5. Public Reporting as a Quality Improvement Strategy

Table 3. Summary of evidence: public reporting on hospitals (continued)
Author Year
Key
(QA) Public Report Study Overview
Question Results
Dranove
2008 86
NYS CSRS Assesses the effectiveness of 4 ↑ Public reports have an effect on patient choice of hospital when they
the “news” that public reports
provide information that differs from prior beliefs, but this is not symmetrical
(Good)
provides to the market by
↑ Hospitals with lower than expected rankings experience a statistically
analyzing hospital demand in
significant decrease in demand
18 hospitals in the NYC
↔ Higher ranking hospitals: public reports have no significant effect on
metro area before (1989) and
after public reporting (1990,
1991).
N=23854 CABG patients
from 1989-1991
market share
Elliott
2010 51
HCAHPS Compares changes in
1 ↔ Marginal increase between 2008 and 2009 in percent of positive
patients’ experiences with
responses on survey in 8 of 9 categories. None had decreases but all
(Good)
inpatient care at American
increases were 0.9% or less. Change in doctor communication was not
hospitals since public
reporting of HCAHPS.
significant.
Analyzes hospital scores
↑ Newcomers to public reporting outperformed hospitals originally
based on when they began
participating in HCAHPS in 7 of 9 categories. 2 categories were not
participating in public
significant. More newcomers were smaller hospitals and smaller hospitals
reporting (original vs
newcomers) and how many
beds they have (100 beds). Also looks at
change in hospitals that
reported in both 2008 and
2009.
N changes depending on
group and year. Overall
N=3863 Hospitals
tend to perform better on CAHPS
Evans
1997 111
PHC4: HER Examines responses of PA
1 ↑ Mortality and Morbidity both had statistically significant declines after
hospitals between 1990 and
reporting in trend analyses that controlled for regression to the mean.
(Fair)
1992 to PHC4’s HER by
6 ↑Hospitals that performed poorly at base line improved in mortality
analyzing changes in
↔ Hospitals that performed poorly at base line had no improvement in
mortality, morbidity, length of
morbidity
stay, and charges.
↑Hospitals in competitive markets had more improvement in mortality
N=134 hospitals
↔ Financial position and competition had no impact on morbidity
↓Hospitals in lower financial position had lower levels of improvement in
mortality
57