Public Reporting im Gesundheitswesen: Die Auswirkungen veröffentlichter Qualitätsdaten auf die Patientensteuerung

Zusammenfassung

Ziel der Studie:

Public Reporting (PR) gewinnt zunehmend an Bedeutung bei dem Versuch der Patientensteuerung. Daher soll untersucht werden, welche Ergebnisse bezüglich der Effektivität von PR vorliegen und ob sich die Ergebnisse in Abhängigkeit des PR-Instrumentes unterscheiden. Die herausgearbeiteten Erfolgsfaktoren können insbesondere der in Deutschland zunehmenden Transparenz-Bewegung zugutekommen.

Methodik:

Systematischer Review mit Literatursuche in den folgenden 5 Datenbanken: The Cochrane Library, Medline (via PubMed), ISI Web of Knowledge, EconLit und PsycINFO. Peer-­reviewed Artikel in den Sprachen Englisch, Deutsch und Spanisch wurden für den Zeitraum seit 2005 gesucht. Studien vor diesem Zeitraum, auf die wir durch Durchsicht der einbezogenen Literatur gestoßen sind, wurden ebenfalls integriert. Eine informelle Handsuche ergänzte die Suche.

Ergebnisse:

Wir identifizieren insgesamt 21 Studien, in denen die Auswirkungen 12 verschiedener PR-Instrumente auf den Patientenfluss untersucht werden. 20 Studien betrachten Erfahrungen aus den USA, eine Studie kommt aus Deutschland. Das am häufigsten untersuchte PR-Instrument ist das New York State Cardiac Surgery Reporting System (CSRS), das in 8 Studien betrachtet wurde. Als Gesamtergebnis hat sich ergeben, dass in 9 Studien ein Effekt auf die Patientensteuerung gezeigt wurde, während 7 Untersuchungen zu keinem eindeutigen Ergebnis kom­men und fünf Studien keinen Effekt nachweisen konnten.

Schlussfolgerung:

PR kann effektiv sein bei dem Versuch, den Patientenfluss zu steuern. Insbesondere bei elektiven Eingriffen hat sich eine Wirksamkeit gezeigt. Um erfolgreich zu sein, müssen die dargestellten Informationen glaubwürdig und verständlich sein, eine Neuigkeit darstellen, verbreitet werden sowie anwendbar und gemäß individueller Präferenzen darstellbar sein.

Abstract

Background:

Public reporting (PR) has been gaining more weight as a mechanism for patient steerage. According to the theory of PR, patients use information about the quality of health care providers before making decisions and selecting health-care providers. This paper contributes further knowledge on the effectiveness of PR and identifies critical success factors. These should be taken into account when implementing PR in the German health care system.

Methodology:

The peer-reviewed English, Spanish, and German language literature was searched in the following five databases: The Cochrane Library, Medline (via PubMed), ISI Web of Knowledge, EconLit, and PsycINFO (since 2005). In addition, reference lists of the included studies and reviews were screened in order to identify previously published studies.

Results:

In total, 21 studies were identified regarding the impact of 12 different PR instruments on patient steerage. An impact could be demonstrated in 9 studies, 7 studies showed mixed results, while 5 studies could not show any effect on patient steerage. 20 studies were carried out in the US environment, 1 study in Germany. The most researched instrument is the New York State Cardiac Surgery Reporting System (N=8).

Conclusion:

PR can be effective in steering pa­tients when seeking a health-care provider, especially for elective procedures. To be successful, information provided must be reliable, easily understandable, should further represent real news, and be disseminated widely. Besides this, it has to be applicable and modifiable according to individual preferences.

Schlüsselwörter

Public Reporting - Transparenz - systematischer Review - Patientensteuerung

Key words

public reporting - transparency - systematic review - patient steerage

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