Report Cards for Health Care: Is Anyone Checking Them?
Jan 1, 2002
Public Release of Information about Quality of Health Care
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Long Abstract (a.k.a. Abstract Full): Public disclosure of the comparative performance of health care providers is seen as one mechanism for improving quality of care and controlling health care costs. This report, the result of a collaboration between the Nuffield Trust in London and RAND, assesses the U.S. experience with publicly releasing health care performance data and offers guidelines for establishing public disclosure policy in the United Kingdom. Because the United States leads the world in reporting clinical information by hospital and by physician name, this report will be of interest to any country considering public release of performance data. Principal findings: Despite a rapidly expanding report card industry, U.S. physicians are skeptical about report cards, and consumers and purchasers rarely use them. Hospitals may respond to performance data with internal changes, especially in a competitive environment. Publishing comparative mortality data seems to improve outcomes, but the mechanism by which this happens is unclear. Key recommendations: Public disclosure should be viewed as an evolutionary process, becoming more sophisticated and comprehensive over time. Disclosure should be a tool to support all quality initiatives in the U.K. National Health Service. Provider organizations should be a key audience for performance information. Health professionals should be fully involved in the public disclosure process. Both process and outcome measures of quality should be published. Public disclosure should be accompanied by possible explanations for the variations reported.
Public disclosure in the context of health care systems
The purpose of public release of performance data
Overview of publicly available performance data in the United States
Evaluation of the impact of public data
Discussion: policy issues for the United Kingdom
Frequency of conditions/procedures studied in report cards
Conceptual model of public disclosure
Summary of reporting systems that have been subject to evaluation
US Diagnosis Related Group frequency data
UK common causes of hospital bed occupancy
Illustrative examples of performance indicators in the UK
The study was conducted within RAND Health.
This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.
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