Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations

Ketelaar, Nicole A. B. M., Faber, Marjan J., Flottorp, Signe, Rygh, Liv Helen, Deane, Katherine H. O. ORCID: https://orcid.org/0000-0002-0805-2708 and Eccles, Martin P. (2011) Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations. Cochrane Database of Systematic Reviews (11:CD004538). ISSN 1465-1858

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Abstract

BACKGROUND: It is becoming increasingly common to release information about the performance of hospitals, health professionals or providers, and healthcare organisations into the public domain. However, we do not know how this information is used and to what extent such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers and purchasers, or to what extent the performance of professionals and providers can be affected. OBJECTIVES: To determine the effectiveness of the public release of performance data in changing the behaviour of healthcare consumers, professionals and organisations. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, MEDLINE Ovid (from 1966), EMBASE Ovid (from 1979), CINAHL, PsycINFO Ovid (from 1806) and DARE up to 2011. SELECTION CRITERIA: We searched for randomised or quasi-randomised trials, interrupted time series and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or individuals. The papers had to report at least one main outcome related to selecting or changing care. Other outcome measures were awareness, attitude, views and knowledge of performance data and costs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers and healthcare purchasers), performance data, main outcomes (choice of healthcare provider and improvement by means of changes in care) and other outcomes (awareness, attitude, views, knowledge of performance data and costs). MAIN RESULTS: We included four studies containing more than 35,000 consumers, and 1560 hospitals. Three studies were conducted in the USA and examined consumer behaviour after the public release of performance data. Two studies found no effect of Consumer Assessment of Healthcare Providers and Systems information on health plan choice in a Medicaid population. One interrupted time series study found a small positive effect of the publishing of data on patient volumes for coronary bypass surgery and low-complication outliers for lumbar discectomy, but these effects did not persist longer than two months after each public release. No effects on patient volumes for acute myocardial infarction were found.One cluster-randomised controlled trial, conducted in Canada, studied improvement changes in care after the public release of performance data for patients with acute myocardial infarction and congestive heart failure. No effects for the composite process-of-care indicators for either condition were found, but there were some improvements in the individual process-of-care indicators. There was an effect on the mortality rates for acute myocardial infarction. More quality improvement activities were initiated in response to the publicly-released report cards. No secondary outcomes were reported. AUTHORS' CONCLUSIONS: The small body of evidence available provides no consistent evidence that the public release of performance data changes consumer behaviour or improves care. Evidence that the public release of performance data may have an impact on the behaviour of healthcare professionals or organisations is lacking.

Item Type: Article
Uncontrolled Keywords: sdg 12 - responsible consumption and production ,/dk/atira/pure/sustainabledevelopmentgoals/responsible_consumption_and_production
Faculty \ School: Faculty of Medicine and Health Sciences > School of Nursing and Midwifery (former - to 2011)
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health in Later Life (former - to 2017)
Faculty of Medicine and Health Sciences > Research Groups > Community and Family Health (former - to 2017)
Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Depositing User: Rhiannon Harvey
Date Deposited: 15 Feb 2012 11:58
Last Modified: 19 Oct 2023 00:28
URI: https://ueaeprints.uea.ac.uk/id/eprint/37128
DOI: 10.1002/14651858.CD004538.pub2

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