Featured Research

from universities, journals, and other organizations

Hospital report cards do not appear to result in significant improvements

Date:
November 27, 2009
Source:
JAMA and Archives Journals
Summary:
An analysis of quality of cardiac care following the public release of data on measures of care at hospitals in Ontario, Canada, did not result in significant system-wide improvement in hospitals' performance on most quality of care indicators, according to a new study.

An analysis of quality of cardiac care following the public release of data on measures of care at hospitals in Ontario, Canada, did not result in significant systemwide improvement in hospitals' performance on most quality of care indicators, according to a new study.

"Public release of hospital performance data is increasingly being mandated by policy makers with the goal of improving the quality of care. Advocates of report cards believe that publicly releasing performance data on hospitals will stimulate hospitals and clinicians to engage in quality improvement activities and increase the accountability and transparency of the health care system. Critics argue that publicly released report cards may contain data that are misleading or inaccurate and may unfairly harm the reputations of hospitals and clinicians," the authors write. "Although there has been considerable debate, few empirical data exist to determine whether publicly released report cards on hospital performance improve the overall quality of care provided."

Jack V. Tu, M.D., Ph.D., of the Institute for Clinical Evaluative Sciences, Toronto, and colleagues conducted the Enhanced Feedback for Effective Cardiac Treatment (EFFECT) trial to determine whether publicly released report card data could improve the quality of cardiac care delivered. The study included 86 hospitals in Ontario, Canada, with patients admitted for acute myocardial infarction (AMI; heart attack) or congestive heart failure (CHF). The researchers chose to focus on hospitals that treat patients with these conditions because of considerable evidence of a large gap between actual and ideal practice patterns. Participating hospitals were randomized to early (January 2004) or delayed (September 2005) feedback of a public report card on their performance at the beginning of the study (between April 1999 and March 2001) on a set of 12 process-of-care indicators for AMI and 6 for CHF. Follow-up performance data (between April 2004 and March 2005) also were collected.

The researchers found that after the public release of the results for the early feedback group the composite AMI process-of-care indicator did not improve significantly in the early feedback group compared with the delayed feedback group (absolute change, 1.5 percent). They note that only the percentage of patients receiving fibrinolytic therapy prior to transfer to a coronary care or intensive care unit improved significantly more in the early feedback group.

There was also no significant improvement in the composite CHF process-of-care indicator (absolute change, 0.6 percent) in the early feedback group after the public release of the report card. "The absolute rate of angiotensin-converting enzyme (ACE) inhibitor and angiotensin II receptor blocker use in patients with left ventricular dysfunction increased by 5.9 percent, but this was the only indicator that improved significantly more in the early feedback group," the authors write.

They add that during the follow-up period, the average 30-day AMI mortality rates were 2.5 percent lower in the early feedback group compared with the delayed feedback group. The hospital mortality rates for CHF were not significantly different.

"The process-of-care findings suggest that public release of hospital-specific performance data may not be a particularly effective systemwide intervention for measurably improving processes of care for either AMI or CHF," the researchers write. "… the EFFECT study data likely stimulated some important local, hospital-specific changes in delivery of care that may have contributed to the better outcomes observed at the early feedback hospitals. Policy makers and clinicians may wish to consider the findings from the EFFECT study in the design and evaluation of future public reporting initiatives. Greater attention to developing common strategies across hospitals for addressing report card results might enhance the systemwide effectiveness of future report cards."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jack V. Tu, MD, PhD; Linda R. Donovan, BScN, MBA; Douglas S. Lee, MD, PhD; Julie T. Wang, MSc; Peter C. Austin, PhD; David A. Alter, MD, PhD; Dennis T. Ko, MD, MSc. Effectiveness of Public Report Cards for Improving the Quality of Cardiac Care The EFFECT Study: A Randomized Trial. JAMA, 2009;302(21) DOI: 10.1001/jama.2009.1731

Cite This Page:

JAMA and Archives Journals. "Hospital report cards do not appear to result in significant improvements." ScienceDaily. ScienceDaily, 27 November 2009. <www.sciencedaily.com/releases/2009/11/091118110656.htm>.
JAMA and Archives Journals. (2009, November 27). Hospital report cards do not appear to result in significant improvements. ScienceDaily. Retrieved September 30, 2014 from www.sciencedaily.com/releases/2009/11/091118110656.htm
JAMA and Archives Journals. "Hospital report cards do not appear to result in significant improvements." ScienceDaily. www.sciencedaily.com/releases/2009/11/091118110656.htm (accessed September 30, 2014).

Share This



More Health & Medicine News

Tuesday, September 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How 'Yes Means Yes' Defines Sexual Assault

How 'Yes Means Yes' Defines Sexual Assault

Newsy (Sep. 29, 2014) Aimed at reducing sexual assaults on college campuses, California has adopted a new law changing the standard of consent for sexual activity. Video provided by Newsy
Powered by NewsLook.com
Scientists May Have Found An Early Sign Of Pancreatic Cancer

Scientists May Have Found An Early Sign Of Pancreatic Cancer

Newsy (Sep. 29, 2014) Researchers looked at 1,500 blood samples and determined people who developed pancreatic cancer had more branched chain amino acids. Video provided by Newsy
Powered by NewsLook.com
Colo. Doctors See Cluster of Enterovirus Cases

Colo. Doctors See Cluster of Enterovirus Cases

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com
Dr.'s Unsure of Cause of Fast-Spreading Virus

Dr.'s Unsure of Cause of Fast-Spreading Virus

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins