Does putting health care report cards online matter?

Pennsylvania, through the Pennsylvania Health Care Cost Containment Council (PHC4), has been a pioneer in developing performance grades on Coronary Artery Bypass Craft Surgery for health care providers and posting them online.  Although PHC4 has published Pennsylvania’s Guide to Coronary Artery Bypass Graft Surgery since the early 1990s, these documents were paper documents and potentially difficult to access.  In 1998, the CABG report cards first appeared online.

One paper by Chou et al. (2014) looks at whether the publication of the CABG report cards improved outcomes and whether the effect was larger in more competitive markets. The authors use data from PHC4’s inpatient database linked to information from the AHA’s Annual Survey of Hospitals.  The authors measure competition using the CABG HHI for each zipcode.
The authors find that “after the report cards went online, hospitals in more competitive markets used more resources per patient, and achieved lower mortality among more severely ill patients.”  Specifically, costs increased by 9.5% in the most competitive markets, but the mortality rate fell by 0.6 to 0.7 percentage points.

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