Data collection

The “Ranking Web of World Hospitals” is an initiative of the Cybermetrics Lab, a research group belonging to the Consejo Superior de Investigaciones Científicas (CSIC), the largest public research body in Spain.[34] The Cybermetrics Lab is devoted to the quantitative analysis of the Internet and Web contents especially those related to the processes of generation and scholarly communication of scientific knowledge. The Lab, using quantitative methods, has designed and applied indicators that allow the measurement of the scientific activity on the Web.[34] The cybermetric indicators are useful to evaluate science and technology and they are the perfect complement to the results obtained with bibliometric methods in scientometric studies.[1,2,11,29,30,32,43]

The unit for analysis is the institutional domain, so only hospitals with an independent web domain are considered. If an institution has more than one main domain, two or more entries are used with different addresses. Names and addresses were collected from both national and international sources, including “Hospitals Worldwide,” among others.[34]

Hospital activity is multidimensional and this is reflected in its web presence. Therefore, the best way to build the ranking is by combining a group of indicators that measure these different aspects. Almind and Ingwersen proposed the first Web indicator, “Web Impact Factor” (WIF), based on link analysis that combines the number of external inlinks and the number of pages of the website, a ratio of 1:1 between visibility and size.[3] This ratio is used for the ranking but adding two new indicators to the size component: number of documents, measured from the number of rich files in a web domain, and number of publications being collected by Google Scholar database. The four indicators were obtained from the quantitative results provided by the main search engines [Table 1].

The four webometrics used in “Ranking Web of World Hospitals” (visibility, size, rich files, and scholar), their method of processing, their weight, and their criteria of use

Next, data were collected on each hospital CEO. To do this, we used hospitals’ websites and, on some occasions, personal contact with institutions (in the form of a request for the name of the CEO). Each CEO was classified into one of the two categories – physician leaders and leaders who are nonphysician managers. To qualify as a physician leader, by this study's criterion, a CEO must have been trained in medicine and obtained a Doctor of Medicine (MD) degree, or its equivalent (MBBS).