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Hospital report cards may not generate quality improvement

It's a common assumption among health planners--nay, an article of faith--that publishing hospital report cards can prompt lagging facilities to improve their quality of care. However, a new study suggests that at minimum, report cards alone aren't enough to spur significant changes.

A new Canadian study concluded that heart patients received the same quality of care from hospitals in the province of Ontario before and after quality report cards were released. These findings were published this week in the online version of the Journal of the American Medical Association.

To conduct their study, researchers looked at medical records from 85 hospitals based in Ontario that admitted patients suffering from heart failure or heart attacks. After examining the process of care, they concluded that in general, the hospitals had not shown improvement since the release of the report cards.

Folks, this finding isn't particularly surprising. After all, making big process changes takes time, money and management commitment, and getting all three in place can be tough to swing. If patients start quoting report cards in detail, it may motivate hospital leaders to take them more seriously, but in the mean time, hospitals are likely to set their own priorities rather than address report card issues.

To get more context on the study:
- read this HealthDay News item

Related Articles:
Patient advocates fight for MRSA screenings, report cards
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As stated in the article, the findings of this study are not surprising. The current US healthcare "system" operates according to capitalist principles; discussions in hospital board rooms are (yes, there are exceptions), primarily about finances and profitability. Public reporting, transparency, etc are unlikely to have much effect in such a system until INCENTIVES are aligned to reward quality and safety: significant financial pain for bad quality, significant financial rewards for good quality.

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