Methodology

For the past decade, Solucient has consistently identified benchmark practices by using solely objective statistical analyses of public data sources, and by constantly improving and refining the study performance measures, thresholds for inclusion, and methodologies.

The Study Universe

The data used in the 100 Top Hospitals study come from Solucient's hospital database and the publicly available MedPAR (Medicare Provider Analysis and Review) data set. Data from the hospital database are used in calculating all the financial measures for this study. This database contains more than 800 data elements for over 6,000 U.S. acute care and specialty hospitals. Data used in calculating mortality, complications, length of stay, and the coding specificity rate are from the MedPAR data set, which contains information on the more than 12 million Medicare discharges from the nation's acute care hospitals annually.

The Comparison Groups

Bed size, teaching status, and residency program involvement have a profound effect on the types of patients a hospital treats and the scope of services it provides. We assign each hospital to one of five peer groups according to its size and teaching status:

• Major Teaching Hospitals
• Teaching Hospitals
• Large Community Hospitals
• Medium Community Hospitals
• Small Community Hospitals
  

Evolution of Performance Measures

One of the major goals of the 100 Top Hospitals: National Benchmarks for Success study is to create useful and relevant balanced scorecard measures for hospital CEOs and boards of trustees-with a selection methodology that accurately reflects the current hospital operating environment. As the market has changed, our methods for defining top performers have evolved.

This evolution led us to make a number of changes to this year's study. As always, our measures are centered on three main components of hospital performance: clinical excellence, operating efficiency and financial health, and responsiveness to the community. The measures for the 2004 study are:

1. Risk-adjusted mortality index
2. Risk-adjusted complications index
3. Risk-adjusted patient safety index
4. Severity-adjusted average length of stay
5. Expense per adjusted discharge, case mix- and wage-adjusted
6. Profitability (operating profit margin)
7. Cash to total debt ratio
8. Tangible assets (net plant, property, and equipment) per adjusted discharge
9. Growth in percent community served

For full details, the 2004 100 Top Hospitals study abstract is now available!

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