Source: Why Five-Star Hospitals May Be More Closely Related to Five-Star Restaurants than Innate Quality
"... The ingredients of the star ratings depend heavily on inputs that fail to account for the upstream social determinants of health that largely determine downstream health outcomes for patients from indigent communities, who rely on the nation’s safety-net hospitals for access to the entire continuum of care — primary to quaternary.
Using the star rating data provided by CMS, we evaluated the socioeconomic characteristics of hospitals’ home ZIP codes by the number of stars they’re awarded on the Hospital Compare website. This slide shows a portion of our findings. Evaluated by an area-level socioeconomic deprivation index that measures multiple factors such as education, poverty, unemployment, environment, and income, we found that one-star hospitals reside in ZIP codes that are nearly three rungs lower on the SES ladder than five-star hospitals. In fact, we found that the socioeconomic health of the hospital’s community grows exclusively with the number of stars awarded, and many of the one- and two-star hospitals are among the country’s elite academic medical centers that treat the most complex patients, who face both clinical and social comorbidities..."