Public disclosure of health care performance reports: a response from the UK

In the UK, the experience with public disclosure of health care performance data related to provider organizations is limited to a small set of administrative data known as the 'Patient's Charter' which has concentrated mainly on aspects of efficiency and which is currently being reviewed, and, most recently, to a set of reference costs by case type (known as Healthcare Resource Groups). Clinically oriented performance data has been published in Scotland since 1994 and will be published in England and Wales early in 1999. Knowledge about the impact and effect of such publication is limited, even in the USA, but there is some evidence that consumers and purchasers become gradually familiar with them and confident in their use. However, even with this scant knowledge, it would appear that the publication of data across the public services will continue to be a policy of the current UK Government for the foreseeable future. It would seem likely that this policy will have the tacit approval of the general population who have been educated to be somewhat wary of professional self-regulation. The greater public accountability that public disclosure of information brings, needs to be evaluated against the overall costs of the exercise, particularly within a publicly financed system, and against the disadvantages in public confidence and impact on the patient-doctor relationship that might occur if not managed appropriately.