Patient satisfaction and aggressive care don't necessarily go hand in hand, according to new hospital ratings prepared by Consumer Reports.

Drawing on government surveys compiled on the Hospital Compare web site and the Dartmouth Atlas of Health Care intensity index, the consumer ratings publisher has ranked the nation's more than 3,000 hospitals on its online health site, using the same red and black blobs familiar from ratings of cars or digital cameras.

Patient satisfaction covered eight categories, from cleanliness to communication, and intensity was measured by the number of tests conducted, doctors' visits made, procedures performed, and days spent in the hospital. Consumer Reports reverses how Dartmouth reports intensity, instead presenting aggressive care at the low end and conservative care at the high end of a spectrum from 1 to 100.

The top 28 teaching hospitals -- those that ranked significantly above the national average in patient satisfaction -- on average practiced more conservative medicine than 59 percent of hospitals, according to Dartmouth benchmarks for chronic care.

Brigham and Women's Hospital and Massachusetts General Hospital, the only two hospitals in the state to make the highest performers' list, were among the exceptions. The Brigham's Dartmouth score says it is more conservative than 29 percent of hospitals and Mass. General is more conservative than 18 percent on a spectrum where aggressive scores are low and conservative scores are high.

That stands in contrast to the Dartmouth-affiliated Mary Hitchcock Memorial Hospital in Lebanon, NH. Its overall patient satisfaction score of 81 is one point ahead of the Brigham and one point below Mass. General, but its Dartmouth score says its care is more conservative than 88 percent of hospitals.

"Mass. General does very well and so does the Brigham among better-performing hospitals. They are more toward the aggressive end of the spectrum, but what we try to communicate to folks is a more conservative approach doesn't lessen patient satisfaction," Dr. John Santa, director of the Consumer Reports Health Ratings Center, said in an interview. "It actually appears to be associated with a better experience."

By Liz Kowalczyk, Globe Staff

President Obama and members of Congress have cited high numbers of hospital readmissions as a main driver of soaring health care costs, as well as being bad for patients. Now, consumers can find out which hospitals have the highest -- and lowest -- readmission rates for three common conditions, heart attack, heart failure, and pneumonia.

The federal Centers for Medicare and Medicaid Services, which posted the information today on its website, says most Boston hospitals performed close to the national average between July 2005 and June 2008.

Massachusetts General Hospital was the only Boston hospital that scored better than average for any condition; 22 percent of Mass. General's heart failure patients are readmitted to the hospital within 30 days, compared with 24.5 percent of patients nationally.

Other hospitals fell below average on some of the measures. Tufts Medical Center scored worse than average for the readmission of heart failure patients, and Caritas St. Elizabeth's Medical Center scored below average for heart attack readmissions, Beth Israel Deaconess Medical Center was the only Boston hospital to score worse than average on all three measures. The hospital's highest readmission rate was for heart failure -- 27.5 percent of patients, compared with 24.5 percent nationally.

By Michael Paulson, Globe Staff

Caritas Christi Health Care, the financially challenged Catholic hospital system founded by the Archdiocese of Boston, is abruptly ending its joint venture with a Missouri-based health insurer at the insistence of Cardinal Sean P. O'Malley, who has decided that the relationship represented too much of an entanglement between Catholic hospitals and abortion providers.

The dramatic development, just days before the joint venture was scheduled to start providing care to low-income residents as part of the state's efforts to establish near universal health coverage here, is a vindication of sorts for a variety of very conservative Catholic critics of the cardinal, who have been arguing angrily and loudly that it would be "evil" for Caritas to partner with a health provider that covers abortion services.

The development is also a setback for Caritas, because it represents the undoing of one of the most significant steps its new chief executive, Dr. Ralph de la Torre, had announced as part of his efforts to turn around the hospital system's finances. It was not immediately clear last night what the financial impact of the change is on Caritas, but the decision is a stark and public reminder from O'Malley to de la Torre and the general public that moral concerns will trump monetary concerns at the Catholic hospitals.

Almost 500 workers at Carney Hospital have voted to join a union, the third hospital in the Caritas Christi Health Care chain to do so, according to election results announced today.

Just under 80 percent of the Dorchester hospital's workers including respiratory therapists, radiology technologists, licensed practical nurses, nurse assistants, pharmacy technologists, clerical workers, housekeepers, and dietary workers, chose Local 1199 of the Service Employees International Union to represent them. Earlier this year, about 800 workers at St. Elizabeth’s Medical Center in Brighton voted to join the same union. Good Samaritan Hospital, a Caritas hospital in Brockton, has about 900 members of the union.

Cardinal Sean P. O'Malley issued a statement this afternoon defending a proposed joint insurance venture between Caritas Christi Health Care and the Centene Corporation.

Caritas, a Catholic hospital network, and St. Louis-based Centene are seeking to offer state-subsidized health insurance to low-income residents through the state's Commonwealth Care program, but the plan has been criticized by anti-abortion groups because the venture, under state law, would be required to cover abortions and other family-planning services.

