University of Iowa Children’s Hospital sees bump in neonatology ranking as NICU expands

IOWA CITY — With plans proceeding on a $49 million expansion of the neonatal intensive care unit in its Stead Family Children’s Hospital, the University of Iowa saw its neonatology rank jump five spots to No. 21 in new U.S. News & World Report rankings released today.

The UI Children’s Hospital — among 119 nationally that U.S. News considered for a top-50 spot in 10 specialties — ranked this year in six specialties. That is one fewer than last year’s seven, but above the five top-50 placements it boasted in 2020 and 2021.

The “2023-2024 Best Children’s Hospital” rankings come after months of backlash against U.S. News for its ranking methodology — which manifest around its graduate school scores, with Ivy League heavy-hitters like Yale and Harvard Law boycotting by refusing to provide internal data. Saying rankings conflict with their campuses’ diversity and affordability ideals, institutional boycotts grew to include medical schools and propelled U.S. News to overhaul its rankings and even delay their release.

In announcing its new children’s hospital rankings, U.S. News noted several methodology changes — giving more weight to a hospital’s commitment to diversity, equity and inclusion and to best practice measures. Meanwhile, it dialed down the weight given to “expert opinion” in the rankings.

The UI Stead Family Children’s Hospital — founded more than a century ago in 1919 before moving in 2017 to a new 14-story, 507,000-square-foot facility costing up to $450 million — earned the following spots in the 2023-2024 rankings:

The UI Children’s Hospital this year fell out of the Top 50 in pediatric cancer, which ranked No. 38 last year, and pediatric pulmonology, ranking 50th last year.

Other pediatric specialties in which the hospital didn’t rank include gastroenterology and gastrointestinal surgery, along with cardiology and heart surgery, which has a slightly different ranking methodology.

Methodology

For every category but cardiology, U.S. News this year gave one-third weight to three components: structure, outcomes and process. For cardiology, 38.3 percent went to outcomes and 28.3 percent to process.

Within the process category was the “expert opinion” component, accounting for 10 percent of every specialty ranking but cardiology, where it accounted for 5 percent.

“Expert opinion can be viewed as a form of peer review of the hospital’s capabilities across a wide variety of processes related to quality of care,” according to the U.S. News methodology.

Physicians asked to evaluate their peers for the U.S. News ranking must be members of Doximity — calling itself the “largest community of health care professionals in the country, with over 80 percent of U.S. doctors and 50 percent of all nurse practitioners and physician assistants as verified members.”

In February, 25,921 Doximity-affiliated physicians were invited to participate in the U.S. News survey. Of that, 6,331 completed the survey, amounting to a final response rate of 24.4 percent. Last year’s response rate was 25.4 percent.

Where UI Children’s Hospital again earned its place as Iowa’s top- and only ranked children’s hospital, it improved its regional rank from No. 12 to No. 11 — just outside the top 10. The Midwest region incorporates more states than any other, including Iowa, its six border states, and North Dakota, Kansas, Indiana, Kentucky, Ohio and Michigan.

Regionally, the Southwest had the most ranked hospitals at 26, followed by the Midwest at 24. Four of the top 10 Midwestern children’s hospitals are in Ohio — including the top-ranked children’s hospital in the country: Cincinnati Children’s Hospital Medical Center.

UI Children’s growth

The UI Children’s Hospital last year cared for more than 94,000 children from more than 45 states and more than 10 countries.

Debuting in 1975, the state’s first neonatal intensive care unit opened at the UI with 12 beds — expanding over time to today’s 88. UIHC survival rates for its smallest and sickest infants born at 22 to 25 weeks are “significantly higher” than they are nationally.

In 2019, when the UI Children’s Hospital was ranked No. 16 in neonatology, it reported a 59 percent survival rate at 22 weeks and 76 percent survival at 23 weeks.

Compare that with a National Institute of Child Health and Human Development study released last year of more than 10,000 U.S. babies born from 2013 to 2018. It found survival of infants born at 22 weeks increased from 6.6 percent in the five years prior to 11 percent. Survival of those born at 23 weeks had improved from 32 to 49 percent.

In April, the Board of Regents gave UIHC the go-ahead to build out the seventh floor of its Children’s Hospital for an expanded NICU. The expansion will include 28 new patient rooms and would connect with the existing NICU and labor and delivery space in the UIHC John Pappajohn Pavillion.

Comments: (319) 339-3158; vanessa.miller@thegazette.com