title: Impact of 'high-profile' public reporting on utilization and quality of maternity care in England: a difference-in-difference analysis.
abstract: OBJECTIVE
  To evaluate the impact of 'high-profile' (with extensive media coverage) public reporting versus public reporting without 'high profile' coverage on utilization and perceived quality of maternity services in England's National Health Service.
  
  
  METHODS
  Analysis of national hospital administrative data using difference-in-difference models with propensity score matching, and of two maternity surveys from 2007 and 2010. Outcomes were counts of women admitted for delivery of a baby and the percentage of women rating their care positively in 2007 and 2010.
  
  
  RESULTS
  Hospitals highly publicized as providing the best maternity care in England had fewer admissions annually and lower occupancy rates than the national comparison group (63.0% vs. 77.3%; p = 0.09). There was no statistically significant change in overall maternity admissions in the best hospitals (+2.2%, p = 0.40 at six months), or the worst hospitals (-2.8%, p = 0.49 at six months) during any period in the 36 months after public reporting relative to their matched comparison groups. Survey analyses found that compared to the national comparison group of hospitals without 'high profile' media coverage, the worst rated hospitals experienced greater improvements in perceived quality after public reporting but these findings were not maintained in the analysis of matched hospitals.
  
  
  CONCLUSIONS
  'High-profile' public reporting of maternity care in England was not associated with changes in the use of maternity services or improvements in patient-reported quality. These findings provide further evidence that public reporting is unlikely to drive major improvements in health system performance through the mechanism of patient choice.
authors.affiliation: Research Fellow, Department of Primary Care & Public Health, Imperial College London, London, UK a.laverty@imperial.ac.uk.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Laverty
authors.affiliation: Senior Lecturer, Health Service Research & Management Division, School of Health Sciences, City University London, London, UK.
authors.forename: Mauro
authors.initials: M
authors.lastname: Laudicella
authors.affiliation: Professor of Health Policy, Centre for Health Policy, Imperial College Business School, London, UK.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Smith
authors.affiliation: NIHR Professor of Public Health, Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
mesh_terms: D002755:Choice Behavior; D016208:Databases, Factual; D004739:England; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D008402:Mass Media; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D011247:Pregnancy; D011787:Quality of Health Care; D013222:State Medicine
keywords: health policy; patient choice; public reporting