What Does ‘Nationally Ranked Care’ Really Mean?

In 2023, U.S. News & World Report named UPMC Children’s Hospital of Pittsburgh to the Honor Roll of Best Children’s Hospitals in the nation. Like an honor roll at school that lists the top students, U.S. News’ Honor Roll is a listing of the top children’s hospitals in the U.S.

This is the fifth consecutive year UPMC Children’s has appeared on the Honor Roll of Best Children’s Hospitals.

We want to make sure that parents understand what exactly it means to have access to “nationally ranked care,” so we’re answering some common questions around the U.S. News ranking process.

Q: When was the U.S. News Best Hospitals Rankings system created and why?

According to U.S. News: “Relatively few children, compared with the number of adults, face life-threatening or rare conditions, or have to go through complicated operations. A typical hospital, where nearly all inpatients are adults, simply cannot provide the caliber of expertise needed by a severely ill child. Even a hospital with a busy maternity unit may not be equipped to deal with a newborn who weighs just a few pounds or requires surgery for a congenital heart defect. Similarly, most hospitals don’t see large numbers of children with cancer, respiratory illnesses, or kidney conditions. Even among children’s hospitals and large pediatric services that do, the reality — as true in pediatrics as in adult care — is that some hospitals are better than others.”

U.S. News began collecting data that would allow the ranking of pediatric centers on their ability to help children who need it the most and in 2006, they introduced the Best Children’s Hospitals rankings. The rankings are now a tool for families of children with these rare or life-threatening illnesses to find the best medical care available. The rankings open the door to an array of detailed information about each hospital’s performance.

Q: What makes a hospital eligible for the rankings?

According to the U.S. News website, “Selection was determined initially by membership in the National Association of Children’s Hospitals and Related Institutions (NACHRI), now called the Children’s Hospital Association, or by nomination from teams of expert advisers. A hospital also can request to be considered. U.S. News makes such decisions not only on a hospital’s willingness to engage in public reporting but also on the size and scope of its pediatric program.

Of the approximately 200 hospitals U.S. News invites to participate in the survey each year, about a quarter of the hospitals are freestanding pediatric-focused facilities. Most of the others are pediatric departments within larger full-service hospitals and are so large that the department functions almost like its own hospital within a hospital — with its own staff, operating rooms, and support services.

Q: How are eligible pediatric hospitals evaluated?

According to the U.S. News website, the exact breakdown of how it calculates each pediatric hospital’s score is:

  • 33.3%  —Structural indicators of quality, such as availability of key patient services.
  • 33.3% —Outcomes such as survival, infections, and surgical complications. (In cardiology and heart surgery, outcomes account for 38.3% because more and better data is available.)
  • 12% — Best practices
  • 10% —Hospital reputation based on an annual survey of pediatric specialists and subspecialists in each of the 10 specialties (5% in cardiology and heart surgery).
  • 9% — Infection Prevention
  • 2.33% — Diversity, Equity, and Inclusion of patients and staff.

Q: What are the 10 ranked pediatric specialties?

The 10 pediatric specialties U.S. News ranks are:

  • Cancer.
  • Cardiology and heart surgery.
  • Diabetes and endocrinology.
  • Gastroenterology and gastrointestinal surgery.
  • Neonatology.
  • Nephrology.
  • Neurology and neurosurgery.
  • Orthopaedics
  • Pulmonology and lung surgery.
  • Urology.

Q: How are the Honor Roll hospitals determined?

According to U.S. News, the Best Children’s Hospitals Honor Roll rankings are “meant for patients with life-threatening or rare conditions who need a hospital that excels in treating complex, high-risk cases. These rankings are helpful if you’re looking for information about a rare condition or difficult diagnosis that isn’t treated at many facilities.”

Specialty rankings determine the Honor Roll. Hospitals received points for being ranked in a specialty, and the 10 hospitals with the most points across the 10 specialties make up the Honor Roll.

Q: Where can I find all the pediatric rankings and how often are they updated?

All information for the 50 best-performing hospitals in each of the 10 pediatric specialties as well as detailed information about the 10 Honor Roll hospitals are available on the U.S. News website.

Unranked hospitals that provided enough information for scoring in a specialty get listed with their data but without rank or score.

U.S. News updates the rankings annually in June.

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The Rankings Are Just a Starting Point

This article’s intention is to give only a brief introduction to the very complex methodology behind these rankings. U.S. News revisits the methodology for the rankings each year based on medical literature and input from hospitals and health care experts and makes appropriate changes at that time.

Though there is value in these rankings, you should take them as a starting point. Families should weigh many considerations when they seek care for a child, including the stress and expense of travel and lodging in another city and their insurer’s willingness to pay for care if a hospital is out of network when making health care choices.

As U.S. News adds on its website: “Within a specialty, hospital performance is judged across a variety of conditions and procedures. So one hospital might outperform another in some of them, the second might do better in others. In the pediatric orthopedic rankings, for example, one hospital might have an especially busy spina bifida clinic but doesn’t treat complex fractures as efficiently as another hospital. Parents and caregivers must decide for themselves which factors they want to weigh more or less heavily. Kids and families are all different. There’s no one-size-fits-all.”


Editor's Note: This article was originally published on , and was last reviewed on .

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.