Do German hospital report cards have the potential to improve the quality of care?

Abstract

Background: Hospitals report cards have been put in place within the past few years to increase the amount of publicly reported quality information in Germany.

Objective: The aim of this study was to assess the potential of German hospital report cards to improve quality of care.

Methods: First, a systematic Internet search aimed at identifying available report cards was conducted. Second, cross-sectional data (August/September 2013) were analyzed with respect to awareness, comprehension, and impact of report cards by using descriptive analysis and binary multivariate logistic regression models.

Results: Hospital report cards (N=62) have become broadly available. However, awareness remains low, about one third (35.6%) of all respondents (N=2027) were aware of German hospital report card. Regarding comprehensibility, in 60.7% of all experiments (N=6081), respondents selected the hospital with the lowest risk-adjusted mortality; significant differences could be determined between the report cards (p<.001) with scores ranging from 27.5% to 77.2%. Binary multivariate logistic regression analysis revealed different significant respondent-related predictors on each report card. Finally, an impact on hospital choice making was determined.

Conclusions: To increase the potential of hospital report cards, health policy makers should promote the availability of report cards. In addition, the comprehensibility of German hospital report cards cannot be regarded as satisfying and should be enhanced in the future.

Keywords: Comprehensibility; Cross-sectional study; Germany; Public reporting; Report card.