US News Releases Best Children's Hospitals List, With Changes

Diana Swift

June 15, 2021

For the eighth consecutive year, Boston Children's Hospital has captured the no. 1 spot in the national honor roll of U.S. News & World Report's Best Children's Hospitals.

Released today, the 2021–2022 rankings, which acknowledge 50 US centers for delivering exceptional care in several specialties, also give the Massachusetts hospital the top spot in 4 of 10 pediatric specialties assessed: nephrology, neurology and neurosurgery, pulmonology and lung surgery, and urology.

Children's Hospital of Philadelphia (CHOP) retains second spot in the annually updated list, and Texas Children's Hospital, in Houston, moves up a rung to third place, bumping Cincinnati Children's Hospital Medical Center from third to fourth place. Children's Hospital Los Angeles comes in at no. 5.

The remaining top 10 placements, in descending order, are as follows:

Children's Hospital Colorado, in Aurora; Children's National Hospital, in Washington, DC; Nationwide Children's Hospital, in Columbus, Ohio; UPMS Children's Hospital, of Pittsburgh, Pennsylvania; and Lucile Packard Children's Hospital Stanford, in California.

New Regional Rankings

This year's edition of offers something new, adding rankings within states and multiple-state rankings within seven regions to facilitate choice. "The Best Children's Hospitals rankings have always highlighted hospitals that excel in specialized care," said Ben Harder, chief of health analysis and managing editor at US News, in a press release. "Now, this year's new state and regional rankings can help families identify conveniently located hospitals capable of meeting their child's needs. As the pandemic continues to affect travel, finding high-quality care close to home has never been more important."

Across the seven regions, the top-ranked institutions are as follows:

  • Mid-Atlantic ― CHOP

  • Midwest ― Cincinnati Children's Hospital Medical Center

  • New England ― Boston Children's Hospital

  • Pacific ― Children's Hospital Los Angeles

  • Rocky Mountains ― Children's Hospital Colorado

  • Southeast ― Children's Healthcare of Atlanta and Monroe Carell Jr. Children's Hospital of Vanderbilt, in Nashville, Tennessee

  • Southwest ― Texas Children's Hospital

Specialties

Boston Children's not only topped the overall list but also led in four specialties. For the other six specialties that were ranked, the top hospitals on the honor roll are as follows:

  • Cancer ― CHOP

  • Cardiology and heart surgery ― Texas Children's Hospital

  • Diabetes and endocrinology ― CHOP

  • Gastroenterology and gastrointestinal surgery ― Children's Hospital Colorado

  • Neonatology ― Children's National Hospital

  • Orthopedics ― CHOP

For the past 15 years, the objective of the rankings has been to offer a starting point for parents in making decisions about the best place to take very sick children for high-quality care. The editors of the rankings acknowledge that considerations of travel costs and insurance coverage are other factors to consider.

Helpful for Families

The rankings are helpful for families, according to Joe W. St. Geme, III, MD, CHOP's physician-in-chief and chair of its Department of Pediatrics. "Some parents, especially those coming from outside an area, find them useful when deciding on care away from home," he told Medscape Medical News. "Most types of pediatric care are available in the community, but sometimes a child has an unusual disease or complex disease for which local care is not available."

St. Geme said the new regional rankings may be useful in helping parents decide where to bring a child for care that is closer to where they live.

A top ranking from U.S. News is just one indication of a hospital's overall performance, according to Angela Lorts, MD, MBA, director of the Ventricular Assist Device Program, at Cincinnati Children's Hospital Medical Center.

"Parents seeking care for their child should use the data to ask questions and understand the limitations," she told Medscape Medical News. "Rankings are only based on a small subset of the children we care for. Many of the metrics may not pertain to their child and may not reflect the care they will receive."

In her view, ranking will not give parents all the information they need about medical care and outcomes for specific conditions.

Hospital Reaction

Hospitals can use the rankings to target improvements, says St Geme. "These rankings can provide an opportunity for some benchmarking, to see what other institutions are doing and how they're able to deliver care. They can serve as a source of ideas and can influence planning," he said.

He cautioned that the data are not as complete as they could be. "A number of services are not included, and we try to keep that in mind," he said.

Rankings may also affect recruitment, St. Geme added, because higher-ranked institutions may find it easier to attract sought-after clinicians and investigators in needed areas.

Another sphere of influence is philanthropy and fund raising. "People are much more likely to consider making both small and large donations to a high-ranked institution," said J. Howard Smart, MD, chair of pediatrics at Sharp Rees-Stealy Medical Group and chair-elect of the Physician Leadership Council at Sharp Mary Birch Hospital for Women and Newborns in San Diego, California.

St. Geme agrees. "Philanthropists are interested in making investments where they feel they're a sure bet, and rankings may indicate a sure bet. But their impact on government funding and grant support is probably less."

Ultimately, however, some families may not have lot of choice in where to go when their children are sick, Smart said. "And people probably don't choose a location to live in based on nearby children's hospitals the way they do for schools," he said.

What about hospitals that continue to rank much lower on the 50-institution list ― excellent though they must be to make it onto the honor roll. "To be on the list but not to have risen in rank in recent years might be a disappointment," said St. Geme. "But it might also motivate a hospital to think about making internal investments in order to strengthen a particular service. And it may motivate nonranked hospitals to improve care in order to break into the list."

Lorts points out that the annual survey process requires hospitals to track the clinical outcomes of a subset of patients, which may lead to improvement in these areas. It also requires data collection on structure and process, which drives needs assessments of select hospital areas. "But ideally, all hospitals would be tracking important outcomes, benchmarking to peer hospitals, and improving where needed without the U.S. News incentive," she said.

This year's data, compiled by research and consulting firm RTI International, derive from feedback on more than 1200 questions provided by 118 responding institutions. Details on each hospital on the list and the methodology used in the analysis are available on U.S. News & World Report's website.

Diana Swift is medical journalist based in Toronto. dianaswift@rogers.com.

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