Asking which hospitals are best in the world means we must first clarify what we mean when we say “best.” Are we referring to low readmission rates? Are we talking about access to specialized care, advanced healthcare services, or surgery? How efficient is the hospital’s admission process? What are their emergency services like? What kinds of health insurance does the hospital typically deal with, and what are the average out-of-pocket costs to patients? How many patients can the hospital support? How accessible are the hospital staff, and how often are they professionally reviewed? What are the working conditions like and how do these conditions affect patients? All of these metrics must be considered if a factually accurate representation is the goal.
In the United States, consumer-centric hospital rankings are usually organized by specialty, such as cancer, gynecology, geriatrics, etc. Dividing hospital performance information in this way allows patients who are suffering with a particular condition to quickly make an informed decision. Along with hospital performance, locality and payment options for patients may also be considered, depending on the researchers coordinating the evaluation.
Rising healthcare costs and an increasing number of American citizens without health insurance formed the rationale behind the Affordable Care Act of 2010, which mandates that all small business owners with more than 50 full-time employees must provide health insurance to their full-time staff. Though the Affordable Care Act is the most significant US healthcare reform since the creation of Medicare (a socialized health insurance system granted to all US citizens over the age of 65), the ACA has been criticized for fundamentally changing the ways in which some hospitals do business with the public. Many of the top hospitals in the United States have already opted out of the ACA entirely, meaning that patients with a public option plan purchased under the ACA would not be able to utilize their healthcare services.
Understandably, this development has produced unease at large across the healthcare industry. Hospital performance ranking may change to reflect the fact that many of the best-performing hospitals are relatively inaccessible for large portions of the population. Such a disparity in service has added to the movement for a universal coverage system in the United States. Contrary to the private health insurance industry (which is often tied to one’s employment), a universal coverage system would, like Medicare, provide health insurance coverage for all citizens. Whether or not such a system will drastically affect hospital performance (or even come into being at all) remains to be seen.
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