Public Reporting of Performance Indicators in Long-Term Care in Canada: Does it Make a Difference?

Area of Science:

• Health Services Research
• Quality Improvement Science
• Public Health Policy

Background:

• Public reporting of healthcare performance is a policy tool aimed at improving quality.
• Evidence linking public reporting to tangible quality improvements in healthcare settings remains inconclusive.
• Long-term care facilities face unique challenges in performance measurement and quality enhancement.

Purpose of the Study:

• To investigate the association between public reporting of performance indicators and quality trends in Canadian long-term care facilities.
• To determine if publicly disclosed performance data influences facility-level quality improvement.
• To identify specific conditions under which public reporting may be more effective.

Main Methods:

• Comparative analysis of 16 performance indicators (8 publicly reported, 8 not) in 1,087 Canadian long-term care facilities.
• Longitudinal study design examining trends between fiscal years 2011-2012 and 2018-2019.
• Statistical examination of the relationship between public reporting status and observed performance changes.

Main Results:

• Improving trends were observed more frequently for publicly reported performance indicators compared to non-reported indicators.
• The positive association between public data disclosure and performance improvement was stronger for indicators that had not previously improved.
• Worst-performing facilities showed a more significant association between public reporting and quality improvement.

Conclusions:

• Public reporting of performance indicators in Canadian long-term care facilities appears to be associated with quality improvement.
• Transparency through public reporting may incentivize better performance, particularly in underperforming facilities.
• Further research is warranted to confirm causality and explore optimal strategies for public reporting.