Of all the hospitals in America, which ones are best? According to a new study, 229 hospitals stand out, earning a “Distinguished Hospital Award for Clinical Excellence.”

The awards come from HealthGrades (search), an independent organization focused on health care quality. For the third straight year, HealthGrades has identified the top five percent of U.S. hospitals for clinical quality.

Nearly 5,000 hospitals nationwide were considered. The rankings are based on death and complication rates of Medicare patients hospitalized from 2001-2003 for 28 common procedures and diagnoses including heart attack, stroke, heart bypass, pneumonia, hip replacement, gastrointestinal problems, and back and neck surgery.

For four of the most common conditions and treatments — heart attack, stroke, community acquired pneumonia, and heart bypass surgery — survival rates were 12-20 percent better at the distinguished hospitals than at an average American hospital.

Here’s how those survival rates compared:

—Stroke: 15.4 percent better at awarded hospitals

—Community-acquired pneumonia: 19.55 percent better at awarded hospitals

—Coronary (heart) bypass surgery: 15.3 percent better at awarded hospitals

—Heart attack: 12.6 percent better at awarded hospitals

The heart attack rate was based on hospitals using angioplasty (search) and stent treatments to reopen blood vessels.

Life-And-Death Implications

To put those percentages in real-world terms, imagine an average-sized crowd at an NFL football game — nearly 53,000 people. That’s how many lives could have been saved if all Medicare patients hospitalized for those four problems had gone to top-ranked hospitals, says HealthGrades.

Distinguished hospitals treated more Medicare patients than average hospitals. Their Medicare patients were often in worse condition than those at average hospitals. The awards included 126 teaching hospitals, which have at least one resident or were connected to an approved medical teaching program for at least one year of the study.

Best, Worst Regions

Geography mattered. Some regions had an abundance of awarded hospitals, while some states had none.

The Great Lakes region had the highest concentration of top-ranked hospitals, based on the 2000 U.S. census. There was one distinguished hospital for every 773,181 residents in that region, which included Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

The Sunbelt was a close second. Like the Great Lakes area, it had 72 distinguished hospitals, but the Sunbelt’s larger population meant more patients per hospital. The Sunbelt states were Alabama, Florida, Georgia, Kentucky, Mississippi, North and South Carolina, Tennessee, Virginia, and West Virginia.

Third place went to the Northeast, with 36 distinguished hospitals. The Northeast included Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and Washington, D.C.

The Great Plains region had 30 awarded hospitals. Those states were Arkansas, Colorado, Iowa, Kansas, Louisiana, Montana, Nebraska, North and South Dakota, New Mexico, Oklahoma, Texas, and Wyoming.

The West Coast had the lowest concentration of top-ranked hospitals. In those states — Alaska, Hawaii, Arizona, California, Idaho, Nevada, Oregon, Utah, and Washington — there was one awarded hospital per almost 3 million people.

Florida and the Upper Great Lakes had the highest per-capita number of distinguished hospitals. Washington, Georgia, and Massachusetts had the lowest per-capita figures.

Here is a list of the top hospitals by state:

Alabama

Riverview Regional MediCalif.l Center, Gadsden, Ala.

Arizona

Del E Webb Memorial Hospital, Sun City West, Ariz.

Mayo Clinic Hospital, Phoenix

Scottsdale HealthCalif.re Shea, Scottsdale, Ariz.

California

Cedars Sinai MediCalif.l Center, Los Angeles

Good Samaritan Hospital, Los Angeles

Glendale Adventist Medical Center, Glendale, Calif.

St Johns Hospital Health Center, Santa Monica, Calif.

Los Robles Regional Medical Center, Thousand Oaks, Calif.

Scripps Mercy Hospital, San Diego

Methodist Hospital Of Southern California, Arcadia, Calif.

Encino Tarzana Regional MediCalif.l Center - Tarzana Campus, Tarzana, Calif.

Sharp Chula Vista Medical Center, Chula Vista, Calif.

Huntington Memorial Hospital, Pasadena, Calif.

El Camino Hospital, Mountain View, Calif.

Glendale Memorial Hospital and Health Center, Glendale, Calif.

Colorado

Centura Health Porter Adventist Hospital, Denver

Penrose - St Francis Health Services, Colorado Springs, Colo.

Connecticut

Danbury Hospital, Danbury, Conn.

