Cochrane Effective Practice and Organisation of Care wanted to find out if publicly releasing information about the performance of healthcare providers (e.g. hospitals and individual professionals) has a measurable influence on changing the behaviour of consumers, providers, and purchasers of care. The authors also sought to determine whether this affected the performance of healthcare providers, patient outcomes, and staff morale.
The recently published review found:
- The available evidence suggests that publishing performance data does not make very much difference to where patients choose to go for treatment. It also appears to make little difference to the behaviour of healthcare providers, i.e. professionals and organisations.
- There has been little high-quality research in this area and so it is difficult to have a high degree of certainty about the actual impact of publishing data about the performance of healthcare providers.
- Public release of performance data may improve patient outcomes in some cases. There is however evidence to suggest that this could increase inequality as some patient groups are more likely to act on this information than others.
“Public release of performance data is becoming increasingly commonplace and is usually assumed to be 'a good thing." says David Metcalfe, Lead Author. "However, there is a risk of such interventions causing harm, e.g. by misleading patients, encouraging providers to “game” the system or avoid treating high-risk patients, distorting clinical priorities, and/or increasing healthcare inequalities. It is therefore important that we pause to evaluate and understand the effects of such initiatives.
There is room within the “research space” for high quality research aimed at understanding how and when public release of performance data can effect positive change for patients. Future research should aim to examine the impact of public release of performance data on patient outcomes rather than simply healthcare processes.”
The authors searched the literature for studies evaluating the effects of publicly releasing healthcare performance information, and found 12 relevant studies that analysed data from more than 7570 providers, and a further 3,333,386 clinical encounters, e.g. individual patients.