The Value of Gynecologic Oncology: Is the US News and World Report of Use to Us?
Since 1990, US News and World Report (USNWR) has published annual hospital and specialty rankings known as America’s Best Hospitals, and in 2015, USNWR added Best Hospitals: Procedures & Conditions. USNWR states that the hospital rankings are “to help consumers determine…which hospitals provide the best care.”
This year, for the first time, USNWR included ovarian and uterine cancer surgery as rated procedures. Leaders of medical institutions consistently state that the USNWR ratings and rankings are flawed and unimportant, but they definitely care. While the rankings are purportedly intended to assist consumers in making their health care choices, they may be more of a marketing tool than a quality metric. Witness the full-page New York Times ads the day after the rankings are released and the seals prominently displayed on hospital materials and communications.
Perhaps inclusion of our conditions among the now 20 USNWR-considered procedures is good for gynecologic oncology and gynecologic oncologists: it helps with specialty recognition and acknowledges the importance of the care we provide.
Unfortunately, the rating descriptors “above average,” “average” and “below average” are certainly not levels to which any of us strive, nor descriptive of the care we provide. And review of these metrics has, as one would expect, revealed major issues in methodology. A simple example: only inpatient endometrial cancer cases are considered. Given that institutional rates of same day discharge for endometrial cancer surgery have been reported to be as high as 80–90%, only considering inpatient surgery will not include the majority of cases at many sites. And while one might question whether including outpatient surgery metrics is feasible for these ratings, they are included in the methodology for evaluation of prostate cancer surgery as well as knee and hip surgery.
The SGO is working with the USNWR team and having ongoing discussions about this issue. While it would be more exciting to report that it had already been fixed, this will take time – and perhaps a lot of it.
The good news? The importance of our daily work is being recognized by a ranking/rating system we love to hate and, as a result, by our institutions. With greater institutional recognition comes a possible seat at the table and perhaps the power to affect changes for the betterment of our patients.
Stephanie V. Blank, MD
SGO President
References
- https://health.usnews.com/media/best-hospitals/BH_Methodology_2022-23