5. Public Reporting as a Quality Improvement Strategy

(yes: 67 percent military; 59 percent non military), but a smaller percent responded that
they were very likely to use this information in selecting a hospital for surgery (34
percent and 30 percent) when asked this in a separate question (1989). 149
• A survey of patients who had CABG surgery in the previous year (n=474) revealed that
only 20 percent were aware of the Pennsylvania Consumers Guide at the time of their
surgery and only 4 percent had seen the report. Twenty-eight percent were not interested
in the report and the major reason was that distance was an important factor in choice
(1998). 148
• Outpatients at University of Missouri Medical Center (n=935) were provided a hospital
public report and completed a questionnaire indicating that most people found it an
effective way to compare providers (59.9 percent), but very few were likely to change
providers based on the information (2003). 146
• Randomly selected Medicare beneficiaries who had selected surgical procedures (n=510;
68 percent response rate) reported that decisions about where to have the surgery were
largely influenced by doctors and family and only a few (11 percent) attempted to find
comparative hospital information before their surgery. Forty-seven percent said they
would use a list of best hospitals if this type of information was available in the future
(2005). 151
• Patients and physicians in Germany were asked to rank indicators currently included in a
nationally mandated public report on hospitals as well and measures common in other
hospital reports. The two groups agreed on the top 10, though the exact order differed.
Both groups rated several indicators that reported on hospital structural characteristics
such as ownership as unimportant to their decisions, which suggests they could be
dropped in order to shorten the report (2007). 133
• Patients who had one of six selected procedures at three hospitals in The Netherlands
were asked how they chose the hospital and what information they would use to choose if
they needed similar care in the future. Hospital reputation was the primary reason for the
past choice and previous experience was the most cited source of information for future
choices (25.3 percent), while quality information was rarely cited as important (2008). 129
• Women in South Korea age 20 to 49 were surveyed by phone (n=505; 57.3 percent
completed of 882 eligible after random sampling) to determine if they were aware of the
public reporting of cesarean section rates for Korean hospitals. Two-hundred twenty eight
reported being aware of the report, and younger women and those with higher levels of
education were more likely to know about the report (2008). 131
• Masor et al. showed 59 people a public report on health care acquired infection rates for
hospitals and in interviews discovered that most people were not aware the hospital
acquired infections (HAIs) existed. While the respondents were distressed to learn about
them, they were unlikely to choose a hospital based on this alone (2009). 152
• Based on responses to a mail survey (n=201; 25 percent return rate), Masor et al.
evaluated formats for a public report on HAIs and found reports were generally easy to
understand with the exception of the section that explained risk adjustment and
confidence intervals; however HAI rate was not cited as likely to influence choice of
hospital (2009). 150
• Researchers surveyed a total 381 people including inpatients, recently discharged
patients, and visitors to a hospital in France about the their knowledge about infection
control and whether a report like the French mandatory report on infection control
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