by Jared Reed  

Hospital report cards are often touted by policy makers as a method to deliver improved care through public transparency - but patients might not be any better off in the end, Canadian researchers say.  

An analysis of cardiac care following the public release of data from 86 Canadian hospitals found there was no significant system-wide improvement in hospital performance, according to the JAMA study (2009; 302: 21).  

Participating hospitals were randomised to early (January 2004) or delayed (September 2005) feedback of a public report card on their baseline performance from 2001, on care process indicators for acute myocardial infarction and congestive heart failure. Follow-up performance data was also collected.  

During the follow-up, there was a slightly lower rate of 30-day mortality for AMI patients in the early feedback group. However there was no significant difference on process measures in either group, or in mortality rates for CHF.  

Based on their results, hospitals in the early feedback group did implement some quality-improvement measures. Unexpectedly, hospitals receiving delayed feedback used media coverage and public reports from the early feedback group to execute new initiatives before receiving their own results.  

But overall, a significant difference in system-wide performance across the hospitals could not be seen, say the researchers.  

“The process of care findings suggest that public release of hospital-specific performance data may not be a particularly effective system-wide intervention for measurably improving processes of care for either AMI or CHF,” the authors write.  

“Policymakers and clinicians may wish to consider the findings from the study in the design and evaluation of future public reporting initiatives.”