Choosing The Best Hospital: The Limitations Of Public Quality Reporting

Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA.
Health Affairs (Impact Factor: 4.97). 11/2008; 27(6):1680-7. DOI: 10.1377/hlthaff.27.6.1680
Source: PubMed


The call for accountability in health care quality has fueled the development of consumer-oriented Web sites that provide hospital ratings. Taking the consumer perspective, we compared five Web sites to assess the level of agreement in their rankings of local hospitals for four diagnoses. The sites assessed different measures of structure, process, and outcomes and did not use consistent patient definitions or reporting periods. Consequently, they failed to agree on hospital rankings within any diagnosis, even when using the same metric (such as mortality). In their current state, rating services appear likely to confuse, rather than inform, consumers.

    • "; 2) Schaefer and Schwarz (2010); 3) Emmert and Meier (2013); 4) Emmert et al. (2013a); 5) Reimann and Strech (2010); 6) Rothberg et al. (2008) "
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    ABSTRACT: The importance of consumer-driven quality reporting initiatives, such as provider rating websites, is on the rise in many industrialized countries like the USA, the UK and Germany. Therefore, this essay covers the issue of online rating websites of healthcare providers as internet-based social networking platforms that facilitate peer-to-peer information exchange and subjective patient experience assessments. Since research on these information tools is in its infancy, this essay uses an explorative approach to outline the five most common views on provider rating websites that appear in the scholarly and public debate. Based on an in-depth literature review of the international evidence, the essay reveals that provider rating websites prove to become a major performance indicator for healthcare managers and a useful tool for individual decision-making in provider choice. Besides a thorough reflection on the most common public misconceptions, the value of this essay lies in the provision of significant recommendations for all stakeholders for the future enhancement of provider rating websites.
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    • "Accountability of caregivers and health authorities to the community is internationally considered of paramount importance [28]. In spite of known limitations, public reporting of comparative information about the quality of health care, often derived from administrative data, is frequently put forward as an important quality improvement tool, which attempts to stimulate caregivers to grade up the provision of services and to reassure patients by demonstrating accountability [29-31]. In this context, ensuring data quality is a continuous challenge especially if the same data are used for reimbursement and for measuring quality [31,32]. "
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    Full-text · Article · Dec 2010 · BMC Health Services Research
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    ABSTRACT: Research-oriented cancer hospitals in the United States treat and study patients with a range of diseases. Measures of disease specific research productivity, and comparison to overall productivity, are currently lacking. Different institutions are specialized in research of particular diseases. To report disease specific productivity of American cancer hospitals, and propose a summary measure. We conducted a retrospective observational survey of the 50 highest ranked cancer hospitals in the 2013 US News and World Report rankings. We performed an automated search of PubMed and for published reports and registrations of clinical trials (respectively) addressing specific cancers between 2008 and 2013. We calculated the summed impact factor for the publications. We generated a summary measure of productivity based on the number of Phase II clinical trials registered and the impact factor of Phase II clinical trials published for each institution and disease pair. We generated rankings based on this summary measure. We identified 6076 registered trials and 6516 published trials with a combined impact factor of 44280.4, involving 32 different diseases over the 50 institutions. Using a summary measure based on registered and published clinical trails, we ranked institutions in specific diseases. As expected, different institutions were highly ranked in disease-specific productivity for different diseases. 43 institutions appeared in the top 10 ranks for at least 1 disease (vs 10 in the overall list), while 6 different institutions were ranked number 1 in at least 1 disease (vs 1 in the overall list). Research productivity varies considerably among the sample. Overall cancer productivity conceals great variation between diseases. Disease specific rankings identify sites of high academic productivity, which may be of interest to physicians, patients and researchers.
    Full-text · Article · Mar 2015 · PLoS ONE
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