Seven years as soon as the government started publicly reporting hospitals' performance on quality measures, evidence shows that this transparency effort has never improved patient outcomes measurably.
The most recent discouraging finding is a survey in the March issue of Health Affairs that analyzes death rates among Medicare patients with cardiac arrest, coronary failure and pneumonia inside the several years before the launch with the government's Hospital Compare website and in these years afterward. Although individual hospitals' compliance with quality metrics for these conditions was reported publicly, the time and effort reduced the chances of a coronary failure patient dying within calendar month by only 3%. Cardiac event and pneumonia patients saw no improvement in death rates, the study concluded.
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Researchers adjusted for differences in patient characteristics and used death rates for nonpublicly reported conditions to isolate the impact of Hospital Compare. Mortality rates already were dropping, and public reporting did little to speed progress.
The learning has come about as officials on the Centers for Medicare & Medicaid Services ponder the way to expand problems Compare web site to include quality data from the January 2013 deadline set with the health system reform law. CMS wants physicians to utilize the public data to enhance their particular care, and then for patients to gravitate toward higher-quality doctors.
""We should temper our expectations as to what programs like public reporting are able to do to push the needle on quality,"" said Andrew Ryan, PhD, the study's lead author.
""Maybe within the margins, if these report cards are designed perfect, they may create a tiny difference. In and also themselves, there're most likely not game-changers.
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