Health Care Provider Report Cards Could Have Negative Effects on Quality of Care, Article Says
Health care "report cards" that evaluate the performance of U.S. physicians, hospitals and health insurers might have "unintended and negative consequences on health care," according to an article published on Wednesday in the Journal of the American Medical Association, CQ HealthBeat reports. The article states that, although report cards encourage "a spirit of openness," they could prompt physicians to avoid sick patients to improve their scores or to perform unnecessary procedures or tests to reach "target rates" (CQ HealthBeat, 3/8).
The article, written by Rachel Werner and David Asch of the Philadelphia Veterans Affairs Medical Center, cited a 1997 survey in which two-thirds of 104 New York surgeons interviewed said that they avoided sick patients to obtain higher scores on report cards. In addition, the article cited a study in which several Department of Veterans Affairs hospitals received low scores despite proper treatment of patients (Johnson, AP/Las Vegas Sun, 3/9).
"[L]ittle research examines the effect of public reporting on the delivery of health care, and even less examine how reports cards may improve care," the article said, adding that "providers who receive low-quality scores face incentives to avoid reporting and the sickest patients will be shifted from rated to unrated providers" (CQ HealthBeat, 3/8).
"I don't want to come across as being against quality improvement, but we need more empirical evidence before we launch the universal projects that people are talking about," Werner said.
Marvin Lipman, medical adviser to Consumers Union, said that patients should have access to information on the quality of care they receive (Johnson, AP/Las Vegas Sun, 3/9).
An abstract of the article is available at online.