Hartford Hospital, Hartford, Conn.

Middlesex Hospital, Middletown, Conn.

William W Backus Hospital, Norwich, Conn.

District of Columbia

Sibley Memorial Hospital, Washington, D.C.

Florida

Delray Medical Center, Delray Beach, Fla.

Central Florida Regional Hospital, Sanford, Fla.

Flagler Hospital, Saint Augustine, Fla.

Sarasota Memorial Hospital, Sarasota, Fla.

University Hospital and Medical Center, Tamarac, Fla.

Martin Memorial Medical Center, Stuart, Fla.

Mount Sinai Medical Center, Miami Beach, Fla.

St. Joseph Hospital Port Charlotte, Port Charlotte, Fla.

Holmes Regional Medical Center, Melbourne, Fla.

Morton Plant Hospital, Clearwater, Fla.

Ocala Regional Medical Center, Ocala, Fla.

Mease Hospital Countryside, Safety Harbor, Fla.

Lawnwood Regional Medical Center, Fort Pierce, Fla.

Brandon Regional Hospital, Brandon, Fla.

Regional Medical Center Bayonet Point, Hudson, Fla.

Cedars Medical Center Inc., Miami, Fla.

Holy Cross Hospital, Fort Lauderdale, Fla.

Lakeland Regional Medical Center, Lakeland, Fla.

Bethesda Memorial Hospital, Boynton Beach, Fla.

Jupiter Medical Center Inc., Jupiter, Fla.

Florida Hospital - Ormond Memorial/Oceanside, Ormond Beach, Fla.

Oak Hill Hospital, Spring Hill, Fla.

Halifax Medical Center, Daytona Beach, Fla.

Baptist Hospital of Miami Inc., Miami

Florida Hospital Heartland Division, Sebring, Fla.

Community Hospital of New Port Richey, New Port Richey, Fla.

Doctors Hospital of Sarasota, Sarasota, Fla.

Bay Medical Center, Panama City, Fla.

Northside Hospital, Saint Petersburg, Fla.

Palm Beach Gardens Medical Center, Palm Beach Gardens, Fla.

St Josephs Hospital, Tampa, Fla.

Helen Ellis Memorial Hospital, Tarpon Springs, Fla.

Saint Lucie Medical Center, Port Saint Lucie, Fla.

Munroe Regional Medical Center, Ocala, Fla.

St Vincents Medical Center Inc., Jacksonville, Fla.

Charlotte Regional Medical Center, Punta Gorda, Fla.

Naples Community Hospital Inc., Naples, Fla.

Boca. Raton Community Hospital Inc., Boca Raton, Fla.

Fawcett Memorial Hospital, Port Charlotte, Fla.

Blake Medical Center, Bradenton, Fla.

JFK Medical Center Center, Atlantis, Fla.

Westside Regional Medical Center, Plantation, Fla.

Putnam Community Medical Center, Palatka, Fla.

Mease Hospital Dunedin, Dunedin, Fla.

Florida Medical Center, Lauderdale Lakes, Fla.

South Bay Hospital, Sun City Center, Fla.

Georgia

Saint Josephs Hospital of Atlanta, Atlanta

Iowa

St. Lukes Hospital, Cedar Rapids, Iowa

Mercy Medical Center North Iowa, Mason City, Iowa

Mercy Medical Center - Des Moines, Des Moines, Iowa

Illinois

Rush North Shore Medical Center, Skokie, Ill.

St. Francis Hospital and Health Center, Blue Island, Ill.

Alexian Brothers Medical Center, Elk Grove Village, Ill.

Advocate South Suburban Hospital, Hazel Crest, Ill.

Advocate Christ Medical Center, Oak Lawn, Ill.

Advocate Lutheran General Hospital, Park Ridge, Ill.

Memorial Hospital, Belleville, Ill.

Evanston Northwestern Healthcare, Evanston, Ill.

Little Company of Mary Hospital, Evergreen Park, Ill.

Ingalls Memorial Hospital, Harvey, Ill.

St. Francis Hospital of Evanston, Evanston, Ill.

Northwest Community Hospital, Arlington Heights, Ill.

Rockford Memorial Hospital, Rockford, Ill.

Sherman Hospital, Elgin, Ill.

Indiana

Saint Johns Health System, Anderson, Ind.

Community Hospital East/ North, Indianapolis

Community Hospital, Munster, Ind.

