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
Foreman
1995 82
Hospital
Uses two of PHC4’s public
4 ↔ Identification of high and low quality hospitals in PA public reports did
Effective-ness reports (HER and CABG
not lead to any significant change in patient growth in any of the 9 regions
(Poor)
Report (HER) Consumer Guide) to examine
whether PA hospitals that
studied.
Consumer received high or low quality
Guide to ratings in the first year of fully
Coronary Artery released data (1989 or 1990)
Bypass Graft experienced subsequent
Surgery (CABG changes in patient
Guide)
admissions.
N=156 Hospitals
Friedberg
2009 67
One of 10 Examines whether public
2 ↔ No evidence that public reporting increased anti-biotic use or
Hospital-level reporting is associated with
inappropriate ED diagnosis. Waiting times for patients with and without
(Good)
performance overdiagnosis of pneumonia,
respiratory symptoms increased slightly after public reporting, but expected
measures excessive antibiotic use, or
over prioritization of patients with respiratory symptoms not evident.
reported by the inappropriate prioritization of
Hospital Quality patients with respiratory
Alliance
symptoms visiting EDs in the
U.S. before and after public
reporting (Jan 2004).
Ghali, 1997 39
NYS CSRS and Compares CABG surgery
1 ↔ Adjusted mortality rates for CABG cases in Massachusetts where there
(Fair)
Northern New mortality trends during 1990,
is no public reporting fell from 1990-1994
England 1992 and 1994 in
↔ Massachusetts experienced similar reductions in the percent of in-
Massachusetts where there
hospital mortality as northern New England where an outcomes feedback
is no public reporting to the
program was in place.
decreases in mortality in NY
↑ New York, where public reporting was present, had slightly larger
State and northern New
England where there is public
reporting and outcomes
feedback programs,
respectively.
N=12 hospitals
Massachusetts Isolated
CABG Procedures: 1990
N=5395; 1992 N=5,818; 1994
N=5,915
reductions in unadjusted in-hospital mortality than Massachusetts.
58