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What city has the best medical care?

US Results Quality of Care No City 1 Boston 75.36 2 Los Angeles 80.29 3 New York 69.78 23 more rows

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METHODOLOGY

The Best Hospital Cities Ranking 2019 determines the top locations around the world for hospital infrastructure, in terms of quality, accessibility and ecosystem. The study analyses all hospitals within a city, so in order for a city to rank highly, the quality of all hospitals within their region must be high. The ranking is designed to celebrate the cities around the world successfully offering high-quality medical care to all of its citizens, and every city in this final ranking should be applauded for their efforts. The cities featured in the index were chosen based on the presence of top-ranking hospitals according to well-known hospital rankings.

The ranking was determined by analysing the following factors:

Infrastructure: Hospital Beds, Nurses/Capita, Surgeons/Capita, Mental Health Specialists/Capita, Top-Ranking Medical Universities and Top-Ranking Hospitals. Infrastructure: Hospital Beds, Nurses/Capita, Surgeons/Capita, Mental Health Specialists/Capita, Top-Ranking Medical Universities and Top-Ranking Hospitals. Quality of Care: Satisfaction, Adverse Events and Cancer Treatment Efficiency. Quality of Care: Satisfaction, Adverse Events and Cancer Treatment Efficiency. Access: Access, Cost of Medicine, and Discretionary Healthcare Spending. Each factor was then scored out of 100, and the final ranking is based on the highest scoring, the higher the ranking, the better the city’s overall hospital infrastructure.

Scoring

Scores were normalized such that 100 is the highest value in the dataset. For columns where a low value is better, the score was inverted such that a high score is always better. Therefore, the higher the score, the better the city ranks for that factor in comparison to the other cities in the index.

The equation for normalization is as follows:

for inverted scores

Below you can find a detailed description of each factor within the study, and the source used.

Calculating per-capita scores

Due to the nature of health-related data in the UK and the United States, workforce, hospital bed and population numbers needed for per-capita factors were collected for broader geographical regions. For the United States, the relationship between cities and reporting units can be found below the factor descriptions under ‘United States City to Metropolitan Area Relationships’.

Calculating top-ranking hospital and university scores

A score was assigned to each university/hospital based on their position in well-known rankings and assigned to a metropolitan area using GIS mapping software. For metropolitan areas with multiple top-ranking universities/hospitals, the final score was calculated as follows: 50% of the score was based on the highest-scoring organization and 50% of the score was based on the sum of weighted scores of all organizations in the area, where the weight of each additional organization is half of the preceding one; that is 100%, 50%, 25%, 12.5% etc.

Infrastructure

Hospital Beds/Capita

The number of hospital beds per capita within the city. Where city data was unavailable, regional or country-level data was used instead. The number of hospital beds per capita within the city. Where city data was unavailable, regional or country-level data was used instead. United Kingdom: Data on hospital beds in the United Kingdom were only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United Kingdom: Data on hospital beds in the United Kingdom were only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United States: Data on hospital beds were assigned to Core-based Statistical Areas (CSBAs) to allow equal comparison with Nurses, Surgeons and Health Care professionals per capita. United States: Data on hospital beds were assigned to Core-based Statistical Areas (CSBAs) to allow equal comparison with Nurses, Surgeons and Health Care professionals per capita. Sources: Eurostat, WHO, OECD NHS, Eurostat, and local statistical pages.

Nurses/Capita

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The number of registered nurses per capita within the city. Where city data was unavailable, regional or country-level data was used instead. The number of registered nurses per capita within the city. Where city data was unavailable, regional or country-level data was used instead. United Kingdom: Data on nurse workforce was available both for geographically defined Care Commissioning Groups (CCGs) and for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United Kingdom: Data on nurse workforce was available both for geographically defined Care Commissioning Groups (CCGs) and for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United States: Data on employed nurses were available for Core-based Statistical Areas (CSBAs). United States: Data on employed nurses were available for Core-based Statistical Areas (CSBAs). Sources: Eurostat, OECD, WHO, NHS, Eurostat, and local statistical pages.

Surgeons/Capita

The number of surgeons under “general surgery” in the city (metropolitan area). Where city data was unavailable, regional or country-level data was used instead. For the UK, it is the number of surgeons within the NHS trust that serves the city. The number of surgeons under “general surgery” in the city (metropolitan area). Where city data was unavailable, regional or country-level data was used instead. For the UK, it is the number of surgeons within the NHS trust that serves the city. United Kingdom: Data on surgeon workforce only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United Kingdom: Data on surgeon workforce only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United States: Data on employed surgeons were available for Core-based Statistical Areas (CSBAs). United States: Data on employed surgeons were available for Core-based Statistical Areas (CSBAs). Sources: Eurostat, OECD, WHO, NHS, Eurostat, and local statistical pages.