St. Vincent Hospital and Health Services, Indianapolis

Clarian Health Partners Inc., Indianapolis

Lutheran Hospital of Indiana, Fort Wayne, Ind.

St. Francis Hospital and Health Centers, Beech Grove, Ind.

Kentucky

Baptist Hospital East, Louisville, Ky.

St. Elizabeth Medical Center, Covington, Ky.

Jewish Hospital, Louisville, Ky.

Caritas Medical Center, Louisville, Ky.

Louisiana

St Francis Medical Center, Monroe, La.

Willis Knighton Bossier Health Center, Bossier City, La.

Rapides Regional Medical Center, Alexandria, La.

Glenwood Regional Medical Center, West Monroe, La.

Massachusetts

Lahey Clinic Medical Center, Burlington, Mass.

Maryland

Good Samaritan Hospital, Baltimore, Md.

Franklin Square Hospital, Baltimore, Md.

Washington Adventist Hospital, Takoma Park, Md.

Greater Baltimore Medical Center, Baltimore, Md.

Suburban Hospital Association, Bethesda, Md.

Sinai Hospital, Baltimore, Md.

Washington County Hospital, Hagerstown, Md.

Northwest Hospital Center, Randallstown, Md.

Doctor's Community Hospital, Lanham, Md.

Montgomery General Hospital Inc., Olney, Md.

Michigan

William Beaumont Hospital, Royal Oak, Mich.

Oakwood Hospital and Medical Center, Dearborn, Mich.

Bon Secours Hospital, Grosse Pointe, Mich.

Munson Medical Center, Traverse City, Mich.

St. Mary Mercy Hospital, Livonia, Mich.

St. Joseph Mercy Oakland, Pontiac, Mich.

St. Josephs Mercy Hospital and Health Services, Clinton Township, Mich.

Henry Ford Wyandotte Hospital, Wyandotte, Mich.

Genesys Regional Medical Center, Grand Blanc, Mich.

Spectrum Health Hospitals, Grand Rapids, Mich.

St. John Macomb Hospital, Warren, Mich.

Harper University Hospital, Detroit

St. John Hospital and Medical Center, Detroit

MidMichigan Medical Center-Midland, Midland, Mich.

Crittenton Hospital, Rochester Hills, Mich.

Minnesota

Abbott Northwestern Hospital Inc., Minneapolis, Minn.

St. Marys Hospital, Rochester, Minn.

St. Marys Medical Center, Duluth, Minn.

United Hospitals Inc., Saint Paul, Minn.

Mercy Hospital, Coon Rapids, Minn.

Healtheast St. John's Hospital, Maplewood, Minn.

Missouri

St Luke's Episcopal-Presbyterian Hospital, Chesterfield, Mo.

Heartland Regional Medical Center, Saint Joseph, Mo.

St. Lukes Hospital of Kansas City, Kansas City, Mo.

St. Joseph Health Center, Saint Charles, Mo.

S S M Depaul Health Center, Bridgeton, Mo.

Montana

Deaconess Billings Clinic, Billings, Mont.

Benefis Healthcare, Great Falls, Mont.

North Carolina

Lenoir Memorial Hospital, Kinston, N.C.

Rex Hospital, Raleigh, N.C.

Mission St. Joseph's Health System - Mission Campus, Asheville, N.C.

Firsthealth Moore Regional Hospital, Pinehurst, N.C.

Nebraska

BryanLGH MediCalif.l Center East, Lincoln, Neb.

New Jersey

Kimball Medical Center, Lakewood, N.J.

Community Medical Center, Toms River, N.J.

Robert Wood Johnson University Hospital, New Brunswick, N.J.

Hackensack University Medical, Hackensack, N.J.

Centrastate Medical Center, Freehold, N.J.

Holy Name Hospital, Teaneck, N.J.

New York

Maimonides Medical Center, Brooklyn, N.Y.

Ellis Hospital, Schenectady, N.Y.

Winthrop University Hospital, Mineola, N.Y.

Beth Israel Medical Center, New York, N.Y.

