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公众报告是否会影响质量、患者和提供者的看法、市场份额和差异?综述。

Does public reporting influence quality, patient and provider's perspective, market share and disparities? A review.

机构信息

Department of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.

National Institute of Health, Rome, Italy.

出版信息

Eur J Public Health. 2017 Dec 1;27(6):972-978. doi: 10.1093/eurpub/ckx145.

DOI:10.1093/eurpub/ckx145
PMID:29186463
Abstract

BACKGROUND

Public reporting (PR) of healthcare (HC) provider's quality was proposed as a public health instrument for providing transparency and accountability in HC. Our aim was to assess the impact of PR on five main domains: quality improvement; patient choice, service utilization and market share; provider's perspective; patient experience; and unintended consequences.

METHODS

PubMed, Scopus, ISI WOS, and EconLit databases were searched to identify studies investigating relationships between PR and five main domains, published up to April 1, 2016.

RESULTS

Sixty-two papers published between 1988 and 2015 were included. Nineteen studies investigated quality improvement, 19 studies explored the unintended consequences of PR, 10 explored the effects on market share, 10 on patients' choice, 7 evaluated the provider's perspective, 4 economic outcome, 4 service utilization, 2 purchasers' use of PR and 2 studies explored patient experiences. The effect of PR was diverse throughout the studies-mostly positive on: patient experience (100%), quality improvement (63%), patient choice, service utilization and market share (46%); mixed on provider's perspective and economic outcome (27%) and mainly negative on unintended consequences (68%).

CONCLUSIONS

Our research covering different outcomes and settings reported that PR is associated with changes in HC provider's behavior and can influence market share. Unintended consequences are a concern of PR and should be taken into account when allocating HC resources. The experiences collected in this paper could give a snapshot about the impact of PR on a HC user's perception of the providers' quality of care, helping them to make empowered choices.

摘要

背景

公众报告(PR)的医疗保健(HC)提供者的质量被提出作为一个公共卫生工具,在 HC 中提供透明度和问责制。我们的目的是评估 PR 对五个主要领域的影响:质量改进;患者选择、服务利用和市场份额;提供者的观点;患者体验;和意外后果。

方法

我们在 PubMed、Scopus、ISI WOS 和 EconLit 数据库中搜索了截至 2016 年 4 月 1 日调查 PR 与五个主要领域之间关系的研究。

结果

共纳入 1988 年至 2015 年期间发表的 62 篇论文。19 项研究调查了质量改进,19 项研究探讨了 PR 的意外后果,10 项研究探讨了对市场份额的影响,10 项研究探讨了对患者选择的影响,7 项研究评估了提供者的观点,4 项研究探讨了经济结果,4 项研究探讨了服务利用,2 项研究探讨了购买者对 PR 的使用,2 项研究探讨了患者体验。PR 的影响在研究中各不相同——大多数对患者体验(100%)、质量改进(63%)、患者选择、服务利用和市场份额(46%)有积极影响;对提供者观点和经济结果(27%)的影响混合,对意外后果(68%)的影响主要为负面。

结论

我们的研究涵盖了不同的结果和环境,报告称 PR 与 HC 提供者行为的变化有关,并可能影响市场份额。意外后果是 PR 的一个关注点,在分配 HC 资源时应予以考虑。本文收集的经验可以提供 PR 对 HC 用户对提供者护理质量的看法的影响的快照,帮助他们做出有影响力的选择。

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