The Issue

Recently passed health reform legislation in Australia encourages public reporting of patient outcomes following hospitalization. The nation has lagged behind others in reporting this information and may be able to learn from international experiences. 

What the Study Found

According to an analysis of existing public reporting programs conducted by Martin Gallagher, former Commonwealth Fund Harkness Fellow, there are several challenges to reporting health outcomes. These include the potential for inappropriate classification of outcomes; difficulty in clarifying methodology; the risk of inaccuracy, particularly for small hospitals; and concerns over unduly raising public fears about quality of care.

The authors offer several recommendations to address these challenges:

• using hospital coding data to extract outcomes information, given the adequacy of this method and its relatively low cost;
• excluding very small facilities, owing to the imprecision of data;
• using a suite of outcomes measures that offers comparisons with other countries;
• clarifying who the primary audience is (e.g., clinicians);
• mitigating potential "gaming" and risk manipulation efforts; and
• using educational strategies to inform the public about hospital performance measures.