Abstract
BackgroundP.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public.The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance data to the public.MethodsP.Re.Val.E. included 54 outcome/process indicators encompassing many different clinical areas. Crude and adjusted rates were estimated for the 2006-2009 period. Multivariate regression models and direct standardization procedures were used to control for potential confounding due to individual characteristics. Variable life-adjusted display charts were developed, and 2008-2009 results were compared with those from 2006-2007.ResultsResults of 54 outcome indicators were published online at http://www.epidemiologia.lazio.it/prevale10/index.php.Public disclosure of the indicators' results caused mixed reactions but finally promoted discussion and refinement of some indicators.Based on the P.Re.Val.E. experience, the Italian National Agency for Regional Health Services has launched a National Outcome Program aimed at systematically comparing outcomes in hospitals and local health units in Italy.ConclusionsP.Re.Val.E. highlighted aspects of patient care that merit further investigation and monitoring to improve healthcare services and equity.
Highlights
P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public
Most indicators were selected based on their previous use in international and national studies [7,8,9,10,11,12,13,14,15,16,17,18,19,21,22,23,24], while other indicators were developed in order to describe particular components of care or clinical pathways
The indicators were defined using information collected from regional health information systems covering the whole Lazio population: the Hospital Information System (HIS), the Emergency Information System (EIS), the Mortality Information System (MIS), the Report AdmissionDischarge for Rehabilitation (RADR), and the Hospital Deliveries Information System (HDIS)
Summary
P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public. As well as research projects, have used different indicators for comparative evaluation of the performance of healthcare providers and professionals. Some have released their results to the public in the form of web-based reports that compare hospital quality [7,8,9,10,11,12,13]. P. Re.Val.E. is the most comprehensive comparative evaluation of regional healthcare outcomes and the only Italian study to publicly disclose performance data
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