Abstract
To the Editor:
Hospital rankings released by U.S. News and World Report (USNWR) are widely accepted and often-used advertising tools by health care institutions. These rankings are released annually and include children’s hospitals, with the scoring methodology publicly available. 1 Evaluating adult hospital USNWR rankings, a previous study reported that rankings were determined largely by hospital reputation and less by contribution of objective measures. 2 A subsequent analysis of a pediatric subspecialty found that the final ranking reflected reputation more than objective measures. 3 A more recent study determined that reputation determined by USNWR rankings for adult cancer hospitals was explained by research productivity. 4 A relationship between research productivity and USNWR rankings for children’s hospitals has not been established, so this analysis compared research productivity measures (publications and grant funding) for the 2018-2019 USNWR highest ranked children’s hospitals (top 10).
Measures of research productivity included total number of publications in the US National Library of Medicine PubMed database and total research funding awarded by the National Institutes of Health (NIH) listed in the Research Portfolio Online Reporting Tools (RePORT). 5 Data used for this analysis were limited to the year prior to the ranking, January to December 2017. All 10 institutions were included in the publications analysis, while the NIH funding analysis was limited to 7 of them as funding for 3 could not be discerned from their affiliated medical school. Using linear regression for each measure of academic productivity, the Pearson correlation coefficient was used to examine the relationship between publications and NIH funding and USNWR ranking.
For 2017, the mean number of total publications for all 10 institutions was 1312 ± 944 (range = 418-3266) with a Pearson r correlation of 0.8 (P = .0042). Mean NIH funding awarded to the children’s hospitals was $82 113 968 ± $59 398 864 with a Pearson r correlation of 0.9 (P = .0048).
The analysis shows a significant correlation between USNWR children’s hospitals’ top 10 ranking and objective measures of research productivity. These USNWR rankings are highly influential and imply a threshold of excellence, as evidenced by their use for marketing, so research is needed to better define the methodology of their determination beyond subjective measures for hospital quality. Importantly, these results should not be interpreted as a validation of the importance of USNWR rankings; this is a focused research analysis examining their correlation to commonly used objective measures of academic productivity.
Although limited by a lack of stratification of publications according to journal impact factor and the inability to include all 10 institutions for the NIH funding analysis, this analysis verifies the significant relationship of academic productivity with USNWR rankings of children’s hospitals. This knowledge may assist in further improvements in ranking methodologies and help hospital administrators and clinical leaders of pediatric health care institutions with decisions regarding strategic advancement. Finally, these results should be taken with caution as this analysis addressed a single area of pediatric health care delivery and cannot adequately evaluate the depth and quality of health care delivered by children’s hospitals.
