Transparency is increasingly viewed as a prerequisite for value-based health care that invites quality in the assessment of achieved value. However, nowadays the ability of transparency initiatives to enhance quality of care remains obscure, if not rejected. A study published in Journal of Risk Management and Healthcare Policy sought to establish how transparency initiatives influence two types of quality of care: clinical and perceived quality. The study focused on three dependent variables: healthcare-associated infections (HAIs), 30-day readmission rates, and patient satisfaction.
Examining general acute care hospitals in the US, the study noted that the ability of public reporting to improve quality of care remains inconclusive and that the pursuit of transparency may lead to inadvertent results. The disclosure of all-payer claims data (APCD) was found to have the power to differentiate hospitals’ clinical and perceived quality, but it failed to reach the desired outcomes without market pressure. The impact of transparency on quality of care diverges depending on the unique characteristics of each transparency policy, even though they pursue the same ends through information dissemination. Furthermore, the same public policy showed starkly disparate impacts on clinical quality (eg, healthcare-associated infections (HAIs) and 30-day readmission rates) and perceived quality (eg, patient satisfaction).
The study concluded that despite the theoretically acknowledged merits of transparency, its ability to enhance quality of care remains inconclusive, and the pursuit of transparency may even inadvertently harm quality of care. While hospitals may need to finetune their strategies for each quality measurement in order to cope with the new environmental pressure, it is health policymakers’ role to coordinate those quality metrics and improve the validity of patient experience measures and surveys.
- Disparate Impacts of Two Public Reporting Initiatives on Clinical and Perceived Quality in Healthcare. Journal of Risk Management and Healthcare Policy. 15 December 2021