Outcome Transparency and its Effects on Quality of Care in Hospitals

点击翻译按钮获取中文摘要

Background Due to high information asymmetries between patients and physicians, patients often have only limited chance to assess the process of care and its success prospects in advance. During the past decade, a growing body of research demonstrated a high variation of quality of care among care providers. This indicates the need for measurement and publication of quality of care results in order to enhance quality transparency and to imbed quality as target variable in health systems. At the same time, however, outcome measurement is characterized by methodological challenges and tremendous resource necessities. The knowledge on the relationship between quality transparency and quality improvement is fragmented, outdated and in the German context rudimentary.AimsThe research project addresses the identified shortcomings in the literature, enlarges the academic basis for public policy and identifies concrete policy measures to enhance quality transparency in Germany and beyond. To meet the requirements of this diverse topic area, the research agenda consists of six separate subprojects: 1. Quality variation in Germany (analysis of hospital quality differences and associated key hospital characteristics); 2. Quality certificates and their influence on quality (analysis of the impact of global KTQ vs. specific DSG certificates); 3. User behavior on the Weisse Liste.de benchmarking portal (analysis of user patterns, click chains, user barriers, and exits);4. Hospital efficiency and quality (analysis of technical efficiency determinants in hospitals pursuit of optimal quality of care); 5. Transparency and quality of care (the effect of quality data publication on the quality of care in hospitals); and 6. Patient guidance/control through hospital rankings (analysis of Focus Klinikliste ranking correlation with PEQ patient experience and outcomes, as well as influence of rankings on patient flows) Methods Basis and prerequisite for the project is an already constructed and in variable and time coverage unique database (2006 to 2014). This database already includes the required data for each subproject and allows a comprehensive empirical analysis of the influencers of quality of care improvement. For the subprojects, different statistical and econometrical techniques are planned and include descriptive analysis; FixedEffect, panel regressions; data mining; and stochastic frontier efficiency estimations. Outlook Based on the multidimensional analysis of quality transparency, this project contributes key elements to the quality measurement, quality reporting, and quality reimbursement strategies in Germany and beyond. The results are particularly relevant for questions for optimal resource utilization in quality measurement.