“Let’s take care of the patient.” That must be the credo of hospitals that make U.S. News & World Report's “Best Hospitals” rankings, in which hospitals are judged not in routine procedures but in difficult cases across an entire specialty. In the nineteenth year of this annual review, hospitals are ranked in 16 specialties, from cancer and heart disease to respiratory disorders and urology. Out of the 5,453 hospitals put through a rigorous statistical mill, only 170 scored high enough to appear in any of the specialty rankings.

For the first time, data and scores are also available online for more than 1,500 hospitals that in the end fell short of being ranked at health.usnews.com.

The hospitals undergo a rigorous review. Twelve of the 16 specialty rankings are driven largely by hard data; in four others, ranking is based on three years of nominations by specialists surveyed. To be considered at all for the 12 data-driven specialties, a hospital had to meet at least one of three requirements: membership in the Council of Teaching Hospitals, affiliation with a medical school, or availability of at least six of 13 key technologies, such as robotic surgery. This year, nearly two-thirds of all hospitals failed this first test.

If they passed, hospitals had to perform a certain number of specified procedures on Medicare inpatients in 2004, 2005, and 2006. The number varied by specialty—294 in orthopedics, for example. Or the hospital had to have been nominated by at least one physician in U.S. News surveys in 2006, 2007, and 2008.

That left 1,569 hospitals eligible for ranking in at least one data-driven specialty. Each facility received a U.S. News Score from 0 to 100, made up in equal parts of reputation, death rate, and care-related factors such as nursing and patient services.

Hospitals were rated for their “mortality index,” which defines the institution’s ability to keep patients alive. It compares the number of Medicare inpatients with certain conditions who died within 30 days of admission in 2004, 2005, and 2006 with the number of deaths that would have been expected after adjusting for severity.

The top five endocrinology departments in U.S. hospitals were:

1. Mayo Clinic, Rochester, MN.
2. Massachusetts General Hospital, Boston, MA
3. Johns Hopkins Hospital, Baltimore, MD
4. University of California, San Francisco Medical Center, CA
5. New York-Presbyterian Univ. Hosp. of Columbia and Cornell, NY

Best Hospitals Report: Endocrinology