5. Public Reporting as a Quality Improvement Strategy

Author, Year
(QA)
Caron 1999 9
(Poor)
Caron 2004 8
(Fair)
9. Context:
Decisionmaker
Characteristics
Patients and Payers
have access to the data.
10. Context:
Type of
Decision/Choice 11. Results: KQ1: (Health Care Outcomes) 12. Results: KQ2 (Harms)
Hospital selection
for future use.
Of 20 Participating hospitals, 16 improved
their cesarean section rates and 15 their
VBAC rates between 1992 and 1997.
none none Descriptive data: Means and Percentage
Improvement, Time 1 vs Time 2 vs Time 3 vs
Time 4 vs Time 5; % improved (lower scores
are improvements for non-obstetric
outcomes, higher scores are improvements
for obstetric outcomes)
Acute MI length of stay (LOS): 7.51 vs 7.04
vs 6.55 vs 6.15 vs 6.09; 93%
Acute MI mortality: 10.79 vs 10.95 vs 11.30
vs 11.57 vs 10.27; 59%
CHF LOS: 6.03 vs 5.80 vs 5.15 vs 4.95 vs
4.73; 100%
CHF mortality: 6.18 vs 5.77 vs 5.02 vs 4.25
vs 4.05; 85%
Stroke LOS: 7.41 vs 6.98 vs 6.07 vs 5.71 vs
5.30; 100%
Stroke mortality: 9.95 vs 9.68 vs 8.72 vs 9.40
vs 9.59; 59%
Primary caesarean delivery rate (not used in
analyses): 15.95 vs 14.99 vs 13.36 vs 12.19;
76%
VBAC delivery rate: 34.85 vs 40.16 vs 44.76
vs 46.52; 67%
Total caesarean delivery rate: 20.20 vs 21.30
vs 19.72 vs 17.82; 67%
----
H-32
13. Results: KQ3 (Provider
Outcomes-QI and other
behaviors)
None 15 of 18 hospitals indicated
that they currently have an
initiative in place to reduce
their cesarean section rate.
Of 18 facilities, 17 had high
scores pertaining to the
prioritization of reducing and
monitoring their cesarean
section rates, and the same
facilities also had high scores
pertaining to organizational
leadership.
None None
There was no significant
correlation between
organizational environment
and predicted cesarean
section rate.