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Gesundheitsökonomie & Qualitätsmanagement 2017; 22(04): 206-212
DOI: 10.1055/s-0043-101804
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Ein internationaler Vergleich zu Public Reporting über die Qualität von Krankenhäusern: Wo stehen wir und was können wir lernen?

An international comparison of public reporting about the quality of hospitals: where do we stand and what can we learn?
Martin Emmert
1   Friedrich-Alexander-Universität Erlangen-Nürnberg, Wirtschaftswissenschaftliche Fakultät, Juniorprofessur für Versorgungsmanagement, Lange Gasse, 2090403 Nürnberg
,
Sandra Becker
1   Friedrich-Alexander-Universität Erlangen-Nürnberg, Wirtschaftswissenschaftliche Fakultät, Juniorprofessur für Versorgungsmanagement, Lange Gasse, 2090403 Nürnberg
,
Uwe Sander
2   Hochschule Hannover, Abteilung Information und Kommunikation, Expo Plaza 12, 30539 Hannover
› Author Affiliations
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Publication History

Publication Date:
02 February 2017 (online)

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Zusammenfassung

Zielsetzung Public Reporting (PR) über die Versorgungsqualität von Krankenhäusern hat in Deutschland eine relativ junge Tradition. Im Rahmen des Beitrages erfolgt ein Vergleich von deutschen PR-Instrumenten mit solchen aus Ländern mit einer umfassenderen PR-Tradition (USA, England) und die Ableitung von Handlungsempfehlungen für das PR in Deutschland.

Methodik 1. Systematische Internetrecherche zur Identifizierung von Report Cards. 2. Analyse der Report Cards hinsichtlich bestimmter Ein- und Ausschlusskriterien. 3. Literaturbasierte Erstellung eines Analyserasters zur Beschreibung der Report Cards. 4. Analyse der Report Cards und Datenerhebung. 5. Auswertung der Ergebnisse und Ableitung von Handlungsempfehlungen.

Ergebnisse Es wurden 186 Report Cards eingeschlossen, die meisten aus den USA (N=112), gefolgt von Deutschland (N=39) und England (N=35). Informationen zur Strukturqualität sind auf 93,5 % aller Report Cards zu finden, solche zur Prozess- (42,5 %) und Ergebnisqualität (43,5 %) seltener. Über die Patientenerfahrung wird auf nahezu jeder zweiten Report Card berichtet (46,2 %). Rund ein Drittel aller Report Cards zeigt Ergebnisse von offline durchgeführten Befragungen und eine online Bewertung von Krankenhäusern ermöglicht nahezu jede sechste Report Card (15,6 %). Ca. 37 % aller Report Cards zeigen Informationen zu bestimmten Krankheiten und medizinischen Prozeduren sowie 29 % zu medizinischen Fachgebieten. Composite Measures finden sich überwiegend auf US Report Cards.

Diskussion Bezüglich der Menge und Breite an Qualitätsinformationen kann Report Cards in Deutschland ein gutes Gesamtergebnis zugesprochen werden. Mögliche Weiterentwicklungen beziehen sich auf die Verwendung von Composite Measures, eine Ausweitung der Darstellung medizinsicher Leistungsbereiche, die einheitliche Verwendung von Instrumenten zur Qualitätsmessung sowie den Ausbau an Information über einzelne Klinikärzte.

Abstract

Objective Public reporting (PR) about the quality of hospitals is still a relatively young discipline in Germany. Thus, we compare German PR instruments with those from countries with a longer tradition (USA, England) and derive implications for policy makers in Germany.

Methods 1. A systematic internet search was carried out to identify hospital report cards, (2.) whereby several inclusion and exclusion criteria were applied. 3. Based on literature, we developed a scheme to describe the content of included report cards. 4. Analysis of the report cards and data collection. 5. Evaluation of the results and deviation of implications.

