Breaking down the categories of the Lown Index by state
By Judith Garber
Every American wants to think that their state is the best (or at least better than their neighbors). The all-knowing internet can tell us which states have the best professional sports teams and even the best food…but what about the best hospitals? That’s where the Lown Institute Hospitals Index comes in.
The states with average composite rankings in the top third of all hospitals (rank 1094 or better) are Connecticut, Delaware, Hawaii, Massachusetts, Maryland, and Rhode Island (Ohio barely missed the cutoff). With the exception of Hawaii, these are all East Coast states.
There is considerable overlap between the states with the best hospitals in patient outcomes and best hospitals overall, which is unsurprising given the higher weight we placed on patient outcomes within the overall ranking. Only New Jersey and Ohio land within the top third for patient outcomes but not the composite. It appears that NJ hospitals’ relatively high outcomes ranking is being tempered by their abysmal ranking in value of care (avoiding overuse), putting the state closer to the middle overall.
Hospitals’ rankings on value of care vary extremely widely by state, ranging from an average ranking of 499 for hospitals in Vermont, to an average ranking of 2377 for hospitals in Nevada. Seven states (Maine, Minnesota, Montana, New Hampshire, New Mexico, Oregon, and Vermont) have hospitals with average rankings better than 1000 for value, while five states have hospitals with rankings worse than 2000 (Arizona, Florida, Maryland, New Jersey, and Nevada).
For civic leadership, no state’s average score landed below a rank of 1000. This may indicate that the positive outliers in civic leadership are spread throughout the country and not concentrated in a single state. Nevertheless, compared to other states, Colorado, Kentucky, Louisiana, Maryland, New Mexico, West Virginia, and Washington, DC, stand out as having better average rankings. Interestingly, none of these are Northeast states although many of the hospitals with the best overall rankings were from that region.