Public reporting of hospital outcomes: a challenging road ahead

Martin P Gallagher and Harlan M Krumholz
Med J Aust 2011; 194 (12): 658-660.


  • Martin P Gallagher1
  • Harlan M Krumholz2

  • 1 The George Institute for International Health, Sydney, NSW.
  • 2 Yale University, New Haven, Conn, USA.


Competing interests:

Martin Gallagher prepared this article during a Harkness Fellowship supported by the Commonwealth Fund. Harlan Krumholtz’s institution has received funding from the US Centers for Medicare and Medicaid Services for outcome measure development. The views expressed here are those of the authors and should not be attributed to the Commonwealth Fund or its directors, officers or staff.

  • 1. Australian Government. A national health and hospitals network for Australia’s future. Canberra: Commonwealth of Australia, 2010.
  • 2. Australian Commission on Safety and Quality in Health Care 2009. Windows into safety and quality in health care. Sydney: ACSQHC, 2009.
  • 3. Mohammed MA, Deeks JJ, Girling A, et al. Evidence of methodological bias in hospital standardised mortality ratios: retrospective database study of English hospitals. BMJ 2009; 338: b780.
  • 4. Kmietowicz Z. Dr Foster patient safety ratings are flawed, confusing, and outdated, trusts say. BMJ 2009; 339: b5181.
  • 5. Duckett SJ, Coory M, Sketcher-Baker K. Identifying variations in quality of care in Queensland hospitals. Med J Aust 2007; 187: 571-575. <MJA full text>
  • 6. Queensland Government. Queensland health systems review. Final report, September 2005. (accessed Apr 2010).
  • 7. Ben-Tovim D, Woodman R, Harrision JE, et al. Measuring and reporting mortality in hospital patients. Canberra: Australian Institute of Health and Welfare, 2009. (AIHW Cat. No. HSE 69.)
  • 8. Morris K, Zelmer J. Public reporting of performance measures in health care. Ottawa: Canadian Policy Research Networks, 2005.
  • 9. Walker B. Interim report of the Special Commission of Inquiry into Campbelltown and Camden Hospitals. Sydney: NSW Government, 2004.$file/Interim_Report_31March2004.pdf (accessed Apr 2010).
  • 10. Learning from Bristol: the report of the public inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984–1995. London: UK Parliament, 2001.
  • 11. Marshall MN. Accountability and quality improvement: the role of report cards. Qual Health Care 2001; 10: 67-68.
  • 12. Australian Associated Press. “The mice in charge of the cheese”: father slams inaction after girl’s hospital death. Sydney Morning Herald 2010; 4 Mar.
  • 13. Berwick DM. Public performance reports and the will for change. JAMA 2002; 288: 1523-1524.
  • 14. UK Department of Health. High quality care for all: NHS Next Stage Review Final Report by Lord Darzi. London: The Stationery Office, 2008.
  • 15. Raleigh V, Foot C. Getting the measure of quality. Opportunities and challenges. London: The King’s Fund, 2010.
  • 16. Fung CH, Lim Y-W, Mattke S, et al. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med 2008; 148: 111-123.
  • 17. Tu JV, Donovan LR, Lee DS, et al. Effectiveness of public report cards for improving the quality of cardiac care. The EFFECT study: a randomized trial. JAMA 2009; 302: 2330-2337.
  • 18. Vladeck BC, Goodwin EJ, Myers LP, Sinisi M. Consumers and hospital use: the HCFA “death list”. Health Aff (Millwood) 1988; 7: 122-125.
  • 19. Kaiser Family Foundation Public Opinion and Survey Research Program. 2008 update on consumers’ views of patient safety and quality information. Menlo Park, Calif: KFF, 2008.
  • 20. Scott IA, Ward M. Public reporting of hospital outcomes based on administrative data: risks and opportunities. Med J Aust 2006; 184: 571-575. <MJA full text>
  • 21. Krumholz HM, Wang Y, Mattera JA, et al. An administrative claims model suitable for profiling hospital performance based on 30-day mortality rates among patients with an acute myocardial infarction. Circulation 2006; 113: 1683-1692.
  • 22. Krumholz HM, Wang Y, Mattera JA, et al. An administrative claims model suitable for profiling hospital performance based on 30-day mortality rates among patients with heart failure. Circulation 2006; 113: 1693-1701.
  • 23. Desai MM, Lin Z, Schreiner GC, et al. 2010 measures maintenance technical report: acute myocardial infarction, heart failure, and pneumonia 30-day risk-standardized mortality measures. New Haven: Centers for Medicare and Medicaid Services, 2009. (accessed Apr 2010).
  • 24. Lilford R, Pronovost P. Using hospital mortality rates to judge hospital performance: a bad idea that won’t go away. BMJ 2010; 340: c2016.
  • 25. Normand S-LT, Glickman ME, Gatsonis CA. Statistical methods for profiling providers of medical care: issues and applications. J Am Stat Assoc 1997; 92: 803-814.
  • 26. Nocera A. Performance-based hospital funding: a reform tool or an incentive for fraud? Med J Aust 2010; 192: 222-224. <MJA full text>
  • 27. Kelman S, Friedman JN. Performance improvement and performance dysfunction: an empirical examination of distortionary impacts of the emergency room wait-time target in the English National Health Service. J Public Adm Res Theory 2009; 19: 917-946.
  • 28. Gubb J. Have targets done more harm than good in the English NHS? Yes. BMJ 2009; 338: a3130.
  • 29. Omoigui NA, Miller DP, Brown KJ, et al. Outmigration for coronary bypass surgery in an era of public dissemination of clinical outcomes. Circulation 1996; 93: 27-33.
  • 30. Moscucci M, Eagle KA, Share D, et al. Public reporting and case selection for percutaneous coronary interventions: an analysis from two large multicenter percutaneous coronary intervention databases. J Am Coll Cardiol 2005; 45: 1759-1765.
  • 31. Resnic FS, Welt FG. The public health hazards of risk avoidance associated with public reporting of risk-adjusted outcomes in coronary intervention. J Am Coll Cardiol 2009; 53: 825-830.
  • 32. Bird SM, Cox D, Farewell VT, et al. Performance indicators: good, bad and ugly. J Royal Stat Soc (A) 2005; 168: 1-27.


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