5. Public Reporting as a Quality Improvement Strategy

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Author Year (QA) Results: KQ1: (Health Care Outcomes) Results: KQ2: (Harms) Results: KQ3: (Provider Outcomes-QI and other behavior) Results: KQ4: (Selection by Patients and Payers) Expected (O-to- E) Mortality Ratio and Patient Predicted Mortality: Patient predicted probability of death: Base Model: Coef: -0.338, p
Author Year (QA) Hannan 1994 21 (Good) Results: KQ1: (Health Care Outcomes) For Individual Surgeons: Actual, Expected, and Risk-Adjusted Mortality in 1989-1992: Based on Surgeons’ 1989- 1990 RAMR Terciles: [Actual; Expected; Risk-Adjusted (95% CI)] 1989-1990: Lowest Tercile (n=32): 1.95; 3.01; 2.01 (1.72- 2.33) Middle Tercile (n=32): 3.20; 2.84; 3.50 (3.10- 3.93) Highest Tercile (n=31): 4.81; 2.53; 5.90 (5.22- 6.63) 1992: Lowest Tercile: 2.07; 3.52; 1.82 (1.49-2.21) Middle Tercile: 2.96; 3.89; 2.36 (1.99-2.79) Highest Tercile: 3.49; 3.26; 3.26 (2.68-3.92) ---- Actual, Expected, and Risk-Adjusted Mortality in 1989-1992: Based on Surgeons’ 1989- 1990 RAMR Outlier Status: [Actual; Expected; Risk- Adjusted (95% CI)] 1989-1990: Low Outliers (n=6): .77; 3.23; .74 (.41-1.25) Results: KQ3: (Provider Outcomes-QI and other behavior) Results: KQ4: (Selection by Patients and Payers) Results: KQ2: (Harms) None None No impact of public reporting on volume for surgeons (data not reported) J-13 Results: KQ5: (Impact of Public Report Characteristics) Results: KQ6: (Impact of Contextual Factors) Summary/Conclusions None None For surgeons, all tercile groups experienced reductions in their RAMR, with the highest RAMR in 1989 being reduced from 5.90 to 3.26 in 1992. Among outliers in the surgeon category, only those who were the lowest outliers in 1989 (with an RAMR of .74) experienced a RAMR rise in 1992 (1.09). The largest reduction in RAMR was among the high outlying surgeons with 7.06% decrease between 1989-1990 and 1992. Funder of Research Agency for Health Care Policy and Research of the US Department of Health and Human Services
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Evidence Report/Technology Assessme
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This report is based on research co
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Acknowledgments We would like to ac
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Public Reporting as a Quality Impro
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Tables Table A. Summary Evidence Ta
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and using reports and other decisio
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• Outcomes (specified for each Ke
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Methods A Technical Expert Panel fo
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setting), and the strength of the b
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Table A. Summary evidence table: ef
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was at the time the included studie
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6. Hibbard JH, Sofaer S. Best Pract
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access to essential information and
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providers, for purposes of this rev
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information and reduces comprehensi
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Methods Topic Nomination and Develo
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Table 1. Public reporting concepts
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• The public reporting was only a
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• Key Question 2. Harms included
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were retained, but they were not as
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Data Extraction Following full text
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Data Synthesis We separated studies
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Results Organization The results of
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Overview of Effectiveness of Public
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Access restrictions. It was unclear
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o The results of two studies sugges
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Key Question 5 What characteristics
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Long-term care • Studies that exa
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Harms (Key Question 2) • Two 52,6
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eport known as QualityCounts was pr
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Table 1. Study findings: hospital c
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o One study found that patients tre
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condition found declines for CHF (7
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developed (HCAHPS) and public repor
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Key Question 6. Context Two studies
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• Survey responses of hospitals i
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activity would influence hospital c
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Lab-Type Experiments The two articl
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Table 3. Summary of evidence: publi
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Individual Clinicians and Outpatien
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public reports influenced the contr
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New York State to trends in other S
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One study evaluated use of a Web si
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Patients. Patient reactions to publ
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Table 4. Summary of evidence: quali
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Table 4. Summary of evidence: Quali
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Health Plans Rating and reporting o
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The public reporting intervention i
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that included adjustment for severa
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Key Question 6. Context Five studie
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about patient-physician relationshi
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CAHPS results. Credibility of the r
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Long-Term Care Services Prior syste
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o Improvement in one QM (influenza
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studies that examined change and tr
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Table 6. Study findings: change in
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ehospitalizations for these patient
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improvements in the pain measure we
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Werner et al. 107 2012 included ext
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Table 7. Summary of evidence: long-
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Figure 3. Number of included quanti
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suggests the possibility that addit
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Table 8. Summary evidence table: Ef
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literature sources that we were abl
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of public reports have a wide range
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approaches to reducing bias in heal
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21. Young G. Multistakeholder regio
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60. Castle NG, Liu D, Engberg J. Th
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99. Knutson DJ, Kind EA, Fowles JB,
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141. Schneider EC, Epstein AM. Infl
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181. Scanlo DP, Chernew M, McLaughl
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222. Ketelaar NA, Faber MJ, Flottor
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Appendix A. Literature Search Datab
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CINAHL EBSCO Plus with Full Text Da
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EMBASE - Elsevier (1973-present) Da
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Public Affairs Information Service
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Full Text Review Include: Based on
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Appendix C. Included and Excluded S
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29. Castle NG, Sonon K, Antonova J.
