Employers' efforts to measure and improve hospital quality: determinants of success.
We examined eleven communities in which an employer coalition created a report card to compare the performance of the community's hospitals. After interviewing employer coalition and hospital representatives from each community, we found great variability in report cards' capacity to prompt quality improvement. Although some were successful, others had less impact because of conflicts between employer coalitions and hospitals. Areas of disagreement included selection of appropriate goals, methodology of quality measurement, whether report cards should be publicly released, and the use of economic incentives to improve quality. We describe these conflicts and offer recommendations for future hospital report cards.
Mehrotra
Ateev
A
Harvard Combined Medicine/Pediatrics Program, USA.
Bodenheimer
Thomas
T
Dudley
R Adams
RA
D001291:Attitude of Health Personnel; D019985:Benchmarking; D019992:Databases as Topic; D030881:Disclosure; D006265:Health Care Coalitions; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D014481:United States