A state hospital trade group has endorsed an educational program for hospital trustees designed to help them monitor and improve quality at the institutions their boards oversee.

The Massachusetts Hospital Association said in a statement today its six-hour curriculum for trustees focuses on mission, culture, performance, leadership, and resource allocation. It was developed with the American Hospital Association and was supported by Blue Cross Blue Shield of Massachusetts. Hospitals, health systems and medical centers may become eligible for incentives from the insurer’s pay-for-performance programs after their trustees complete the course, the hospital group said.

Six organizations took part in a pilot project to test the program, which is tailored to each healthcare setting. They were Emerson Hospital in Concord, HealthAlliance Hospital in Leominster and Fitchburg, New England Baptist Hospital in Boston, North Shore Medical Center in Salem, North Adams Regional Hospital, and Atrius Health, a Newton-based alliance of physician groups, including Harvard Vanguard Medical Associates.

Massachusetts General Hospital and Brigham and Women's Hospital held on to their honor roll positions in the annual rankings by U.S. News & World Report called "America's Best Hospitals." Nine Boston hospitals are featured in the guide.

Mass. General finished fifth in the standings, down one rung from last year, and the Brigham took tenth place, up one from last year. Once again, Johns Hopkins Hospital and the Mayo Clinic finished first and second. UCLA Medical Center moved up to third from fifth and the Cleveland Clinic slipped to fourth from third.

The magazine evaluated 5,462 hospitals in 16 specialties, excluding pediatrics, and came up with 173 hospitals that met standards in one or more specialties based on reputation, care-related factors such as nursing and patient services, and mortality rate. Eighteen hospitals scored at or near the top in at least six specialties to make the honor roll.

Other hospitals were ranked in the specialty areas, but not in a cumulative score. Beth Israel Deaconess Medical Center was in the top 50 for 10 categories: diabetes (in conjunction with the Joslin Clinic); digestive disorders; respiratory care; heart and heart surgery; cancer care; kidney diseases; geriatrics; gynecology, urology; and ear, nose and throat care.

Boston-area hospitals known for their specialties also made the top 50. Dana-Farber Cancer Institute placed fifth in the list for cancer care. Joslin Clinic, with its partner Beth Israel Deaconess, was ranked 12th for endocrinology. New England Baptist Hospital was 17th for orthopedics and Spaulding Rehabilitation Hospital ranked eighth for rehabilitation. Massachusetts Eye and Ear Infirmary placed fourth in ophthalmology and in the ear, nose and throat specialty.

Boston Medical Center was ranked 41st in geriatrics.

Mass. General's winning specialty areas were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; heart and heart surgery; gynecology; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; psychiatry; and rheumatology.

The Brigham's top specialties were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; and rheumatology.

Beth Israel Deaconess Medical Center and New England Baptist Hospital will work together on a suburban expansion. Tufts-New England Medical Center had planned to build a $300 million suburban hospital with New England Baptist but will now proceed alone.

Harry Spence, commissioner of the Department of Social Services, defended how his agency handled the case of 4-year-old poisoning victim Rebecca Riley but said his department needs more medical expertise to help social workers review the diagnoses and drugs prescribed by doctors treating children overseen by the agency. JudyAnn Bigby, secretary of Health and Human Services, said she would appoint an independent physician in the next few days to be on call to help DSS, until the agency develops a medical review system.

About 1 in 150 American children has autism, an urgent public health concern, said US health officials yesterday who reported on the largest study done so far on the disorder. The new numbers, based on 2002 data from 14 states, are higher than previously reported.

Babies conceived through fertility treatments have higher rates of birth defects, but the overall risk is so small that it should not keep couples from having children this way, doctors are reporting.