"I want to confirm for the Catholic community and the wider interested public that Caritas Christi Health Care has assured me that it will not be engaged in any procedures nor draw any benefits from any relationship which violate the Church's moral teaching," the cardinal's statement says.

Caritas and Centene issued a statement last week saying that it would contract with providers in and out of the Caritas network to ensure access to state-required services, "including confidential family planning services."

Paul Levy understands why Norwood Hospital is nervous.

On his blog Running a Hospital, the CEO of Beth Israel Deaconess Medical Center recounts his visit to Foxboro, where the Brigham and Women's/Mass General Health Care Center is being built at Patriot Place, a complex next to Gillette Stadium.

The newest satellite of the Partners Healthcare System offers many of the same medical services found about eight miles north at Norwood Hospital, which is part of the Caritas Christi hospital network. But doctors at the two hospitals are paid different amounts, despite no documented differences in quality of care they provide, Levy says, citing the recent Globe Spotlight series.

"Now, let's acknowledge that MGH and the Brigham are powerful brands," Levy writes. "To the extent patients are influenced by that reputation or other factors to migrate to the PHS facility from Norwood Hospital, the overall health care bill for the state will rise for no documented additional value to those patients or society."

The head of New England's second-largest hospital network has some advice for President Obama in the current issue of Business Week.

Dr. Ralph de la Torre, chief executive of Caritas Christi Health Care, suggested clarifying the concepts of access, cost, and quality rather than focusing on vague goals such as "universal care" or "affordability." Reaching consensus will not be an easy feat, he says.

"That's why I suggest you launch a kind of 90-day Manhattan Project as soon as possible. Invite 50 to 70 of our country's smartest thinkers—people willing to spend three months in Washington—to solve what is one of the biggest domestic problems facing the U.S. today," he writes. "Avoid policy wonks and business consultants, simply because the economics of health care differ so radically from those of other industries. Station the National Guard at every entrance to the meeting room and instruct them to keep out all lobbyists. "

By Liz Kowalczyk, Globe Staff

The University of Massachusetts Medical School in Worcester is poised to appoint Dr. Michael Collins as the new chancellor. A search committee recommended today that Collins, who has run the medical school on an interim basis for more than a year, be appointed the school's permanent leader.

He would replace Dr. Aaron Lazare, who stepped down after 16 years as leader of the state's only public medical school.

Collins is the former chancellor of UMass-Boston and the former president of Caritas Christi Health Care System, a large Catholic hospital network. UMass President Jack Wilson and the board of trustees must approve Collins' appointment.

MIT biochemist Alexander Rich has won the Welch Award in Chemistry for his fundamental insights into the structure and function of RNA and DNA. He will receive the $300,000 prize in October.

Caritas Christi Health Care's senior vice president and chief information officer is leaving for Vermont. Charles H. Podesta, 50, will become chief information officer of Fletcher Allen Health Care in Burlington, Vt., in June. Last month Roger Deshaies, formerly senior vice president for finance at Brigham and Women’s Hospital, joined Fletcher Allen as its chief financial officer. The hospital is affiliated with the University of Vermont School of Medicine.

Clifford J. Tabin, a professor of genetics at Harvard Medical School, is one of two scientists to win the 2008 March of Dimes Prize in Developmental Biology. He will share the $250,000 award with Philip A. Beachy of Stanford. They are being honored for their work with "hedgehog" genes and how they affect the way embryos develop and form limbs, the brain, and other organs. Hedgehog genes got their name from the prickly appearance they gave fruit fly embryos.

Dr. Andy Whittemore, chief medical officer at Brigham and Women's Hospital, has been elected president of the American Surgical Association. Whittemore trained as a vascular surgeon, was a division chief at Brigham and Women's, and has been chief medical officer there since 1999.

Caritas St. Elizabeth's Medical Center in Brighton should end its role as a top-level academic hospital treating complex cases and Caritas Carney Hospital in Dorchester should consider becoming primarily a mental health center, says a report on the Caritas Christi Health Care System by Attorney General Martha Coakley. The report, based on a four-month study by a consultant, also urges the Archdiocese of Boston to cede control of the eastern Massachusetts hospital chain to an independent board with expertise in healthcare management. The board running the hospitals now answers to Cardinal Sean P. O'Malley. In an editorial, the Globe says Caritas' internal recommendations for changing governance would leave O'Malley with too much control, adding "sluggishness that Caritas cannot afford."

Scientists in California reported in the journal Science today on a new approach to developing a vaccine against Group A streptococcal infections, the cause of strep throat, rheumatic fever and necrotizing fascitis, commonly known as "flesh-eating" syndrome.

In business, Exact Sciences Corp.'s shares soared nearly 45 percent after the American Cancer Society and other health groups recommended use of its stool DNA test to screen for colon cancer; Genzyme Corp. launched its kidney disease drug Renvela; and German dialysis patients have gotten sick using a different brand of heparin than the Baxter International product that has been linked to 19 deaths in the US, leading the FDA yesterday to advise all US suppliers of the blood-thinner to use a special high-tech test for a contaminant found in some batches of Baxter's heparin.