeks ago, when first examining the subject of hospitals, and hospital rankings. Often one will find that a hospital is seen one way through the lens of institutional reviews, and another way seen from the perspective of a patient receiving treatment at a hospital. In fact, given the prevalence of hospitals that receive 5 stars in quality of care and 3 (or in one case, 2) in patient satisfaction, it may even be the case that hospitals that see themselves as effective and efficient end up damaging their reputations by coming across as arrogant or insensitive to patients. The reverse is also true; there are hospitals with low (1, 2 star) ratings in quality of care that receive 3 or 4 stars from patients in terms of satisfaction.

Midwestern (blue) states compare favorably to and in many cases outperform competitors in New England (gold), in spite of New England’s reputation for medical and scientific excellence.

When it comes to health care as a service, it may be possible (within reason of course) that the patient’s view of their experience is actually as important as the physician’s view of the treatment.

We have yet to finish Region 1: the Northeast. Those results will be published next week. Analysis of the West and South will follow. I can already say having looked at the numbers that I was surprised at how poorly Region 1 fared, especially given its reputation.

Care Compare is just one way of evaluating hospitals and health care that provide service. From the perspective of veterans and active duty service members, it should be nice to know that the Department of Veterans Affairs does an exceptional job of providing top quality health care to patients in the midwest. That’s not PR, that’s born out by data.

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