quality-of-care measures. The fundamental aims of such public disclosure, in the context of this study, are to improve the public's understanding about health care issues generally and to help consumers select providers of health care.1

These elements imply that HDOs should be required to gather, analyze, generate, and publicly release such data and information: 

  • in forms and with explanations that can be understood by the public;
  • in such a manner that the public can distinguish actual events (i.e., primary data) from derived, computed, or interpretive information;
  • in ways that reveal the magnitude of any differences among providers as well as the likelihood that differences could be the result of chance alone;
  • in sufficient detail that all providers can be easily described and compared, not just those at the extremes;
  • with descriptions and illustrations of the steps necessary to predict outcomes in the present or future from information relating only to past experience; and
  • with statements and illustrations about the need to particularize information for an individual in the final stages of decision making. 

Acceptance of HDO activities and products relating to public disclosure will depend in part on the balance struck for fairness to patients, the public in general, payers, and health care providers. Fairness to patients involves protecting their privacy and the confidentiality of information about them, as examined in Chapter 4. Fairness to the public involves distributing accurate, reliable information that is needed to make informed decisions about providers and health care interventions; the broader aims are to promote universal access to affordable and competent health care, enhance consumer choice, improve value for health care dollars expended, and increase the accountability to the public of health care institutions. Fairness to payers may be a subset of this category. They should receive the information that is available to the public at large, but perhaps in more detail or in a more timely manner. Finally, fairness to providers entails ensuring that

1  

SEC. 5003 of the HSA (1993) calls for a National Quality Management Council to develop a set of national measures of quality performance to assess the provision of health care services and access to such services.

SEC. 5005 (1) requires health alliances annually to publish and make available to the public a performance report outlining in a standard format the performance of each health plan offered in the alliance and the results of consumer surveys conducted in the alliance



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