Mental Health Professionals/Capita

The number of mental health specialists (psychologists, psychiatrists etc.) per capita on a country-level, except in the United Kingdom and United States. The number of mental health specialists (psychologists, psychiatrists etc.) per capita on a country-level, except in the United Kingdom and United States. United Kingdom: Data on mental health workforce only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United Kingdom: Data on mental health workforce only available on for NHS Trusts, which can serve more than one city. A best effort was made to assign NHS Trusts to the city that they predominantly serve. United States: Data on employed mental health professionals were available for Core-based Statistical Areas (CSBAs). United States: Data on employed mental health professionals were available for Core-based Statistical Areas (CSBAs). Sources: OECD, NHS, WHO, Eurostat, and local statistical pages.

Top-Ranking Medical Universities

If the city is home to top-ranking medical universities and academic hospitals.

If the city is home to top-ranking medical universities and academic hospitals. United States: Universities scores were assigned to cities based on their Metropolitan Statistical Areas (MSAs).

Top-Ranking Hospitals

If the city is home to top-ranking hospitals.

If the city is home to top-ranking hospitals. United States: Hospital scores were assigned to cities based on their Metropolitan Statistical Areas (MSAs). United States: Hospital scores were assigned to cities based on their Metropolitan Statistical Areas (MSAs). Sources: Newsweek Best Hospitals in the World, US. News Hospitals in the US, Webometrics Ranking web of hospitals

Quality of Care

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Satisfaction

How satisfied patients are with hospitals in their city. The satisfaction score was created by combining the latest data available from Numbeo and patient satisfaction survey results. How satisfied patients are with hospitals in their city. The satisfaction score was created by combining the latest data available from Numbeo and patient satisfaction survey results. Source: IPSOS national satisfaction survey, Numbeo, and local patient surveys.

The rate of adverse effects due to medical treatment, such as injury.

The rate of adverse effects due to medical treatment, such as injury. The “Adverse effects from medical treatment” factor of the Health Access and Quality (HAQ) index. Adverse effects is scored such that a high score means that there are few injuries from medical treatment. The “Adverse effects from medical treatment” factor of the Health Access and Quality (HAQ) index. Adverse effects is scored such that a high score means that there are few injuries from medical treatment. Sources: Health Access and Quality index

Cancer Treatment Efficiency

The Cancer Treatment Efficiency score gives an indication of overall medical performance by looking into data on the treatment efficiency of one of the most common illnesses affecting people the world over, cancer. The Cancer Treatment Efficiency score gives an indication of overall medical performance by looking into data on the treatment efficiency of one of the most common illnesses affecting people the world over, cancer. The Cancer component of the Health Access and Quality (HAQ) index. The HAQ index provides a score based on the age-adjusted mortality-to-incidence rates of cancers considered amenable to clinical care. The Cancer component of the Health Access and Quality (HAQ) index. The HAQ index provides a score based on the age-adjusted mortality-to-incidence rates of cancers considered amenable to clinical care. Sources: Health Access and Quality index

Access

Access

The accessibility for all local citizens to hospitals within the city. The Access Score was created constructed primarily from the Health Access and Quality (HAQ) index and the Economist Intelligence Unit “Equity of access to healthcare” factor score. The score for individual states in the United States further took into account their ranking in the US News “Health Care Access Rankings” The accessibility for all local citizens to hospitals within the city. The Access Score was created constructed primarily from the Health Access and Quality (HAQ) index and the Economist Intelligence Unit “Equity of access to healthcare” factor score. The score for individual states in the United States further took into account their ranking in the US News “Health Care Access Rankings” Sources: EIU, WHO

Cost of Medicine

The cost of medicine was determined by sourcing the costs of a basket of three medications, listed on the WHO list of essential medicines: cortisone, aspirin, and activated charcoal. The cost of medicine was determined by sourcing the costs of a basket of three medications, listed on the WHO list of essential medicines: cortisone, aspirin, and activated charcoal. Sources: Online pharmacies (city-level where possible, otherwise country-level).

Discretionary Healthcare Spending

Household out-of-pocket payments and voluntary health care payments per capita in local currency.

United States City to Metropolitan Area Relationships

When calculating the scores for per capita factors, employment numbers were available by Core-based Statistical Area (CBSA). However, when determining the influence of hospitals and universities on a city, the Metropolitan Statistical Area is a more appropriate definition of the geographic boundaries of a city’s economy. The following table provides a mapping between the cities in our ranking and their MSA and CBSA metropolitan areas.

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