Monday, June 6, 2011

[EQ] How health systems make available information on service providers - Experience in seven countries

How health systems make available information on service providers
- Experience in seven countries

Mirella Cacace, Stefanie Ettelt, Laura Brereton, Janice Pedersen, Ellen Nolte
RAND and London School of Hygiene and Tropical Medicine – 2011

Available online PDF [112p.] at:

“…..There is growing interest in the public release of information on the performance of healthcare providers as a means to improve the quality of care and promote transparency and accountability. Countries have made considerable investments in creating systems to make available such information.

However, there is lack of systematic comparative assessment of such systems. Thus, there is a need to better understand the drivers behind and leaders of initiatives and their aims and objectives; the nature, frequency and source of information provided; their availability to and usability by the public, and, finally, whether and how these systems might have an impact on the quality of care.


This report aims to contribute to filling these gaps by reviewing information systems reporting on the quality or performance of providers of healthcare (‘quality information systems’) in seven countries: Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States.


Data collection involved a review of the published and grey literature, complemented by information provided by key informants in the selected countries using a detailed questionnaire.

The review highlights that as the policy context for quality reporting in countries varies, so also does the nature and scope of quality information systems within and between countries. Systems often pursue multiple aims and objectives, which typically are:

• to support patient choice

• to influence provider behaviour to enhance the quality of care

• to strengthen transparency of the provider–commissioner relationship and the healthcare system as a whole

• to hold healthcare providers and commissioners to account for the quality of care they provide and the purchasing decisions they make…..”



Executive summary

CHAPTER 1 Introduction

1.1 Background

1.2 Public reporting and quality improvement

1.3 Methodology

1.3.1 Conceptualising ‘quality information systems’

1.3.2 Selection of countries

1.3.3 Data collection

1.4 This report

CHAPTER 2 Overview of findings

2.1 Institutional and policy context of quality information systems

2.2 Quality information systems available to patients

2.3 Quality information aimed at commissioners, regulators and healthcare providers

2.4 Data and indicators used by quality information systems

2.5 Evidence of the use of quality information systems

2.6 Impact of information systems on provider quality

2.7 Considerations for the design of quality information systems

CHAPTER 3 Denmark

CHAPTER 4 England

CHAPTER 5 Germany


CHAPTER 7 The Netherlands

CHAPTER 8 Sweden

CHAPTER 9 United States



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