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Hospital care: Does your state rate?

All states — even ones at the bottom of the barrel when it comes to hospital care — have good hospitals and bad hospitals. What do you look for in a good hospital?
/ Source: WebMD

All states — even ones at the bottom of the barrel when it comes to hospital care — have good hospitals and bad hospitals. What do you look for in a good hospital?

Suffering a heart attack in a state such as Mississippi is likely to be much more dangerous than in Colorado.

In fact, a new report shows where you live may play a major role in the quality of hospital care you get for various conditions.

The sixth annual HealthGrades Hospital Quality in America Study shows the quality of healthcare at the nation’s hospitals varies greatly among states.

Researchers ranked each of the country’s nearly 5,000 hospitals on 26 common procedures and conditions and found better-performing hospitals tended to be in northern or sparsely populated states.

Here’s how the 50 states and District of Columbia fared:


  1. North Dakota
  2. Florida
  3. Ohio
  4. Michigan
  5. Maryland
  6. Colorado
  7. Pennsylvania
  8. Connecticut
  9. Utah
  10. South Dakota
  11. Virginia
  12. Minnesota
  13. Arizona
  14. Montana
  15. New Jersey
  16. Maine
  17. Illinois
  18. Rhode Island
  19. Washington
  20. Indiana
  21. Oregon
  22. Washington, D.C.
  23. New Hampshire
  24. Idaho
  25. California
  26. Massachusetts
  27. Missouri
  28. Louisiana
  29. North Carolina
  30. Texas
  31. New Mexico
  32. Nebraska
  33. New York
  34. Kentucky
  35. Delaware
  36. Nevada
  37. Georgia
  38. Wisconsin
  39. Alaska
  40. Iowa
  41. West Virginia
  42. South Carolina
  43. Wyoming
  44. Hawaii
  45. Oklahoma
  46. Vermont
  47. Kansas
  48. Tennessee
  49. Arkansas
  50. Alabama
  51. Mississippi


“The quality chasm at American hospitals is real, and it is very alarming and concerning — despite evidence of process improvements,” says Dr. Samantha Collier, HealthGrades’ vice president of medical affairs, in a news release.

Although there are exceptional hospitals in even the lowest-ranking states, researchers say that, on average, patients get better quality healthcare in the higher-ranking states.

For example, the report shows that a person has a 55 percent increased chance of dying if he or she had a balloon angioplasty or other similar heart procedure in Texas rather than in New York.

“In Mississippi, your chance of dying from a heart attack is 49 percent higher, on average, than if you were treated in Colorado,” says Collier.

Researchers say that the greatest differences at the state level were among certain heart procedures, such as balloon angioplasty, stenting, and others. For these procedures, New York was the best performing state and Alaska was the worst.

The report shows states such as Texas and Tennessee also had above-average death rates associated with these procedures — which resulted in hundreds of unnecessary deaths between 2000 and 2002, researchers say. Meanwhile, hospitals in New York, New Jersey, and Florida had lower-than-normal death rates associated with these procedures that prevented many deaths.

A complete list of rankings for each of the 26 procedures studied at almost 5,000 hospitals is available at

Researchers compiled the rankings based on whether the patient outcomes at the various hospitals were better or worse than could normally be expected. A five-star rating reflects performance significantly better than expected, three stars reflects an average level of performance, and a one-star rating reflects care that was significantly worse than expected.


How can you choose the best quality hospital for the care you need? It is important to consider quality because research shows that some hospitals simply do a better job than others. For example, we know that hospitals that do a greater number of the same surgeries have better outcomes for their patients.

Look for a hospital that:

  • Is accredited by the Joint Commission on Accreditation of Healthcare Organizations
  • Is rated highly by state or consumer or other groups
  • Is one where your doctor has privileges, if that is important to you
  • Is covered by your health plan
  • Has experience with your condition
  • Has had success with your condition
  • Checks and works to improve its own quality of care


Asking the right questions can help you make the best choices.


Hospitals can choose to be surveyed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to make sure they meet certain quality standards. The standards address the quality of staff and equipment and the hospital’s success in treating and curing patients. If a hospital meets those standards, it becomes accredited (gets a “seal of approval”). Reviews are done at least every three years. Most hospitals participate in this program.

You can order JCAHO’s performance reports free of charge by calling (630) 792-5800. Or check the JCAHO’s Web site at for a hospital’s performance report or for its accreditation status.


One important way to learn about hospital quality is to look at hospital report cards developed by states and consumer groups. A recent study about such reports found that besides helping consumers make informed choices, they also encourage hospitals to improve their quality of care. This is a very good reason to look for and use consumer information about hospitals. Also, ask your doctor what he or she thinks about the hospital.


For example, “general” hospitals handle a wide range of routine conditions, such as hernias and pneumonia. “Specialty” hospitals have a lot of experience with certain conditions (such as cancer) or certain groups (such as children). You may be able to choose General Hospital “X” for gallbladder surgery, Specialty Hospital “Y” if you need care for a heart condition, and Specialty Hospital “Z” for your children.

You also may want to find out if the hospital has a special team of health professionals that works with people with your condition or treatment.


Research shows that hospitals that do many of the same types of procedures tend to have better success with them. In other words, “practice makes perfect.” Ask your doctor or the hospital if there is information on:

How often the procedure is done there

How often the doctor does the procedure

The patient outcomes (how well the patients do)


More and more hospitals are trying to improve the quality of their care. One way is to keep track of patient outcomes for certain procedures. Another way is to keep track of patient injuries and infections that occur in the hospital. By finding out what works and what doesn’t, the hospital can improve the way it treats patients.

Ask the hospital quality management (or assurance) department how it monitors and improves the hospital’s quality of care. Also, ask for any patient satisfaction surveys the hospital has done. These will tell you how other patients have rated the quality of their care.

WebMD content is provided to MSNBC by the editorial staff of WebMD. The MSNBC editorial staff does not participate in the creation of WebMD content and is not responsible for WebMD content. Remember that editorial content is never a substitute for a visit to a health care professional.