Four Utah hospitals are among the top 20 small hospitals in the country, according to a national survey released this week.

Alta View Hospital in Sandy, Valley View Medical Center in Cedar City, American Fork Hospital and Castle View Hospital in Price were lauded in the report, conducted by New York-based HICA Inc. and William M. Mercer Inc, two national health-care research organizations."The study says that these hospitals are examples for other hospitals to follow," said Daron Cowley, spokesman for Intermountain Health Care, which owns Alta View, Valley View and American Fork hospitals. "If all hospitals would operate like these top 100 hospitals, national health-care expenses would decline by $26 billion. They're cost-effective."

"The Top 100 Hospitals -- Benchmarks for Success" study looked at all the hospitals in the country to come up with the winners, based on eight measures of clinical quality practices, operations and financial management. The four hospitals fell into the category of 25-99 beds, among the 20 hospitals that made the overall top 100 list.

None of Utah's larger hospitals made the top 100 list.

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Quality of care, measured by mortality and complications, was at least 16 percent better than in the rest of the country at the benchmark hospitals. The hospitals also do more with less, averaging 18 percent fewer staff members and a 22 percent higher occupancy rate. And the average length of stay in the honored hospitals was 7 percent shorter.

This is the sixth year the study was conducted. American Fork Hospital was ranked in the top for the second year in a row and the third time since the study began. Alta View Hospital also made the list in 1998 and 1996. Valley View and Castle View appeared on the list for the first time.

Hospitals consider the study very accurate because it includes every hospital in the count and uses the same data to compare each hospital. That data is reported by Medicare, rather than relying on self-reporting or assessment, so it's considered more reliable, said Cowley.

"This is a nice honor, and we're really pleased," he said.

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