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58. Gabel JR. When employers choose
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86. Hibbard JH, Peters E, Dixon A,
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117. Marshall M, Noble J, Davies H,
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145. Pettijohn TL, Lawrence ME. The
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174. Spranca MD, Elliott MN, Shaw R
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6. NCQA releases HEDIS 2.0 standard
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40. Pacific Business Group on Healt
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74. The effect of report cards on M
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110. MGMA addresses accuracy concer
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137. Applebaum R, Kunkel S, Wilson
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165. Barkauskas VH, Pohl JM, Benker
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193. Bindman AB, Wholey DR, Christi
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219. Bratzler DW. Development of na
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247. Caldwell B. Employers use perf
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275. Centre for R, Dissemination. P
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301. Chesanow N. Managed care 1999.
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329. Commonwealth Fund. Commission
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358. Daly JM, Jogerst GJ. Associati
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386. DeLiberty RN. Developing a pub
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412. Doty MM, Koren MJ, Sturla EL,
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439. Elliott MN, Beckett MK, Kanous
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467. Feeley TW, Fly HS, Albright H,
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494. French J. 2003 E.I. Hood Award
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522. Ginsburg PB, Kemper, N. M. Hea
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551. Graham JD. Is reporting of qua
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581. Gruber T, Rudnitsky B. Can we
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608. Hardingham L. Informed decisio
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633. Heidenreich PA, Lewis WR, LaBr
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660. Hodgson ES, Simpson L, Lannon
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689. Izakovic M. New trends in the
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718. Kakkar A, Jacobson BC. Interne
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747. Ketelaar N, Faber M, Flottorp
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772. . Importance of stratification
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800. Leonardi MJ, McGory ML, Ko CY.
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827. Livingston EH. Bariatric surge
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856. Mantone J. Massachusetts site
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882. Mazza G, Fazzi B. Five good re
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907. McKibben L, Horan T, Tokars JI
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935. Miller R, Lazar J. Public repo
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963. Morrison K. The road to JCAHO
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989. National Committee for Quality
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1017. O’Malley C. Quality measure
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1045. Peabody J. Why we love qualit
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1073. Qaseem A, Snow V, Gosfield A,
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1100. Robinowitz DL, Dudley RA. Pub
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1129. Roski J, Kim MG. Current effo
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1156. Sangl JA, Wolf LF. Role of co
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1183. Schull MJ, Guttmann A, Leaver
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1212. Shea JA, Guerra CE, Weiner J,
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1238. Simpson AG, DeGuzman PB, Barb
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1264. Sofaer S. What information do
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1292. Stewart DW, Hickson GB, Pechm
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1320. Tjia J, Field TS, Fischer SH,
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1346. Van Beek K, Duchemin S, Gersh
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1374. Weingarten JP, Jr., Fan W, Pe
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1401. Wiljer D, Bogomilsky S, Catto
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1426. Zaslavsky AM, Shaul JA, Zabor
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Appendix E. Description of Public R
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Table E1. Descriptive information a
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Table E1. Descriptive information a
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Appendix F. Method for Quality Asse
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the time periods actually prior to
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Application to Public Reporting Thi
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Table G1. Quality assessment criter
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Table G1. Quality assessment criter
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Section A Appendix H. Hospitals: Qu
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Table H1. Hospital quantitative stu
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Section B Table H2. C Hospital quan
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Author, Year (QA) Baker 2003 4 (Fai
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Author, Year (QA) Clough 2002 10 (F
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Author, Year (QA) Dranove 2003 13 (
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Author, Year (QA) Foreman 1995 16 (
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Author, Year (QA) Guru 2006 19 (Fai
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Author, Year (QA) Hibbard 2003 24 (
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Author, Year (QA) Jang 2011 28 (Fai
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Author, Year (QA) Mennemeyer 1997 3
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Author, Year (QA) Omoigui 1996 34 (
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Author, Year (QA) Pope 2009 36 (Fai
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Author, Year (QA) 9. Context: Decis
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Author, Year (QA) Vladeck 1988 42 (
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Author, Year (QA) Wuebker, 2008 45
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Table I1. Hospital qualitative stud
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Section B Table I2. Hospital qualit
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Author, Year 10. KQ3:Results 11. KQ
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Author, Year 10. KQ3:Results design
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Page 457 and 458: Author, 15. Funder of Research/ Yea
Page 463 and 464: Regarding the least useful aspects,
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Page 483 and 484: Author Year (QA) Mukamel 1998 33 (F
Page 487 and 488: Author Year (QA) Werner 53 2005 (Go
Page 489: Author Year (QA) Glance 2008 48 (Fa
Page 493 and 494: Author Year (QA) Results: KQ1: (Hea
Page 499 and 500: Author Year (QA) Ranganathan 2009 5
Page 503 and 504: Author Year (QA) Werner 2005 53 (Go
Page 507 and 508: Author Year Barr 2008 144 1. Study
Page 509 and 510: Author Year Casalino 2007 146 1. St
Page 511 and 512: Author Year Fanjiang 2007 150 1. St
Page 513 and 514: Author Year Friedber g 2010 151 1.
