Picking the best hospitals
6/6/2004 By Avery Comarow No matter how friendly the ads and cheery the redecorated rooms, hospitals are not hotels. Patients aren't pampered, especially with nurses and other key hospital workers in short supply. Besides, would you go to a hotel if told you had a 1 in 30 or so chance of not emerging? That's true for many surgical procedures. Even great hospitals have their tragedies. A year ago, in June, a healthy 24-year-old woman died after volunteering for a study at Johns Hopkins Hospital in Baltimore. Last January, a healthy man who had donated part of his liver to his ailing brother died at Mount Sinai Medical Center in New York; his surgeon is tops at live-donor liver transplants. Face it: People who check into hospitals are there because they are too ill, or need treatment that is too ambitious or difficult, to be outpatients. Elite in a grim way, they are a class in decline. In 1980, about 1 hospital patient in 7 stayed overnight. By 1990 that had dwindled to 1 in 10 and by 2000 to a scant 1 in 16. The sicker the patient, the more pressing the need for the best care–which is why U.S. News is publishing its 13th annual edition of "America's Best Hospitals." They rank 205 top medical centers, winnowed from 6,045, in 17 specialties. These hospitals excel partly because their doctors perform large numbers of tricky and risky procedures. Study piled upon study has shown the critical role of volume. [...]