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Reductions in Mortality Associated With Intensive Public Reporting of Hospital Outcomes

Departments of Surgery and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, chollenbeak{at}psu.edu

Christopher P. Gorton, MD, MHSA

APS Healthcare, Inc.

Ying P. Tabak, PhD

Cardinal Health, Marlborough, Massachusetts

Jayne L. Jones, MPH

Pennsylvania Health Care Cost Containment Council, Harrisburg, Pennsylvania

Arnold Milstein, MD, MPH

Pacific Business Group on Health, San Francisco, California

Richard S. Johannes, MD, MS

Cardinal Health

It is unclear whether public reporting of hospital and physician performance has improved outcomes for the conditions being reported. We studied the effect of intensive public reporting on hospital mortality for 6 high-frequency, high-mortality medical conditions. Patients in Pennsylvania were matched to patients in other states with varying public reporting environments using propensity score methods. The effect of public reporting was estimated using a difference in differences approach. Patients treated at hospitals subjected to intensive public reporting had significantly lower odds of in-hospital mortality when compared with similar patients treated at hospitals in environments with no public reporting or only limited reporting. Overall, the 2000-2003 in-hospital mortality odds ratio for Pennsylvania patients versus non-Pennsylvania patients ranged from 0.59 to 0.79 across 6 clinical conditions (all P < .0001). For the same comparison using the 1997-1999 period, odds ratios ranged from 0.72 to 0.90, suggesting improvement when intensive public reporting occurred. (Am J Med Qual 2008;23:279-286)

Key Words: public reporting • databases • hospital mortality • outcome assessment

American Journal of Medical Quality, Vol. 23, No. 4, 279-286 (2008)
DOI: 10.1177/1062860608318451


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