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Death and reputation: how consumers acted upon HCFA mortality information
S T Mennemeyer1, M A Morrisey, L Z Howard
1Lister Center for Health Policy, School of Public Health, University of Alabama, Birmingham 35294, USA.
Summary
The Health Care Financing Administration
Area of Science:
- Health Services Research
- Public Health Policy
- Healthcare Quality Measurement
Background:
- The Health Care Financing Administration (HCFA) released hospital-specific patient death rate data from 1986-1992.
- This data release was intended to help consumers make informed hospital choices.
- The impact of this public reporting on hospital utilization was not well understood.
Purpose of the Study:
- To evaluate the effect of HCFA's mortality data release on hospital utilization.
- To assess whether consumers used the data to select hospitals.
- To inform future healthcare report card initiatives.
Main Methods:
- Analysis of hospital discharge data in relation to HCFA mortality reports.
- Statistical evaluation of the impact of published death rates on hospital utilization.
- Comparison of the effects of HCFA data versus media reports on hospital admissions.
Main Results:
- The HCFA data release had a statistically significant but very small effect on hospital utilization.
- Hospitals with double the expected death rates saw less than one discharge reduction per week.
- Media reports of single unexpected deaths correlated with a 9% decrease in hospital discharges.
Conclusions:
- HCFA's mortality reports were not effectively used by consumers for hospital selection.
- The elimination of the HCFA mortality report was justified due to its lack of consumer impact.
- Findings suggest that media attention, not official reports, drives significant changes in hospital utilization.