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Editorials: POINT/COUNTERPOINT EDITORIALS |

Counterpoint: Will Public Reporting of Health-care Quality Measures Inform and Educate Patients? NoPublic Reporting of Quality Measures Good? No

Jeffrey T. Kullgren, MD, MPH; Rachel M. Werner, MD, PhD
Author and Funding Information

From the Robert Wood Johnson Foundation Clinical Scholars (Dr Kullgren); Philadelphia Veterans Affairs Medical Center (Drs Kullgren and Werner); Leonard Davis Institute of Health Economics (Drs Kullgren and Werner), University of Pennsylvania; and Division of General Internal Medicine (Dr Werner), Perelman School of Medicine at the University of Pennsylvania.

Correspondence to: Jeffrey T. Kullgren, MD, MPH, Robert Wood Johnson Foundation Clinical Scholars, 1303B Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104; e-mail: kullgren@mail.med.upenn.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(5):1117-1120. doi:10.1378/chest.11-2094
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Health-care report cards, which publicly report provider performance on quality measures, are becoming increasingly common.1,2 These report cards seek to improve health-care quality through two main mechanisms. First, they enable consumers to choose higher-quality providers, and second, as a result, they force providers to compete to improve their ranking on report cards. Although the consumer choice pathway generally is believed to be the more important of the two because it is consumer choice that motivates change in provider quality,3 few patients actually use quality information to choose their providers.4 For example, fewer than one in four patients who chose a new primary care physician in 2007 used any quality information to make their decision; even fewer used quality information to choose a specialist or a facility for a procedure.5 Indeed, despite the potential of report cards to inform patients and guide them toward high-quality providers, these tools currently are not achieving their intended goals. This failure is partly due to the disconnect between basic principles of quality reporting and patient ideas about health-care quality, limitations in the design of report cards, and competing factors that dominate patient choice.

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