Quality Improvement and Patient Safety Pathway, Medical College of Wisconsin, Milwaukee, USA.
Health Aff (Millwood). 2013 Mar;32(3):536-43. doi: 10.1377/hlthaff.2012.1275.
Public reporting of how physicians and hospitals perform on certain quality of care measures is increasingly common, but little is known about whether such disclosures have an impact on the quality of care delivered to patients. We analyzed fourteen publicly reported quality of ambulatory care measures from 2004 to 2009 for the Wisconsin Collaborative for Healthcare Quality, a voluntary consortium of physician groups. We also fielded a survey of the collaborative's members and analyzed Medicare billing data to independently compare members' performance to that of providers in the rest of Wisconsin, neighboring states, and the rest of the United States. We found that physician groups in the collaborative improved their performance during the study period on many measures, such as cholesterol control and breast cancer screening. Physician groups reported on the survey that publicly reported performance data motivated them to act on some, but not all, of the quality measures. Our study suggests that large group practices will engage in quality improvement efforts in response to public reporting, especially when comparative performance is displayed, as it was in this case on the collaborative's website.
公共报告医生和医院在某些医疗质量措施上的表现越来越常见，但对于这些披露是否会对患者的医疗质量产生影响知之甚少。我们分析了 2004 年至 2009 年期间威斯康星州医疗质量合作组织（一个由医生团体组成的自愿联盟）的 14 项公开报告的门诊护理质量措施。我们还对该合作组织的成员进行了调查，并分析了医疗保险计费数据，以便将成员的表现与威斯康星州其他地区、邻近州和美国其他地区的提供者进行独立比较。我们发现，在研究期间，合作组织中的医生团体在许多措施上提高了他们的表现，如胆固醇控制和乳腺癌筛查。医生团体在调查中报告说，公开报告的绩效数据激励他们对一些（但不是所有）质量措施采取行动。我们的研究表明，大型团体实践将根据公共报告进行质量改进，特别是当显示比较绩效时，就像在这种情况下在合作组织的网站上显示的那样。
