Can public reporting impact patient outcomes and disparities? A systematic review.

OBJECTIVE: Recent US healthcare reforms aim to improve quality and access. We synthesized evidence assessing the impact that public reporting (PR), which will be extended to the outpatient setting, has on patient outcomes and disparities. METHODS: A systematic review using PRISMA guidelines identified studies addressing the impact of PR on patient outcomes and disparities. RESULTS: Of the 1970 publications identified, 25 were relevant, spanning hospitals (16), nursing homes (5), emergency rooms (1), health plans (2), and home health agencies (1). Evidence of effect on patient outcomes was mixed, with 6 studies reporting a favorable effect, 9 a mixed effect, 9 a null effect, and 1 a negative effect. One study found a mixed effect of PR on disparities. CONCLUSION: The evidence of the impact of PR on patient outcomes is lacking, with limited evidence that PR has a favorable effect on outcomes in nursing homes. There is little evidence supporting claims that PR will have an impact on disparities or in the outpatient setting. PRACTICE IMPLICATIONS: Health systems should collect information on patient-relevant outcomes. The lack of evidence does not necessarily imply a lack of effect, and a research gap exists regarding patient-relevant outcomes and PR.