Public quality reporting does not affect mortality

Contrary to its intent, public reporting of hospital quality through the Centers for Medicare & Medicaid Services' Hospital Compare website has little or no effect on mortality rates, according to a study in Health Affairs.

The study calls into question the basis for public quality data, that is, Medicare's seven-year project aimed at collecting and publicizing performance data. Although Hospital Compare includes data on heart attack, heart failure, pneumonia, children's asthma and surgical outcomes, according to the website, researchers from Weill Cornell Medical College looked at Medical claims data from 2000 to 2008 for three measures: heart attack, heart failure and pneumonia.

They found that hospitals had no reductions in mortality "beyond existing trends" for heart attack and pneumonia and only modest reduction in heart failure deaths, according to the study abstract. Researchers suggested they couldn't say for sure if the modest improvements were due to clinical innovation over the seven years since Hospital Compare began or if it was, in fact, the effects of public reporting.

"The jury's still out on Medicare's effort to improve hospital quality of care by posting death rates and other metrics on a public website," lead author Andrew M. Ryan, assistant professor of public health at New York City's Weill Cornell Medical College, said in a Health Affairs blog post. "Additional studies must prove that public reporting does in fact push hospitals to raise the quality of care standard," he said.

Patient safety advocates have long championed transparency for public reporting as the gateway for quality care, but the study may contradict their arguments, concluding "that Medicare's public reporting initiative for hospitals has had a minimal impact on patient mortality."

For more information:
- read the Health Affairs blog post
- see the Health Affairs study abstract
- check out the Hospital Compare overview
- read the Advisory Board summary brief

Related Articles:
Study: Healthcare-acquired infections down but still a problem
Confused hospitals underreport infections
Public mortality rates identify extreme performers
State hospital reporting to become obsolete?
Reporting quality measurement works: Collaborative care improved

[Updated 3/6/12: The headline included an error in the headline. This article has been updated to include the correct spelling.]

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