India ranks its hospitals on everything except what matters

Every year, glossy hospital rankings flood India’s media; best cardiac centre, top oncology hospital, and the most trusted brand. Patients scan them the way they scan restaurant reviews. But ask a simple question of any of these lists-what is this hospital’s actual survival rate for the surgery I need, and the answer, in nearly every case, is silence. We must ban these hollow hospital rankings! 

Three rankings, zero outcomes

India’s hospital quality architecture rests on three pillars, and none of them measure what happens to the patient. NABH accreditation, held by over 25,000 facilities, audits structure and process: documentation, infection-control protocols, staffing ratios, hundreds of objectives across multiple chapters. It answers whether a hospital has the right systems. It does not ask whether those systems save lives. In 2023, we filed an RTI with NABH, if they conducted any study on the impact of NABH on healthcare outcomes and patient safety- they responded they did not have any such data.  Then why does a hospital with NABH get extra reimbursement? Media rankings – Best Hospitals surveys, academic-index rankings – lean on reputation, footfall, and research output: useful for prestige, irrelevant to a family deciding, at 2 a.m., where to take a father with a ruptured aneurysm. And JCI, held up as the international gold standard, follows the same script – governance, safety culture, documented protocols.

What all three have in common is what they leave out: the one number that should anchor every ranking is outcomes. Procedure-specific mortality. Risk-adjusted complication and readmission rates. Success rates by condition, by hospital, by surgeon volume. In a country performing millions of surgeries a year, we still cannot tell a patient, in hard numbers, which hospital does a given procedure better. 

No study has ever answered the question that matters

This is not a criticism built on anecdote; it is the honest finding of the accreditation literature itself. Systematic reviews of NABH accreditation in Indian hospitals report real gains in compliance, documentation accuracy, and discharge efficiency. What they do not report, because no study has been designed to capture it, is a single Indian dataset linking NABH accreditation to procedure-specific mortality or survival rates. The evidence trail stops at process. 

JCI fares no better on this specific question, globally. The international literature is explicit that evidence connecting JCI accreditation to patient outcomes remains limited and inconsistent – strongest on patient satisfaction and safety-culture surveys, thin to non-existent on hard clinical endpoints like mortality or long-term survival. A hospital can hold both NABH and JCI plaques on its lobby wall and still have never had its actual surgical survival rates independently studied against a peer hospital’s.

This matters because both certifications function, in practice, as proxies for quality- in patients’ minds, in insurer empanelment decisions, in medical-tourism marketing. Patients are told, correctly, that accreditation reflects safety protocols and governance discipline. What they are not told is that no accreditation body, Indian or international, has published the risk-adjusted outcomes data that would let anyone verify whether accredited Hospital A actually saves more lives for a given procedure than accredited Hospital B. The certificate answers “is this a well-run institution?” It cannot answer “will I survive this operation here, versus there?” Conflating the two is the single most consequential gap in Indian healthcare transparency today, and it is precisely the gap the National Health Policy 2017 was written to close.

The policy already told us to fix this

When I drafted the National Health Policy 2017, I put it plainly: India needs “mandatory disclosure of treatment and success rates across facilities in a transparent manner,” and patients have a right to know their condition and treatment prospects. That sentence is eight years old. It has never been operationalized. No regulator enforces it. NABH never absorbed it into its indicator set. It sits in a policy document while hospital rankings continue exactly as before, measuring everything except the thing the policy demanded.

What the rest of the world already does

We do not need to invent this from scratch. The United States built Hospital Compare- now Care Compare- where CMS publishes outcome measures designed to reflect the actual results of care, not merely whether a procedure was performed, alongside standardised patient-experience data. The United Kingdom went further: its Competition and Markets Authority forced private hospitals to publish infection rates, mortality rates, and readmissions, backed by a regulator with the power to direct compliance, not merely recommend it. Both systems share a design principle India has never adopted,  outcomes reporting must be standardized, risk-adjusted, and mandatory, or it collapses into marketing. The evidence also carries a caution: transparency without enforcement and risk-adjustment produces uneven results, as hospitals sometimes optimize the numbers that are measured rather than the care that is delivered. The lesson is not to abandon disclosure- it is to build it properly the first time.

Why this is the real foundation of value-based care

Value-based care has a simple definition: outcomes achieved per rupee spent-an equation with a numerator and a denominator. India’s health system today obsesses over the denominator- bed count, cost per procedure, insurance tariffs,  while leaving the numerator, outcomes, undefined. No value-based system, outcome-linked insurance model, or AI-driven quality framework can be built on a foundation with no outcomes data. Every dashboard, every star rating, every quality score in Indian healthcare is only as honest as the data beneath it, and that data, at present, does not exist in usable form.

The reform is not complicated. It is just undone.

A national, condition-specific outcomes registry; procedure-level mortality, complication and readmission rates, patient-reported outcomes, integrated into NABH accreditation and made a precondition for PM-JAY empanelment, would convert Indian hospital rankings from prestige contests into instruments of patient safety. It would give insurers an actuarial basis for paying for outcomes rather than procedures. It would give every patient, for the first time, the right NHP 2017 already promised them.

Eight years is long enough to wait for a sentence in a policy document to become a number on a hospital’s public record. The rankings India publishes today tell patients who has the best brand. The rankings India needs would tell them who has the best chance of walking out alive. That is the difference between a hospital that looks good on paper and a healthcare system that is actually accountable to the people it serves.