Impact of public reporting on quality of postacute care.
OBJECTIVE
Evidence supporting the use of public reporting of quality information to improve health care quality is mixed. While public reporting may improve reported quality, its effect on quality of care more broadly is uncertain. This study tests whether public reporting in the setting of nursing homes resulted in improvement of reported and broader but unreported quality of postacute care.


METHODS
1999-2005 nursing home Minimum Data Set and inpatient Medicare claims.


METHODS
We examined changes in postacute care quality in U.S. nursing homes in response to the initiation of public reporting on the Centers for Medicare and Medicaid Services website, Nursing Home Compare. We used small nursing homes that were not subject to public reporting as a contemporaneous control and also controlled for patient selection into nursing homes. Postacute care quality was measured using three publicly reported clinical quality measures and 30-day potentially preventable rehospitalization rates, an unreported measure of quality.


RESULTS
Reported quality of postacute care improved after the initiation of public reporting for two of the three reported quality measures used in Nursing Home Compare. However, rates of potentially preventable rehospitalization did not significantly improve and, in some cases, worsened.


CONCLUSIONS
Public reporting of nursing home quality was associated with an improvement in most postacute care performance measures but not in the broader measure of rehospitalization.
Werner
Rachel M
RM
Center for Health Equity Research and Promotion, Philadelphia VAMC, the Division of General Internal Medicine, University of Pennsylvania School of Medicine, PA, USA. rwerner@mail.med.upenn.edu
Konetzka
R Tamara
RT
Stuart
Elizabeth A
EA
Norton
Edward C
EC
Polsky
Daniel
D
Park
Jeongyoung
J
D022126:Access to Information; D014487:Centers for Medicare and Medicaid Services, U.S.; D030881:Disclosure; D019538:Health Care Surveys; D006801:Humans; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000379:methods*; D012866:Skilled Nursing Facilities / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States