Publicly Reported Quality-Of-Care Measures Influenced Wisconsin Physician Groups To Improve Performance

Lamb, Geoffrey C.; Smith, Maureen A.; Weeks, William B.; Queram, Christopher

doi:10.1377/hlthaff.2012.1275

Cited by 43 publications

(25 citation statements)

References 14 publications

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“…Previous collaboratives like MSQC have demonstrated quality improvement through public reporting. 22 When the Alliance Group of Madison, Wisconsin publically released hospital quality rankings for hip and knee surgery, cardiac care and obstetrics, significant improvements in quality were seen in those hospitals included in the report. 23 Despite this, market share was unaffected by the move and there was no significant change in volume across hospitals.…”

Section: Discussionmentioning

confidence: 99%

Patients' Perspectives of Care and Surgical Outcomes in Michigan

et al. 2014

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Objective To determine the relationship between postoperative morbidity and mortality and patients' perspectives of care. Summary Background Data Priorities in healthcare quality research are shifting to place greater emphasis on patient-centered outcomes. Whether patients' perspectives of care correlate with surgical outcomes remains unclear. Methods Using data from the Michigan Surgical Quality Collaborative clinical registry (2008–2012), we identified 41,833 patients undergoing major elective general or vascular surgery. Our exposure variables were the HCAHPS Total and Base Scores derived from the Hospital Value-Based Purchasing (VBP) Patient Experience of Care Domain. Using multilevel mixed-effects logistic regression models, we adjusted hospitals' rates of morbidity and mortality for patient comorbidities and case mix. We stratified reporting of outcomes by quintiles of hospitals' Total and Base Scores. Results Risk-adjusted morbidity (13.6% to 28.6%) varied widely across hospitals. There were no significant differences in risk-adjusted morbidity rates between hospitals with the lowest versus highest HCAHPS Total Score (24.5% vs. 20.2%, p=0.312). The HCAHPS Base Score, which quantifies sustained achievement or improvement in patients' perspectives of care, was not associated with a reduction in postoperative morbidity over the study period despite an overall decrease of 2.5% for all centers. We observed a similar relationship between HCAHPS Total and Base Scores and postoperative mortality. Conclusions and Relevance Patients' perspectives of care do not correlate with the incidence of morbidity and mortality following major surgery. Improving patients' perspectives and objective outcomes may require separate initiatives for surgeons in Michigan.

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Section: Discussionmentioning

confidence: 99%

Patients' Perspectives of Care and Surgical Outcomes in Michigan

et al. 2014

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“…11 These programs have been designed with the idea that increasing the amount of information available will result in better clinical outcomes. Previous studies have shown that public reporting can improve implementation of quality measures 12 ; however, before this study, there have been no clinical outcome studies that support the efficacy of a public reporting strategy. In contrast, previous studies have described detrimental effects of public reporting while finding no difference in clinical outcomes.…”

Section: Discussionmentioning

confidence: 83%

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

Cavender

Joynt

Parzynski

et al. 2015

The American Journal of Cardiology

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Public reporting has been proposed as a strategy to improve health care quality. Percutaneous coronary interventions (PCIs) performed in the United States from July 1, 2009, to June 30, 2011, included in the CathPCI Registry were identified (n = 1,340,213). Patient characteristics and predicted and observed in-hospital mortality were compared between patients treated with PCI in states with mandated public reporting (Massachusetts, New York, Pennsylvania) and states without mandated public reporting. Most PCIs occurred in states without mandatory public reporting (88%, n = 1,184,544). Relative to patients treated in nonpublic reporting states, those who underwent PCI in public reporting states had similar predicted in-hospital mortality (1.39% vs 1.37%, p = 0.17) but lower observed in-hospital mortality (1.19% vs 1.41%, adjusted odds ratio [ORadj] 0.80; 95% confidence interval [CI] 0.74, 0.88; p <0.001). In patients for whom outcomes were available at 180 days, the differences in mortality persisted (4.6% vs 5.4%, ORadj 0.85, 95% CI 0.79 to 0.92, p <0.001), whereas there was no difference in myocardial infarction (ORadj 0.97, 95% CI 0.89 to 1.07) or revascularization (ORadj 1.05, 95% CI 0.92 to 1.20). Hospital readmissions were increased at 180 days in patients who underwent PCI in public reporting states (ORadj 1.08, 95% CI 1.03 to 1.12, p = 0.001). In conclusion, patients who underwent PCI in states with mandated public reporting of outcomes had similar predicted risks but significantly lower observed risks of death during hospitalization and in the 6 months after PCI. These findings support considering public reporting as a potential strategy for improving outcomes of patients who underwent PCI although further studies are warranted to delineate the reasons for these differences.

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“…Survey data from physicians indicated that public reporting significantly influences performance improvement [22]. Recent data from the Wisconsin Collaborative for Healthcare Quality showed that public reporting has an impact on quality improvement [23, 24]. …”

Section: Discussionmentioning

confidence: 99%

General practitioners’ perceptions of public reporting of institution and individual medicine prescribing data

Zhang

Tang

2016

BMC Health Serv Res

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BackgroundPublic reporting of institution- and individual-level performance data has recently become a popular topic in the health care field. This study (1) evaluated the perceptions of general practitioners on the public reporting of institutional and individual medicine prescribing data in primary care institutions, and (2) compared the difference among the perceptions of general practitioners on the dimensions of necessity, methodological rigor, and impact of public reporting medicine prescribing data.MethodsWe conducted a survey in 10 primary care institutions in Q city, Hubei province. General practitioners who hold prescribing license were eligible for this study; we surveyed all eligible general practitioners in July 2014. The survey instrument was developed based on previous studies and expert opinions. Paired t-test or nonparametric test was used to evaluate the difference in perceptions between the institutional and individual medicine prescribing data reporting. An analysis of variance test was used to analyze the score differences among the three dimensions (i.e., necessity, methodological rigor, and impact).ResultsA total of 154 general practitioners were surveyed in this study. No significant difference in the perceptions of general practitioners was observed between the institution- and individual-level medicine prescribing data reporting (p > 0.05). General practitioners have significantly different perceptions on the three dimensions of the institution- and individual-level data reporting (p < 0.05). Methodological rigor obtained the lowest score. Regarding the strategies to facilitate the medicine prescribing data reporting, over 80 % of general practitioners selected the items that disclose process measures and not outcome measures, as well as educate patients on data interpretation.ConclusionThe perceptions of general practitioners between institution- and individual-level data reporting have no significant difference. General practitioners place their utmost concern on public reporting on the methodological rigor. Processing measures and patient education to improve the efficiency of public reporting require substantial attention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1893-5) contains supplementary material, which is available to authorized users.

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Publicly Reported Quality-Of-Care Measures Influenced Wisconsin Physician Groups To Improve Performance

Cited by 43 publications

References 14 publications

Patients' Perspectives of Care and Surgical Outcomes in Michigan

Patients' Perspectives of Care and Surgical Outcomes in Michigan

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

General practitioners’ perceptions of public reporting of institution and individual medicine prescribing data

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