LAUSR

Relationship Between Stress Rankings and the Overall Hospital Star Ratings: An Analysis of 150 Cities in the United States The Centers for Medicare & Medicaid Services (CMS) recently released an Overall Hospital Quality Star Rating on its Hospital Compare website.1 Large, teaching, and disproportionateshare hospitals were more likely to have lower star ratings, consistent with prior work examining hospital rates of readmission, surgical mortality, and hospital-acquired infection.2-4 These studies have focused on characteristics of hospitals, patients, and recently, communities in which hospitals are located5 as predictors of hospital quality. The goal of this study was to use a recently released “stress” ranking of 150 US cities as a community characteristic and explore associations with the hospital star ratings.