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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Judith H Hibbard, DrPH and Jean Stockard. Dept of Planning, Public Policy, and Management, University of Oregon, 119 Hendricks Hall, Eugene, OR 97403-1209, 541 346-3364, jhibbard@oregon.uoregon.edu
While substantial resources are being expended to measure and report health care quality, the impact of such reporting is still unclear. This study uses an experimental design to evaluate the impact of a public hospital performance report on subsequent hospital quality improvement efforts and actual improvements. Further the study examines the impact of the public report on consumer perceptions of hospital quality and their intentions about future hospital choice.
The study includes all the120 hospitals in the state of Wisconsin. An employer purchasing coalition created the public hospital performance report (focusing on hospital safety: complications, deaths, and errors) for 24 hospitals in south central Wisconsin. The other 96 hospitals in the state were randomly assigned to have no report, or to receive a private report on their performance only. The public report was widely disseminated and publicized. Obstetrical care, hip/knee replacement, and cardiac care were included. In addition two summary measures of performance were included: surgery and general medicine. The report was inserted into the local newspapers and sent directly to employees by employers. The report was based on HCUP data and risk adjusted by MedStat. The performance data is available on all the hospitals in the state, but only publicly reported for the 24 hospitals in south-central Wisconsin. Hospital management will be interviewed following the dissemination of the report. Consumers were interviewed prior to and following the dissemination of the report.
Preliminary findings from the consumer surveys indicate that about 30% of consumers in the community saw the report and regarded the information as important for future choices. The report appears to have influenced consumer perceptions of the relative quality and safety of the hospitals in their community. The interviews with hospitals will be completed over the next two months. The interviews focus on hospital perceptions of how the report will affect their public image and their market share. In addition the interviews will ask about specific quality improvement efforts in the clinical areas included in the report. Preliminary data from the hospital interviews are not yet available.
This study will be the first that employ an experimental design to assess the impact of the making performance public on both providers (hospital) and consumers. The research will help to determine whether the assumptions underlying public reporting are warranted. Will making performance public stimulate providers to improve the quality of care they provide, and will the information influence consumer choices?
Learning Objectives:
Keywords: Performance Measurement, Quality Improvement
Related Web page: www.qualitycounts.org/
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.