Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Role of IT and informatics
Results of current approaches to quality assessment
Slide content:Effect of Public Reporting of Quality Systematic review finds scant evidence for documented benefit in quality of care (Fung et al., 2008) Combining public reporting with P4P improves performance on measures, whereas reporting alone does not ( Lindenauer et al., 2007) US general internists support financial incentives for quality, although they have concerns about public reporting, especially its impact on incentive to care for sicker or more complex patients ( Casalino et al., 2007) Public report cards in Canada did not improve indicators for MI or heart failure ( Tu et al., 2009) Patients have difficulty understanding; better approach consists of a framework and plain language (Hibbard, Greene, & Daniel, 2010) 15
Slide notes:Does public reporting have any effect on quality measures? A recent systematic review looked at studies addressing this question and found that there was very little evidence of improved quality of care when the performance of a physician or hospital was publicly reported. Another study, however, did show that public reporting, when combined with P4P, improved performance and quality measures compared to public reporting alone. Another study looked at general internists in the United States and assessed their views on approaches to quality; it found that many internists supported financial incentives for quality, but they had concerns for public reporting, especially the impact that it would have on the incentive to care for patients who were sicker or had more complex medical conditions. More recently, studies have shown that public report cards in Canada didnt improve indicators for MI or CHF and that patients have difficulty understanding such report cards, suggesting a better approach might consist of a framework and plain language. 15