A Report Card on Provider Report Cards: Current Status of the Health Care Transparency Movement
A Report Card on Provider Report Cards: Current Status of the Health Care Transparency Movement
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DOI：
10.1007/s11606-010-1438-2
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发表时间：
2010-11-01
影响因子：
5.7
通讯作者：
Scanlon, Dennis P.
中科院分区：
文献类型：
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作者：
Christianson, Jon B.;Volmar, Karen M.;Scanlon, Dennis P.
背景：供应商业绩的公开报告可以帮助消费者选择供应商，并刺激供应商提高质量。报告质量措施得到了整个政治领域医疗改革倡导者的支持。目的：通过跨地理区域的比较，评估现有医院和医生质量公共报告的可用性、可信度和适用性。APPROACH：通过审查网站、电话和面谈收集21个地理区域263份公共报告的相关信息，并用于构建公共报告状态的指标。其中14个领域的访谈数据被用来评估报告的最新变化及其影响。伙伴：受访者包括州和地方协会的工作人员、健康计划代表和地方医疗保健联盟的领导人。结果：在研究地区，关于医院绩效的报告(161份)多于关于医生绩效的报告(103份)。更多的报告包括来自索赔数据的衡量标准(平均每个区域7.2份医院报告和3.3份医生报告)，而不是来自医疗记录数据。通常，关于医生表现的报告包含在医疗小组层面构建的慢性病治疗衡量标准，其中糖尿病衡量标准最常见(每个非健康计划报告的平均数字，2.3)。患者体验测量在更多的医院报告(平均报告数，1.2)中可用，而在医生报告中(平均，0.7)。尽管有国家医院报告和由国家健康计划赞助的报告，但从消费者的角度来看，公共报告的状况在很大程度上取决于居住地和健康计划成员。结论：从消费者和提供者的角度来看，当前的公共报告，特别是关于医生护理质量的报告，都有很大的局限性。针对消费者的新信息源的开发，以及消费者和供应商对更新信息的需求，对目前的报告方式提出了挑战。
BACKGROUND: Public reporting of provider performance can assist consumers in their choice of providers and stimulate providers to improve quality. Reporting of quality measures is supported by advocates of health care reform across the political spectrum.OBJECTIVE: To assess the availability, credibility and applicability of existing public reports of hospital and physician quality, with comparisons across geographic areas.APPROACH: Information pertaining to 263 public reports in 21 geographic areas was collected through reviews of websites and telephone and in-person interviews, and used to construct indicators of public reporting status. Interview data collected in 14 of these areas were used to assess recent changes in reporting and their implications.PARTICIPANTS: Interviewees included staff of state and local associations, health plan representatives and leaders of local health care alliances.RESULTS: There were more reports of hospital performance (161) than of physician performance (103) in the study areas. More reports included measures derived from claims data (mean, 7.2 hospital reports and 3.3 physician reports per area) than from medical records data. Typically, reports on physician performance contained measures of chronic illness treatment constructed at the medical group level, with diabetes measures the most common (mean number per non-health plan report, 2.3). Patient experience measures were available in more hospital reports (mean number of reports, 1.2) than physician reports (mean, 0.7). Despite the availability of national hospital reports and reports sponsored by national health plans, from a consumer standpoint the status of public reporting depended greatly on where one lived and health plan membership.CONCLUSIONS: Current public reports, and especially reports of physician quality of care, have significant limitations from both consumer and provider perspectives. The present approach to reporting is being challenged by the development of new information sources for consumers, and consumer and provider demands for more current information.