Outcome Transparency and its Effects on Quality of Care in Hospitals

由于患者和医生之间的高度信息不对称，患者通常只有有限的机会来评估护理过程及其成功前景。在过去的十年中，越来越多的研究表明，护理提供者之间的护理质量差异很大。这表明需要衡量和公布护理质量结果，以提高质量透明度，并将质量作为目标变量纳入卫生系统。然而，与此同时，成果计量的特点是方法上的挑战和巨大的资源需求。质量透明度和质量改进之间的关系的知识是零散的，过时的，在德国的情况下，ruminical.AimsThe研究项目解决了文献中发现的缺点，扩大了公共政策的学术基础，并确定具体的政策措施，以提高质量透明度在德国和超越。为了满足这一不同主题领域的要求，研究议程包括六个独立的子项目：1。德国的质量差异（分析医院质量差异和相关的关键医院特征）; 2.质量证书及其对质量的影响（分析全球KTQ与特定DSG证书的影响）; 3. Weisse Liste.de基准门户网站上的用户行为（分析用户模式、点击链、用户障碍和退出）;4.医院效率和质量（分析医院追求最佳护理质量的技术效率决定因素）; 5。透明度和护理质量（质量数据公布对医院护理质量的影响）;以及6。通过医院排名进行患者指导/控制（分析Focus Klinikliste排名与PEQ患者经验和结局的相关性，以及排名对患者流量的影响）方法该项目的基础和前提是已经构建的可变和时间覆盖范围独特的数据库（2006年至2014年）。该数据库已包含每个子项目所需的数据，并允许对护理质量改善的影响因素进行全面的实证分析。对于次级项目，计划采用不同的统计和计量经济学技术，包括描述性分析;固定效应、面板回归;数据挖掘;以及随机前沿效率估计。展望基于对质量透明度的多维分析，该项目为德国及其他国家的质量测量、质量报告和质量补偿战略提供了关键要素。结果是特别相关的质量测量的最佳资源利用的问题。

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 The knowledge on the relationship between quality transparency and quality improvement is fragmented, outdated and in the German context rudimentary.AimsThe research project addresses the identified shortcomings in the literature, enlarges the academic basis for public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.