In its annual review and ranking of hospitals updated every July, U.S. News surveyed nearly 10,000 specialists and analyzed the data for approximately 5,000 medical centers to establish the best hospitals in the U.S. in 16 adult specialties, from cancer to urology. Death rates, patient safety, and hospital reputation were among the factors considered. The publication created an Honor Roll, which recognizes the small number of hospitals that are unusually competent across a range of specialties, not just one or two. This year's Honor Roll features the 18 medical centers that scored near the top in at least six specialties; of the total, 147 hospitals were nationally ranked in one or more specialties.

The underlying reason for a comprehensive ranking of hospitals is two-fold. "Every year, as many as two million hospital patients face surgery or care that is technically challenging or a risk of death or harm that is multiplied because of age, physical condition or infirmities," wrote the editors. "The rankings provide such patients with a tool to help them find unusually skilled inpatient care." That said, any hospital recommended by a doctor "probably is fine," according to the editors, for most patients who are at a low level of risk and do not require an unusual or challenging procedure.

The first step in rating these hospitals is grouping them into 16 individual specialty lists.

50 Top Hospitals

Twelve of the 16 lists showcase the 50 top hospitals, which have been scored on death rates for the most demanding cases, patient safety, and other categories of performance that can be weighed with hard data. A significant factor is the results of the physician's survey; annually, U.S. News asks physicians to name hospitals they consider the best in their specialty for difficult cases. Hospitals with scores that fall within the top 25 percent in a given specialty are recognized as high-performing in the specialty even if they may be unranked nationally.

These 12 data-dependent specialties are cancer, cardiology & heart surgery, diabetes & endocrinology, ear, nose & throat, gastroenterology & GI (gastrointestinal) surgery, geriatrics, gynecology, nephrology, neurology & neurosurgery, orthopedics, pulmonology, and urology. Meanwhile, an additional four specialties — ophthalmology, psychiatry, rehabilitation, and rheumatology — are ranked by reputation-only.

Those hospitals that received nominations from at least five percent of the specialists responding to the last three surveys are nationally ranked as 'Best Hospitals' while those nominated by at least three percent (but less than five percent) of physicians are ranked as 'Best Regional Hospitals.'

For the 12 data-driven rankings, the publication started with virtually all nonfederal community hospitals in the U.S. of any size, a universe that comprised 4,806 hospitals. From that starting pool, a hospital had to meet any of four possible criteria to qualify for consideration in the data-driven specialties: teaching-hospital status, medical school affiliation, bed size of 200 or more, or bed size of 100 or more plus availability of four or more specific types of medical technology, such as a PET/CT scanner and certain precise radiation therapies. This year, 47 percent or 2,262 hospitals matched the inclusion criteria.

Highlights

Johns Hopkins Hospital, located in Baltimore, achieved the highest position on the Honor Roll. The hospital not only scored near the top in at least six specialties, but it ranked as the number one hospital, an extraordinary achievement, in five areas: ear, nose, & throat, geriatrics, neurology & neurosurgery, urology, and rheumatology. Handily, then, Johns Hopkins replaced last year's winner on the Honor Roll, Massachusetts General Hospital, which this year placed second by achieving high rankings in the following specialties: diabetes & endocrinology (third place), psychiatry (third place), gastroenterology & GI surgery (fourth place), neurology & neurosurgery (fourth place), orthopedics (fourth place), and ophthalmology (fourth place).

The Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, UCLA Medical Center in California, Northwestern Memorial Hospital in Illinois, New York-Presbyterian University Hospital of Columbia and Cornell in New York, and UCSF Medical Center in California follow on the Honor Roll list. Clearly all institutions cited in this category are exceptional medical centers.

Common Disease, Top Hospitals

The top ranking adult cancer hospital is University of Texas MD Anderson Cancer Center based in Houston, followed by New York City's Memorial Sloan-Kettering Cancer Center and Rochester, Minnesota's Mayo Clinic. Within the children's category, Cincinnati Children's Hospital Medical Center in Ohio places at the top of the list, followed by Dana-Farber Boston Children's Cancer and Blood Disorders Center in Massachusetts and Children's Hospital of Philadelphia in Pennsylvania.

Cleveland Clinic in Ohio achieved the number one ranking within the category of cardiology and heart surgery, followed by the Mayo Clinic of Minnesota and New York-Presbyterian University Hospital of Columbia and Cornell, based in New York City, which placed third.

For a complete list as well as the lists for all other specialties, please go here.

Children, A Special Consideration

The rankings for Best Children's Hospitals is updated annually in June while the children's Honor Roll recognizes hospitals with outstanding rankings in at least three specialties.

Although only few children ever face life-threatening conditions or undergo complicated surgeries, those who do need expertise that most hospitals simply cannot provide. Even those hospitals with solid pediatric departments are hard put to deal with some of the unusual procedures necessary for a sick child. Among those hospitals that do routinely treat children with serious health problems, some are simply better than others.

The rankings for children, then, list the 50 best-performing hospitals in ten specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology. To read the complete list of rankings of children's hospitals and the honor roll, please go here.

The top five children's hospitals on the honor roll were: Children's Hospital of Philadelphia, Boston Children's Hospital, Cincinnati Children's Hospital Medical Center, Texas Children's Hospital (Houston), and Children's Hospital Los Angeles.

Source: Best Hospitals. US News & World Report. 2013.