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For knee replacements, hospital ranking may not be crucial

Some key outcomes were similar for patients who had total knee arthroplasty whether or not they had the surgery at a hospital ranked as among the best for orthopedics by U.S. News and World Report. The study was conducted by investigators at the University of Iowa's Carver College of Medicine and VA's Center for Comprehensive Access and Delivery Research and Evaluation. Using Medicare data, they compared outcomes for nearly 65,000 patients, looking at post-surgery complications, length of stay in the hospital, and hospital readmission. The study found no significant differences in these areas. The researchers didn't examine outcomes such as patient satisfaction, long-term functional improvement, and pain relief. Lead author Peter Cram says the take-home message of the study is that "there are good hospitals across the country, and limiting yourself to the top-ranked hospitals is not always necessary." U.S. News and World Report rankings are used widely by hospitals to market their services and by patients to choose where to receive care. Past studies have suggested that hospitals ranked high by the magazine do perform better, but most of these studies have looked only at heart care. ( Mayo Clinic Proceedings, April 2012)

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