Friedberg Mark W, Bilimoria Karl Y, Pronovost Peter J, Shahian David M, Damberg Cheryl L, Zaslavsky Alan M
Rand Health Q. 2016 Jun 20;6(1):4.
In the summer of 2015, ProPublica published its , which displays "Adjusted Complication Rates" for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. In September 2015, RAND released a critique of the authored by a group of health policy researchers from RAND and other institutions, and on October 7, 2015 ProPublica published a rebuttal of our critique. In this follow-on Perspective, we revisit the main points in our initial critique, summarize ProPublica's rebuttal, explain why this rebuttal fails to address our methodological concerns, provide suggestions on how to validate and improve the , and explain why we continue to advise potential users of the , as it is currently constructed, not to consider it a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide.
2015年夏天，ProPublica发布了其报告，该报告展示了医院中针对特定姓名的外科医生所实施的八种外科手术的“调整后并发症发生率”。关于医疗服务提供者表现的公开报告有可能提高患者所接受医疗服务的质量。一份有效的表现报告能够推动质量提升，并为患者选择医疗服务提供者提供有益参考。然而，有效性和可靠性欠佳的表现报告可能会对所有相关方造成损害。2015年9月，兰德公司发布了一份由来自兰德公司及其他机构的一组卫生政策研究人员撰写的对该报告的批评意见，2015年10月7日，ProPublica发布了对我们批评意见的反驳。在这篇后续的观点文章中，我们重新审视我们最初批评意见中的要点，总结ProPublica的反驳内容，解释为何这一反驳未能解决我们在方法上的担忧，就如何验证和改进该报告提供建议，并解释为何我们继续建议该报告目前形式下的潜在用户，不要将其视为任何个体外科医生可能提供的健康结果的有效或可靠预测指标。
