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Scant Data on Usefulness of Public Reporting

Public reporting on health care quality stimulates quality improvement activity at the hospital level, but has little effect on consumer choices

TUESDAY, Jan. 15 (HealthDay News) -- The use of publicly reported performance data to improve quality of health care is supported by little evidence, particularly for individual providers and practices, according to a systematic review published in the Jan. 15 Annals of Internal Medicine.

Constance H. Fung, M.D., formerly of RAND in Santa Monica, Calif., and colleagues analyzed data from 45 articles, 27 of them published since 1999, that evaluated the effect of public reporting on quality of care.

Data from studies at the health-plan level suggest that public reporting has a modest effect on a consumer's selection of plans. Studies at the hospital level suggest that public reporting boosts hospitals' quality improvement activity. Studies at the hospital and individual-provider level show inconsistent effects of public reporting on consumer choice of hospitals and providers. Finally, due to scarcity of research, the effect of public reporting on patient safety and patient-centeredness is unknown.

"We should not interpret the results of Fung and colleagues' systematic review as an indication that we should give up on consumers as important actors in the quality improvement equation and move on to a new paradigm. Rather, they suggest that we should improve the execution of public reporting efforts and only then reevaluate the effect of public reporting on quality," writes Judith H. Hibbard, of the University of Oregon, in an accompanying editorial.

Fung has worked as a consultant for the Society of General Internal Medicine and Health Benchmarks, and has received grants from the California HealthCare Foundation.

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