Ohio

Christ Hospital, Cincinnati

Hillcrest Hospital, Mayfield Heights, Ohio

Summa Health System, Akron, Ohio

Akron General Medical Center, Akron, Ohio

Marymount Hospital, Garfield Heights, Ohio

Deaconess Hospital, Cincinnati

Parma Community General Hospital, Parma, Ohio

E M H Regional Medical Center, Elyria, Ohio

Southwest General Health Center, Middleburg Heights, Ohio

Meridia Euclid Hospital, Euclid, Ohio

University Hospitals of Cleveland, Cleveland

Community Health Partners Of Oh West, Lorain, Ohio

Cleveland Clinic Foundation, Cleveland

Fort Hamilton Hughes Memorial Hospital, Hamilton, Ohio

Riverside Methodist Hospital, Columbus, Ohio

Fairview Hospital, Cleveland

St. John West Shore Hospital, Westlake, Ohio

Grandview Hospital and Medical Center, Dayton, Ohio

St. Elizabeth Health Center, Youngstown, Ohio

Mercy Medical Center of Springfield, Springfield, Ohio

Jewish Hospital, Cincinnati

Good Samaritan Hospital, Dayton, Ohio

Mercy Hospital Anderson, Cincinnati

Oklahoma

Deaconess Hospital, Oklahoma City

Oregon

Mercy Medical Center Inc., Roseburg, Ore.

Pennsylvania

Mercy Hospital, Scranton, Pa.

Lehigh Valley Hospital, Allentown, Pa.

Hamot Medical Center, Erie, Pa.

Lancaster General Hospital, Lancaster, Pa.

York Hospital, York, Pa.

St. Lukes Hospital, Bethlehem, Pa.

Main Line Hospitals Inc. Lankenau, Wynnewood, Pa.

Easton Hospital, Easton, Pa.

Pennsylvania Hospital, Philadelphia

Doylestown Hospital, Doylestown, Pa.

South Dakota

Sioux Valley Hospital, Sioux Falls, S.D.

Tennessee

Memorial Hospital, Chattanooga, Tenn.

Texas

Good Shepherd Medical Center, Longview, Texas

Mc Allen Heart Hospital, Mc Allen, Texas

Baylor University Medical Center, Dallas, Texas

Christus Santa Rosa Hospital, San Antonio, Texas

Memorial Medical Center of East Texas, Lufkin, Texas

Memorial Hospital System, Houston, Texas

St. Davids Hospital, Austin, Texas

Bayshore Medical in Pasadena, Pasadena, Texas

Covenant Health System, Lubbock, Texas

Rio Grande Regional Hospital, Mc Allen, Texas

Seton Medical Center, Austin, Texas

St. Lukes Episcopal Hospital, Houston

South Austin Hospital, Austin, Texas

Texoma Medical Center, Denison, Texas

Christus Spohn Hospital Memorial, Corpus Christi, Texas

Laredo Medical Center, Laredo, Texas

Utah

LDS Hospital, Salt Lake City

St. Marks Hospital, Salt Lake City

Virginia

Inova Fairfax Hospital, Falls Church, Va.

Rockingham Memorial Hospital, Harrisonburg, Va.

Sentara Norfolk General Hospital, Norfolk, Va.

Virginia Baptist Hospital and Lynchburg General, Lynchburg, Va.

Chesapeake General Hospital, Chesapeake, Va.

Sentara Leigh Hospital, Norfolk, Va.

C J W Medical Center, Richmond, Va.

Winchester Medical Center Inc., Winchester, Va.

Inova Alexandria Hospital, Alexandria, Va.

Lewis-Gale Medical Center, Salem, Va.

Henrico Doctors Hospital Forest Calmpus/ Parham Campus, Richmond, Va.

Augusta Medical Center, Fishersville, Va.

Bon Secours Memorial Regional Medical, Mechanicsville, Va.

Washington

Virginia Mason Medical Center, Seattle

Wisconsin

Theda Clark Memorial Hospital, Neenah, Wis.

Wausau Hospital, Wausau, Wis.

West Virginia

Charleston Area Medical Center, Charleston, W. Va.

United Hospital Center, Clarksburg, W. Va.

States Without Top-Ranked Hospitals

The 16 states without top-ranked hospitals were:

Alaska

Arkansas

Delaware

Hawaii

Idaho

Kansas

Maine

Mississippi

New Hampshire

New Mexico

Nevada

North Dakota

Rhode Island

South Carolina

Vermont

Wyoming

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: HealthGrades, “The Third Annual HealthGrades Hospital Quality and Clinical Excellence Study,” Jan. 24, 2005. News release, HealthGrades.