Performance of the '100 top hospitals': What does the report card report?

We examine whether Medicare patients with acute myocardial infarction (AMI) admitted to one of HCIA-Mercer's "100 top hospitals" received better care or had better outcomes than patients treated in other hospitals. Among four hospital peer groups, the top 100 hospitals had similar thirty-day mortali ty and use of aspirin, beta-blockers, and reperfusion compared with their p eers, but lower lengths-of-slay and in-hospital costs, with similar or lowe r readmission rates. Our findings suggest that the 100 Top Hospitals study may be better suited for identifying hospitals with higher performance on f inancial and operating measures than superior clinical performance in treat ing elderly AMI patients. However, there was no evidence that quality was s acrificed for increased financial efficiency among the top 100 hospitals.