title: Reductions in mortality associated with intensive public reporting of hospital outcomes.
abstract: 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.
authors.affiliation: Departments of Surgery and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA. chollenbeak@psu.edu
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Gorton
authors.forename: Ying P
authors.initials: YP
authors.lastname: Tabak
authors.forename: Jayne L
authors.initials: JL
authors.lastname: Jones
authors.forename: Arnold
authors.initials: A
authors.lastname: Milstein
authors.forename: Richard S
authors.initials: RS
authors.lastname: Johannes
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data*; D030881:Disclosure; D006333:Heart Failure / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010414:Pennsylvania; D011014:Pneumonia / Q000401:mortality; D018805:Sepsis / Q000401:mortality; D020521:Stroke / Q000401:mortality