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. 2012 Oct;47(5):1880-901.
doi: 10.1111/j.1475-6773.2012.01401.x. Epub 2012 Mar 30.

Reporting of quality indicators and improvement in hospital performance: the P.Re.Val.E. Regional Outcome Evaluation Program

Cristina Renzi  1 , Chiara Sorge, Danilo Fusco, Nera Agabiti, Marina Davoli, Carlo A Perucci
Affiliations

Reporting of quality indicators and improvement in hospital performance: the P.Re.Val.E. Regional Outcome Evaluation Program

Cristina Renzi et al. Health Serv Res. 2012 Oct.

Abstract

Objective: To evaluate whether reporting of hospital performance was associated with a change in quality indicators in Italian hospitals.

Data sources/study setting: Nationwide Hospital Information System for 2006-2009.

Study design: We performed a pre-post evaluation in Lazio (before and after disclosure of the Regional Outcome Evaluation Program P.Re.Val.E.) and a comparative evaluation versus Italian regions without comparable programs. We analyzed risk-adjusted proportions of percutaneous coronary intervention (PCI), hip fractures operated on within 48 hours, and cesarean deliveries.

Data collection/extraction methods: Using standardized ICD-9-CM coding algorithms, we selected 381,053 acute myocardial infarction patients, 250,712 hip fractures, and 1,736,970 women who had given birth.

Principal findings: In Lazio PCI within 48 hours changed from 22.49 to 29.43 percent following reporting of the P.Re.Val.E results (relative increase, 31 percent; p < .001). In the other regions this proportion increased from 22.48 to 27.09 percent during the same time period (relative increase, 21 percent; p < .001). Hip fractures operated on within 48 hours increased from 11.73 to 15.78 percent (relative increase, 34 percent; p < .001) in Lazio, and not in other regions (29.36 to 28.57 percent). Cesarean deliveries did not decrease in Lazio (34.57-35.30 percent), and only slightly decreased in the other regions (30.49-28.11 percent).

Conclusions: Reporting of performance data may have a positive but limited impact on quality improvement. The evaluation of quality indicators remains paramount for public accountability.

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Figures

Figure 1
Figure 1
Trends in the Proportion of Patients with Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention within 48 Hours in Lazio and Other Italian Regions
Figure 2
Figure 2
Trends in the Proportion of Hip Fracture Patients Operated within 48 Hours in Lazio and Other Italian Regions
Figure 3
Figure 3
Trends in the Proportion of Primary Cesarean Deliveries in Lazio and Other Italian Regions
See this image and copyright information in PMC

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