Sunday, April 10, 2011

Likely outcomes of public HAI reporting

As mandatory healthcare-associated infection (HAI) reporting takes hold, and as NHSN data becomes available publicly on CMS Hospital Compare, what are the likely outcomes?

Will healthcare consumers become more savvy?

Let’s take a look at existing international reporting systems as analogues. University of Exeter performed a study in 2000 on seven health reporting systems. The study found that consumers and purchasers rarely sought out publicly available information, and did not understand the data when it was found. AHRQ similarly makes the case that public reporting does not affect consumer behavior. ARHQ’s Talking Quality web site states: 1) that information is not used, 2) quality data can be misleading, and 3) quality data can be difficult to understand.

Will infection rates decrease?

While public reporting may not affect consumer behavior, it still holds the potential to positively affect health outcomes and quality improvement. The same University of Exeter study found that hospitals tended to be the most responsive to publicly reported data with some correlation between public performance data and quality of care improvement. Another 2008 study published in the Annals of Internal Medicine similarly states that “publicly releasing performance data stimulates improvement activity at the hospital level.”

Let’s hope this holds true for the latest iteration of public reporting in the US. Perhaps self-scrutiny (rather than consumer pressure) will be part of the solution.

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