5. Public Reporting as a Quality Improvement Strategy

Author, Year
(QA)
Ghali, 1997 18
(Fair)
9. Context:
Decisionmaker
Characteristics
10. Context:
Type of
Decision/Choice 11. Results: KQ1: (Health Care Outcomes) 12. Results: KQ2 (Harms)
None None Massachusetts CABG Cases, 1990-1994:
Trends in Observed, Predicted, and Adjusted
Mortality [Observed Mortality, % (95% CI);
Predicted Mortality, % (95% CI); SMR (95%
CI); Adjusted Mortality, % (95% CI)]
1990 (baseline; n=5395): 4.7 (4.2-5.3); 4.7
(4.2-5.3); 1.00 (.78-1.2); 5.3 (4.1-6.4)
1992 (n=5818): 3.5 (3.0-3.9); 5.4 (4.8-6.0);
.65 (.50-.82); .65 (.50-.82); 3.4 (2.6-4.3)
1994 (n=5915): 3.3 (2.8-3.8); 5.7(5.1-6.3);
.58 (.45-.73); 3.1 (2.4-3.9)
----
CABG In-Hospital Mortality trends over time
for Massachusetts, New York, and Northern
New England:
[Years Studied; Observed Mortality
Reduction, % (Baseline; Final year); SMR
H-38
[Pre-Reporting %; Public Reporting %
(Adjusted P value for difference)]
Diagnosis:
Pneumonia: 10; 11 (.06)
Bronchitis: 26; 25 (.17)
CHF: 9; 8 (.40)
Antibiotic Use:
With any ED diagnosis: 34; 35 (.45)
With an ED diagnosis of pneumonia:
70; 78 (.86)
With no ED diagnosis of pneumonia:
26; 27 (.79)
With an inappropriate ED diagnosis:
21; 24 (.80)
Mean Waiting Times to See a
Physician:
Visits for respiratory symptoms: 39; 50
(.06)
Visits not for respiratory symptoms:
47; 53 (.002)
Difference, respiratory vs no
respiratory symptom: 8; 3 (.06)
None None
13. Results: KQ3 (Provider
Outcomes-QI and other
behaviors)