quality reporting and consumer choice
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By Olivia S. Jung
Mentor: Jonathan Kolstad, Ph.D August 11, 2011
Quality Reporting and Consumer Choice
Background Study Aim Method Finding Takeaways
One purpose of quality reporting is to solve the problem of information asymmetry.
Health care report cards publicly report information about physicians, hospital, and health plan quality.
Quality information can: (1) improve quality of health care organizations. (2) motivate consumer participation by enabling them to make
informed choices.
Thus, public reporting can be used to stimulate transparency and accountability.
The Patient Protection Affordability and Care Act even has a specific provision for quality reporting, mandating disclosure of information of hospitals and physicians on a website.
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Background Study Aim Method Finding Takeaways
This study aims to determine whether consumers use quality information and if so, to what magnitude.
Despite all efforts, however, public reporting has not been
shown to be conclusively effective in aiding patients to
choose their health care provider.
Does public reporting impact consumer
choice?
If yes, by how much?
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Background Study Aim Method Finding Takeaways
This study aims to determine whether consumers use quality information and if so, to what magnitude.
Despite all efforts, however, public reporting has not been
shown to be conclusively effective in aiding patients to
choose their health care provider.
Does public reporting impact consumer
choice?
If yes, by how much?
Questions to be addressed in this study
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Background Study Aim Method Finding Takeaways
This study employed systematic review of literature using Google Scholar and PubMed.
Keywords: Quality reporting and consumer choice Quality information and choice
Review only the papers that have been published in or after 2000.
Determine: empirical methodology, finding, magnitude, shortcoming
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Background Study Aim Method Finding Takeaways
Twenty-four articles were reviewed.
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Background Study Aim Method Finding Takeaways
Summary of finding
58% 11/19
26% 5/19
16% 3/19
Quality reports do significantly influence patients’ choice.
Quality reports do not significantly influence patients’ choice.
Quality reports sometimes do or do not influence patients’ choice.
To reach their finding, papers used one of the two methods:
Observe change in behavior after introducing quality reports
Setup models to see if one movement in quality leads to a change of magnitude in consumes' behavior
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Background Study Aim Method Finding Takeaways
More than 1 in 10 patients (but not more than 1 in 5) use quality reports to make their decision.
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Background Study Aim Method Finding Takeaways
An increase in quality measure leads to an increase in choice.
Because each paper uses a different measure, it's hard to conclude exactly by how much an increase in quality measure leads to an increase in choice.
An incremental increase in quality does seem to be related to the incremental increase in choice (i.e. as quality rating goes up, choice goes up).
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Background Study Aim Method Finding Takeaways
The magnitude of impact is greater in health care than in education (1 in 20).
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Background Study Aim Method Finding Takeaways
Limitations with experiments that concern differences in time (i.e. testing the before and after effects)
• something else could have influenced patients about the hospital or plan
Exogenous influence
• Ex) surgeons at poorly performing hospitals simply choosing to do fewer procedures
Supply-side factors
These limitations need to be considered because they could invalidate the results if true.
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Background Study Aim Method Finding Takeaways
SO, does quality reporting impact consumer choice? If so, by how much?
Quality reporting does
impact consumer
choice.
About 10-20% of patients respond.
Has the problem of information asymmetry
been solved?
Are we better off as society
because of quality
reporting?
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Background Study Aim Method Finding Takeaways
SO, does quality reporting impact consumer choice? If so, by how much?
Quality reporting does
impact consumer
choice.
About 10-20% of patients respond.
Has the problem of information asymmetry
been solved?
Are we better off as society
because of quality
reporting?
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Background Study Aim Method Finding Takeaways
SO, does quality reporting impact consumer choice? If so, by how much?
Quality reporting does
impact consumer
choice.
About 10-20% of patients respond.
Has the problem of information asymmetry
been solved?
Are we better off as society
because of quality
reporting?
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Background Study Aim Method Finding Takeaways
SO, does quality reporting impact consumer choice? If so, by how much?
Quality reporting does
impact consumer
choice.
About 10-20% of patients respond.
Has the problem of information asymmetry
been solved?
Are we better off as society
because of quality
reporting?
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Background Study Aim Method Finding Takeaways
Lessons Learned
Finding scholarly articles using PubMed (app on Droid) and Google Scholar
Reading scholarly literature Need to learn more economic theories/models!
“What has all of this literature review made you think about? Do you think quality reporting has solved the problem of information asymmetry?” Research = more than reading and writing literature = more like a
lifelong consulting/problem-solving project
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Background Study Aim Method Finding Takeaways
THANK YOU
Joanne Levy
Prof. Jonathan Kolstad
SUMR Staff: Lissy, Megan, Hoag, and Renee
SUMR Scholars!
Leonard Davis Institute
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