Tokyo and Boston Are 'Top Hospital Cities' for Cancer Treatment

Roxanne Nelson, RN, BSN

November 08, 2019

Tokyo, Japan, appears to be one of the best places in the world for cancer treatment, according to a new survey regarding the top "hospital cities" in the world.

The Japanese capital snagged the top spot for cancer treatment efficiency, and it had the highest overall quality-of-care score, the highest top-ranking hospitals score, and a very high score for access.

The second best hospital city in the world was Boston, Massachusetts, with the highest overall infrastructure score, including the best top-ranking medical universities and high scores for top-ranking hospitals and mental health specialists.

In third place was London, United Kingdom, followed in fourth place by Paris, France.

In contrast, Dubai, United Arab Emirates; Krakow, Poland; and Beijing, China, were rated the three worst cities for cancer treatment efficiency.

Somewhat surprisingly, London was number 92 (out of 100 cities) for lowest cancer treatment efficiency, even though it had a very high score in the best hospital city ranking.

The study was conducted by Medbelle, a digital healthcare company based in London.

A spokesperson for Medbelle explained that although the scoring for London may be confusing, it is actually straightforward.

London scored third (of 20) for best hospital cities and second (of 10) for best medical universities, but it scored near the bottom for cancer treatment efficiency. "But this is because the cancer treatment score is a country-level score for England," explained the spokesperson. "All English cities therefore have the same score."

Medbelle further explained that data relating to scores for cancer treatment efficiency are city-level where possible and are otherwise country-level. For example, for Israel, Spain, France, and the Unied Kingdom, a city that appears in the bottom 10 list indicates that the country is in the bottom 10 overall for cancer treatment efficiency.

"Despite having some of the top-ranking hospitals and medical universities in the world, the UK still falls short on quality of care compared to other developed nations. Until quality of care is not raised to the highest standards, the NHS [UK's National Health Service] will remain at the top of the agenda in the political discourse," Daniel Kolb, co-founder and managing director of Medbelle, commented in a statement.

"Our hope is that this study will highlight how fortunate the British public is to have the National Health Service, while also illustrating the areas where it needs to improve in order to fully offer the standard of care that tax-paying citizens deserve," he added.

Methods

Access and quality of cancer care can vary tremendously, and Medbelle notes in their survey that as part of the "wave of digitalized medical solutions," it learned that infrastructure can have a significant impact on the experience of patients. For example, even if a city has a world-class hospital, "there is room for improvement" if the overall infrastructure creates barriers to high-quality care for all residents.

Medbelle's ranking of the best hospital cities focuses on the overall hospital ecosystem in specific locations, as opposed to individual institutions.

The study sought to determine the top global locations for hospital infrastructure in terms of quality, accessibility, and ecosystem. All hospitals within a city were analyzed, so a high ranking could only be attained if the quality of all facilities within the region was high.

Rankings were determined after analysis of the following features:

  • Infrastructure, which includes the number of hospital beds, nurses, surgeons, and mental health specialists

  • Quality of care, which includes satisfaction, adverse events, and cancer treatment efficiency

  • Access, which includes access to care, cost of medicines, and discretionary healthcare spending

And the Winners Are...

Each factor was then scored, with 100 being the highest mark. The final ranking was based on the highest scoring, so the higher the ranking, the better the overall hospital infrastructure in a particular city.

In the infrastructure category, Heidelberg, Germany, had the highest ranking for hospital beds; Basel, Switzerland, for nurses; Hamburg, Germany, for surgeons; and Richmond, Virginia, United States, for mental health specialists.

The highest score for top-ranking medical universities went to Boston, and for top-ranking hospitals, Tokyo.

Under quality of care, satisfaction, the top score went to Incheon, South Korea. Adverse events was a "joint score" between cities in Switzerland, Norway, and Singapore. Tokyo had the top score for cancer treatment efficiency.

For the access category, Oslo, Norway, had the highest score. Canadian cities scored highest for cost of medicine, and Beijing, China, was at the top for discretionary healthcare spending.

US Care Uneven

Only one US city made the list of top 20 hospital cities, whereas five were included in the top 10 cities for cancer treatment efficiency (Boston; Denver, Colorado; Seattle, Washington; Baltimore, Maryland; and Richmond).

Only Boston and Baltimore made the list of top 10 cities with best quality of care. That category was heavily dominated by Japan and South Korea. Boston, New York, Los Angeles, and Chicago were on the list of the top 10 cities with the best medical universities.

Rankings as best hospital cities doesn't mean that all parameters are optimal. For example, although Los Angeles ranked second among the best hospital cities in the United States, it has a relatively low score for nurses per capita, at 29.47 (out of 100). Seattle does as well (28.28), although it is a best hospital city and also one of the top ten globally for cancer treatment efficiency.

Medbelle noted that access to care in the United States is less than optimal. "This study illustrates that America has one of the highest-quality hospital infrastructures in the world, yet in terms of access to all citizens, US benchmarks well below other developed countries," said Kolb. "A key case is Houston, which comes in the top 15 for world-class hospitals with a score of 94.92 out of 100, yet ranks second to last place in terms of access, with a score of only 48.83 out of 100."

Medbelle. Best Hospital Cities Rankings 2019. Full text

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