Results In total, we reviewed 186 report cards from the United States (112), Germany (39) and England (35). Structure related information was identified more frequently (93.5 %) than process measures (42.5 %), outcomes (43.5 %) or patient satisfaction results (46.2 %). One third of all report cards contain results from offline conducted surveys while every sixth report card (15.6 %) enables the opportunity to rate hospitals online. Every third report card displays information about certain diseases, procedures or medical disciplines. Composite measures were most likely to be found on US report cards.

Conclusions Report cards from Germany perform relatively well regarding the amount and broadness of hospital quality information. Possible improvement areas refer to the use of composite measures as well as standardized survey instruments. Besides, further clinical areas should be integrated and more physician-related information should be published.

Schlüsselwörter

Public Reporting - Krankenhausqualität - Transparenz - Internet

Keywords

Public Reporting - hospital quality - transparency - Internet
 

  • Literatur

  • 1 Berwick DM, James B, Coye MJ. Connections between quality measurement and improvement. Medical care 2003; 41 (01) I30-I38
    PubMedGoogle Scholar
  • 2 Amelung V. Managed Care: Neue Wege im Gesundheitsmanagement. 5th ed.. Wiesbaden: Gabler; 2012
    Google Scholar
  • 3 Totten AM, Wagner J, Tiwari A, O`Haire C, Griffin J, Walker M. Public Reporting as a Quality Improvement Strategy. Closing the Quality Gap: Revisiting the State of the Science. 12th ed.. 2012
    Google Scholar
  • 4 Lansky D. Perspective: Measuring What Matters To The Public. Health affairs (Project Hope) 1998; 17 (04) 40-41
    PubMedGoogle Scholar
  • 5 Iezzoni LI. 100 apples divided by 15 red herrings: a cautionary tale from the mid-19th century on comparing hospital mortality rates. Annals of Internal Medicine 1996; 124 (12) 1079-1085
    CrossrefPubMedGoogle Scholar
  • 6 Chen J. Public reporting of health system performance: a rapid review of evidence on impact on patients, providers and healthcare organisations. An Evidence Check review brokered by the Sax Institute. 2010
    PubMedGoogle Scholar
  • 7 Patel S, Cain R, Neailey K, Hooberman L. Exploring Patients' Views Toward Giving Web-Based Feedback and Ratings to General Practitioners in England. A Qualitative Descriptive Study. Journal of medical Internet research 2016; 18 (08) e217-e217
    CrossrefPubMedGoogle Scholar
  • 8 Emmert M, Meszmer N, Simon A, Sander U. Internetportale für die Krankenhauswahl in Deutschland. Eine leistungsbereichsspezifische Betrachtung. 2015
    PubMedGoogle Scholar
  • 9 Gemeinsamer Bundesausschuss. Qualitätsbericht der Krankenhäuser. https://www.g-ba.de/institution/themenschwerpunkte/qualitaetssicherung/qualitaetsdaten/qualitaetsbericht/?
    PubMedGoogle Scholar
  • 10 Institut für Qualitätssicherung und Transparenz im Gesundheitswesen. Strukturierter Qualitätsbericht. https://iqtig.org/ergebnisse/strukturierter-qualitaetsbericht/
    PubMedGoogle Scholar
  • 11 AQUA-Institut. German Hospital Quality Report. 2014/2015
    PubMedGoogle Scholar
  • 12 Cronin C, Riedel A. State-of-the-Art of Hospital and Physician/Physician Group Public Reports. Washington D.C.: 2011
    PubMedGoogle Scholar
  • 13 Kurtzman ET, Greene J. Effective presentation of health care performance information for consumer decision making. A systematic review. Patient education and counseling 2016; 99 (01) 36-43
    CrossrefPubMedGoogle Scholar
