Understanding the audience: Improving the impact of public performance reporting on quality of care.

Abstract

Introduction: Despite its’ promise public performance reporting has had little impact on improving quality of care for consumers. In this study we examine consumer advocates, purchasers and providers’ understanding of public performance reporting and how it contributes to quality of care. The aim of the study is to improve the impact of public performance on quality of care. Theory: Public performance reporting is hypothesised to improve quality of care by eliciting organisational response to improve quality or by leading consumers to select away from poor quality services. Methods: We conducted 41semi-structured interviews nationally. The aim of the study was to examine differences in perceptions of the aims, implementation and impact public performance reporting. Data was transcribed and themes were analysed using NVivo. Results: The study revealed that consumers, providers and purchasers share similar perceptions of the goals of public performance reporting. However they have very different views about the extent to which to current public performance reporting is likely to meet the needs of consumers. Discussion: While consumers are supportive of public performance reporting current iterations are unlikely to influence either public perceptions of health services or consumer choice. Developing fit for purpose reporting is likely to improve the extent to which public performance reporting will improve quality of care. Conclusions: Overall the views of all respondents highlighted the need to better target publically reported information to inform the actions of the intended audience. Lessons learned: Public performance reporting is currently driven by what is most consistently reported at a national level. While this facilitated implementation it may undermined the perceived benefits of the enterprise. Limitations: Findings are health system specific. Suggestions for future research: We are conducting a meta-analysis and studies with medical directors, GPs and consumers to better understand how theory around public performance reporting translates into practice.