The Best Hospital

Background:

Almost everyone will seek health care at some point in life. In an emergency, an individual will most likely go to the closest hospital, but for non-emergencies we may have a choice of where to seek treatment.

Suppose there are 4 or 5 hospitals reasonably accessible to your residence. You wish to pick the "best" hospital. How would you measure and choose the "best" of these local hospitals? Suppose the gravity of your situation is such that you are willing to travel for your health care and you want to pick the “best” of 50 or so hospitals. What variables do you use and how well can you measure each?

Certainly mortality is an important variable. Measuring death rates has the advantage that death is a definite unique event. The total number of deaths may not be a good measure of the quality of the hospital at all, but the number of evitable deaths could be a very good measure. How do we decide whether a death is evitable or inevitable? Each death case can be coded with data to include, for example, primary diagnosis, age, gender, urgency of admission, comorbidity, length of stay, social deprivation, and other factors. With large sample sizes, the performance of different hospitals could possibly be measured by comparing cases with similar characteristics.