  • 14 Friedemann J, Schubert H-J, Schwappach D. On the comprehensibility of German hospital quality reports: systematic evaluation and need for action. Gesundheitswesen 2009; 71 (01) 3-9
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Austin JM, Jha AK, Romano PS. et al. National hospital ratings systems share few common scores and may generate confusion instead of clarity. Health affairs (Project Hope) 2015; 34 (03) 423-430
    CrossrefPubMedGoogle Scholar
  • 16 Christianson JB, Volmar KM, Alexander J, Scanlon DP. A report card on provider report cards: current status of the health care transparency movement. J Gen Intern Med 2010; 25 (11) 1235-1241
    CrossrefPubMedGoogle Scholar
  • 17 Giordano LA, Elliott MN, Goldstein E, Lehrman WG, Spencer PA. Development, implementation, and public reporting of the HCAHPS survey. Med Care Res Rev 2010; 67 (01) 27-37
    CrossrefPubMedGoogle Scholar
  • 18 Gehrlach C, Altenhöner T, Schwappach D. Der Patients’ Experience Questionnaire. Patientenerfahrungen vergleichbar machen. Gütersloh: 2009
    PubMedGoogle Scholar
  • 19 Kanouse DE, Schlesinger M, Shaller D, Martino SC, Rybowski L. How Patient Comments Affect Consumers' Use of Physician Performance Measures. Medical care 2016; 54 (01) 24-31
    CrossrefPubMedGoogle Scholar
  • 20 Ranard BL, Werner RM, Antanavicius T. et al. Yelp Reviews Of Hospital Care Can Supplement And Inform Traditional Surveys Of The Patient Experience Of Care. Health affairs (Project Hope) 2016; 35 (04) 697-705
    CrossrefPubMedGoogle Scholar
  • 21 Emmert M, Sander U, Pisch F. Eight questions about physician-rating websites: a systematic review. J. Med. Internet Res 2013; 15 (02) e24-e24
    CrossrefPubMedGoogle Scholar
  • 22 Rothberg MB, Benjamin EM, Lindenauer PK. Public reporting of hospital quality: Recommendations to benefit patients and hospitals. Journal of hospital medicine (Online) 2009; 04 (09) 541-545
    PubMedGoogle Scholar
  • 23 Gemeinsamer Bundesausschuss. Externe stationäre Qualitätssicherung. https://www.g-ba.de/institution/themenschwerpunkte/qualitaetssicherung/extern/stationaer/
    PubMedGoogle Scholar
  • 24 Grosch B, Ozegowski S, Fischer A, Schweizer C, Wagner I, Becker M. Qualitätswettbewerb: Chancen für Deutschlands Gesundheitssystem. Berlin: 2013
    PubMedGoogle Scholar
  • 25 Centers for Medicare & Medicaid Services. About the data: Hospital Compare overall rating. How the Hospital Compare overall rating is calculated. https://www.medicare.gov/hospitalcompare/Data/Hospital-overall-ratings-calculation.html
    PubMedGoogle Scholar
  • 26 Centers for Medicare & Medicaid Services. About the data: Survey of patients' experiences (HCAHPS). Survey of patients' experiences (HCAHPS) star ratings. https://www.medicare.gov/hospitalcompare/Data/HCAHPS-Star-Ratings.html
    PubMedGoogle Scholar
  • 27 Chen LM, Staiger DO, Birkmeyer JD, Ryan AM, Zhang W, Dimick JB. Composite quality measures for common inpatient medical conditions. Medical care 2013; 51 (09) 832-837
    CrossrefPubMedGoogle Scholar
  • 28 Marang-van de Mheen PJ, Dijs-Elsinga J, Otten W. et al. The relative importance of quality of care information when choosing a hospital for surgical treatment: a hospital choice experiment. Med Decis Making 2011; 31 (06) 816-827
    CrossrefPubMedGoogle Scholar
  • 29 Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists. N Engl J Med 1996; 335 (04) 251-256
    CrossrefPubMedGoogle Scholar
  • 30 Keeley FX. Public Reporting of individual surgeons` outcomes in the UK. The Canadian Journal of Urology 2014; 05 (21) 742-742
    PubMedGoogle Scholar