5. Public Reporting as a Quality Improvement Strategy

Author
Year
Schneid
er
1996 138
Cont.
1. Study
Purpose
and/or a
priori
Hypothesis
2.
Geographic
Location
3. Study
Design/
Type
4. Sample/
Population:
Who or what
is studied? 5. Outcomes
among
cardiothoraci
c surgeons.
After
excluding
incomplete
surveys or
ineligible
physicians,
n=337 (279
cardiologists
and 58
cardiac
surgeons)
questions
related to
potential
limitations
Influence on
providers/Acces
s to Care: 5
Point Likert
scale, for
surgeons:
Willingness to
operate; for
cardiologists:
difficulty finding
surgeons willing
to operate
K-18
6. Name of
Report or
Subject
Matter 7. Results 8. Summary
Importance of Consumer Guide
Ratings:
Minimally or not important:
158(70); 39(68)
Moderately important: 49(22):
12(21)
Very or extremely important:
20(9); 6(11)
Influence of Consumer Guide
ratings on referrals (only
cardiologists):
none: 1240(62)
Minimal: 57(25)
Moderate: 25(11)
Substantial: 5(2)
Percentage of patients with whom
respondent discussed Consumer
Guide in past year:
0: 149(66); 33(57)
1-10: 54(24); 22(38)
>10: 24(11); 3(5)
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Limitations of the Consumer
Guide Rated by Respondents as
Very or Extremely Important:
[#,(%) for Cardiologists; #,(%)for
Cardiac Surgeons]
Important factors other than
mortality rates not included:
171(78); 45(78)
Risk-adjustment methods
inadequate to compare surgeons
fairly: 169(77); 49(85)
Mortality rates are an incomplete
indicator of surgeon’s quality:
162(74); 49(85)
Surgeons and hospitals can
manipulate data: 113(52); 33(57)
Ratings are based on out-of-date
more difficult to
find surgeons
willing to
operate on their
most severe
cases. Of note,
10% stated it
was easier to
find surgeons
willing to
operate. Only
30% of
cardiologists
said the
Consumer
Guide had a
moderate to
substantial
influence on
their referrals.
9. Funder of
Research