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Public Report Cards: What providers want consumers to know
Sandra Leggat
March 2002
Presentation Outline
• Public Report Cards: what providers are telling consumers
• Public Report Cards: what consumers want to know
Who provides public report cards?
“Various organisations
produce report cards,
with diverse motivations
& little communication
or collaboration among
them” (Marshall et al
2000)
• Governments
• Non-government
coalitions
• Media
• Health plans, health
services & hospitals
California Hospital Outcomes Project (CHOP)
Legislative mandate
requiring State office
to study & report on
risk-adjusted
measures of patient
outcomes in California
hospitals
• AMI mortality
• ICU mortality
• Hip fracture mortality
• Maternal outcomes
following delivery
• Pneumonia mortality
New York State Cardiac Surgery Reporting System
Ontario Hospital Reports
• To help people in Ontario
understand the performance
of their hospital system
• Includes hospital specific
data for 95 hospital
corporations
• Condensed version of the
2001 report published in
newspapers
Ontario Hospital Balanced Scorecard
Patient SatisfactionWhat patients say about their hospital stay: overall quality, clinical & support service quality
Patient CareHow patients fare during & after hospitalisation: access to technology, length of stay, complications
Hospital FinancesWhat resources hospitals have & how they are used: financial position, equipment spend, staff time on patient care
Keeping Pace with ChangeWhether hospitals partner with community: partnerships, IT, coordination of care
ORYX
• JCAHO link between accreditation & outcomes of
patient care
• Participating organisations select 6 measures from
listed performance measures
• Core measures for hospitals – MI, heart failure,
community acquired pneumonia, pregnancy
US News – Best Hospitals 2001
London Health Sciences Centre, Canada
London Health Sciences Centre, Canada
London Health Sciences Centre, Canada
London Health Sciences Centre, Canada
Presentation Outline
• Public Report Cards: what providers are telling consumers
• Public Report Cards: what consumers want to know
Information requested by focus groups
• Equipment technology
• Hospital specialisation
• Nurse/doctor to patient
ratios
• Average waiting times
• Success/mortality rates
• Reputation/quality of
care
• Hospital facilities
• Number of beds
• Cleanliness/sanitation
• Doctor/nurse
qualifications
Information requested by individuals
• Equipment technology
• Hospital specialisation
• Average waiting times
• Nurse/doctor to patient
ratios
• Availability of support
services
• Success/mortality rates
• Doctor/nurse
qualifications
• Reputation/quality of
care
• Research conducted
• Financial information
Summary of type of information
Descriptive:
information about
services, specialties
and the health system
Evaluative:
information to help
chose the ‘best’
hospital for different
things, but was not
always sure what this
information should be
• Existing report cards were unable to reliably detect
true practice differences in the management of
diabetes among doctors at the medical practices
studied (Greenfield & Kaplan 1999)
• Hospital mortality rate is extremely inaccurate &
publication does more to misinform (Thomas & Hofer 1998,
1999)
Efforts to aid patient decision making with performance reports are unlikely to succeed without a tailored and intensive program for dissemination and patient education (Schneider & Epstein 1998)