Page 515 and 516: Author Year 1. Study Purpose and/or
Page 517 and 518: Author Year Longo 2003 119 1. Study
Page 519 and 520: Author Year Marshall 2006 154 Mayth
Page 521 and 522: Author Year 1. Study Purpose and/or
Page 523 and 524: Author Year Schneid er 1996 138 Con
Page 525 and 526: Author Year Schultz 2001 158 Stein
Page 527 and 528: Author Year QA Beaulieu 2002 56 Fai
Page 529 and 530: Author Year QA Chernew 2004 58 Fair
Page 531 and 532: Author Year QA Farley 2002 62 Good
Page 533 and 534: Author Year QA Hendricks 2009 66 Po
Page 535 and 536: Author Year QA 1. Study Purpose and
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Author Year QA Beaulieu 2002 56 Fai
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Author Year QA Chernew 2004 58 Fair
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Author Year QA 11. Results: KQ1: (H
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Author Year QA Farely 2002 62 Good
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Author Year QA Fowles 2000 63 Good
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Author Year QA Hendricks 2009 66 Po
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Author Year QA Hendricks 2009 66 Po
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Author Year QA Jung 2010 68 Good Kn
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Author Year QA 11. Results: KQ1: (H
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Author Year QA Pham 2002 73 Good 11
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Author Year QA Tae-Seale 2004 76 Fa
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Appendix M. Health Plans: Qualitati
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Author Year Farley-Short 2002 162 1
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Author Year Gabel 1998 163 1. Study
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Author Year Gibbs 1996 164 1. Study
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Author Year 1. Study Purpose 2. Geo
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Author Year Harris- Koejetin 2000 1
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Author Year Hibbard 1997 171 1. Stu
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Author Year Hibbard 2001 178 Hibbar
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Author Year Paulsbo 2007 183 Peters
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Author Year Rosenthal 2007 186 1. S
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Author Year Scanlon 2001 188 1. Stu
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Author Year Spranca 2000 190 1. Stu
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Author Year Teleki 2007 192 1. Stud
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Author Year Uhrig 2006 194 1. Study
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Section A Appendix N. Long-Term Car
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Author Year Jung 2010 85 Konetzka 2
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Author Year Werner 2009a 92 Werner
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Author Year Zinn 2010 99 1. Study P
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Author Year Castle 2007 79 Cont. 11
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Author Year Castle 2010 81 11. Resu
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Author Year Jung 2010 85 11. Result
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Author Year Mukamel 2008 86 Mukamel
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Author Year Park 2011 b 90 11. Resu
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Author Year Werner 2009 b 93 11. Re
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Author Year Werner 2010 94 Werner 2
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Author Year Zinn 2005 97 11. Result
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Author Year Zinn 2010 99 11. Result
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Appendix O. Long-Term Care: Qualita
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Author Year Castle 2005 197 1. Stud
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Author Year Gerteis 2007 198 1. Stu
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References 1. AHRQ. Methods Guide f
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36. Pope DG. Reacting to rankings:
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77. Wedig GJ, Tai-Seale M. The effe
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118. Laschober M, Maxfield M, Felt-
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157. Pettijohn TL, Lawrence ME. The
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198. Gerteis M, Gerteis JS, Newman
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5. Public Reporting as a Quality Improvement Strategy

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