Women and people needing lung or orthopedic care may feel comforted knowing they've got one of the best facilities in the nation right at their doorstep.

The University Hospital and its clinics ranked among the top 40 in three specialties in the annual U.S. News & World Report rankings of "America's Best Hospitals," released Monday.Of the 16 specialties the magazine considered, the U. ranked 23rd in pulmonary, 23rd in orthopedics, and 31st in gynecology.

"I think it's a matter of continuing a tradition of being recognized nationally for excellence in some specific service areas," said Christine St. Andre, executive director of the University Hospital.

Those three specialties have been strong for the U. in the past - in 1997, orthopedics earned the same ranking, and gynecology ranked 30th. The pulmonary specialty moved up from its 32nd ranking last year.

Cardiology, which ranked 41st last year, dropped out of the rankings in 1998. Though it puzzles St. Andre, she said it doesn't reflect the quality of care, or the number of people served.

"I don't know the reason for that," she said. "Our volume has actually increased in that area, so who's to say that it isn't more a reflection of the other hospitals than it is on us."

The rankings were determined using a somewhat controversial model, based on the hospital's reputation among doctors chosen at random. Board-certified physicians in each specialty are asked to name the five hospitals they consider the best in their field, without regard to cost or location. Although some specialties combine reputation with death rates and other data, four specialties are ranked by reputation alone: ophthalmology, pediatrics, psychiatry and rehabilitation.

But, never being one to turn down compliments, St. Andre said the U. will take this year's rankings in the best possible light.

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"I think the rankings have been done consistently over time, and while one could argue that the system might not use the criteria we would use, I think it is a sign of recognition.

"I think for us it's positive regardless of the criteria that is used. Reputation is important, and not to be discounted. Perception is a big part of what reality really means, when you get right down to it," St. Andre said.

Other specialties the magazine ranked were: cancer, cardiology and cardiac surgery, endocrinology, gastroenterology, geriatrics, neurology and neurosurgery, otolaryngology (ear, nose and throat), rheumatology and urology.

To be considered for ranking, U.S. News & World Report said a hospital had to meet one of the three following requirements: It had to be a member of the Council of Teaching Hospitals, be affiliated with a medical school, or achieve a minimum score on a mathematical index developed by the magazine. Of the 6,400 U.S. hospitals, 1,985 met the eligibility criteria. The final rankings included 132 hospitals.

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