Intended for healthcare professionals

Feature Hospital Ratings

Dr Foster goes to America

BMJ 2015; 351 doi: (Published 22 July 2015) Cite this as: BMJ 2015;351:h3928
  1. Owen Dyer, journalist, Montreal, Canada
  1. owen_dyer{at}

A plethora of hospital rating systems has caused confusion in the US but now, with the help of healthcare analysts Dr Foster, that may be changing. Owen Dyer reports

Choosing one hospital over another can mean the difference between life and death. Parents who took their babies for congenital heart surgery at Bristol Royal Infirmary in the west of England in the early 1990s later learnt that up to 35 died who probably would have survived had their operations been carried out elsewhere. Unbeknown to the parents, Bristol’s death rate was twice that of the other designated centres.

The Bristol tragedy helped to spur a move to greater transparency about the safety and quality of individual hospitals. In 2001 the healthcare information provider Dr Foster published its first hospital guide for England, including mortality data for every hospital. It was the first comparative measure of quality commissioned by a national healthcare system.

Although the US had a head start on hospital ratings—US News and World Report has produced a Best Hospitals guide since 1990—a plethora of rating systems has led to a confusing picture. The rating agencies, which include Healthgrades, Leapfrog, Consumer …

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