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Publicly disclosed information about the quality of health care: response of the US public
  1. E C Schneider, instructor1,
  2. T Lieberman, director2
  1. 1Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School and Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts 02115, USA
  2. 2Center for Consumer Health Choices, Consumer's Union, New York, USA
  1. Dr E C Schneider eschneider{at}


Public disclosure of information about the quality of health plans, hospitals, and doctors continues to be controversial. The US experience of the past decade suggests that sophisticated quality measures and reporting systems that disclose information on quality have improved the process and outcomes of care in limited ways in some settings, but these efforts have not led to the “consumer choice” market envisaged. Important reasons for this failure include limited salience of objective measures to consumers, the complexity of the task of interpretation, and insufficient use of quality results by organised purchasers and insurers to inform contracting and pricing decisions. Nevertheless, public disclosure may motivate quality managers and providers to undertake changes that improve the delivery of care. Efforts to measure and report information about quality should remain public, but may be most effective if they are targeted to the needs of institutional and individual providers of care.

  • public disclosure
  • quality of health care
  • quality improvement

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