Regístrese
covid
Revista de Calidad Asistencial
Suscríbase a esta revista
Buscar en
Revista de Calidad Asistencial
Toda la web
Inicio Revista de Calidad Asistencial Difusión de resultados asistenciales: ventajas e inconvenientes de los report c...
Información de la revista
Artículo anterior | Artículo siguiente
Vol. 18. Núm. 4.
Páginas 209-224 (enero 2003)
Exportar referencia
Compartir
Compartir
Imprimir
Descargar PDF
Más opciones de artículo
Estadísticas
Vol. 18. Núm. 4.
Páginas 209-224 (enero 2003)
DOI: 10.1016/S1134-282X(03)77606-4
Acceso a texto completo
Difusión de resultados asistenciales: ventajas e inconvenientes de los report cards
Visitas
4054
Descargar PDF
José Joaquín Miraa,1
Autor para correspondencia
jose.mira@umh.es

Correspondencia: José Joaquín Mira. Universidad Miguel Hernández de Elche. Avda. del Ferrocarril, s/n. 03202 Elche. Alicante. España
, Susana Lorenzob, Alicia Martínez-Sanza
a Universidad Miguel Hernández. Elche
b Instituto de Investigación Fundación Hospital Alcorcón. Madrid. España
Este artículo ha recibido
4054 Visitas
Información del artículo
Estadísticas
Resumen
Contexto

Las políticas de difusión de resultados asistenciales buscan incrementar la calidad asistencial y la satisfacción de los pacientes. Los report cards son utilizados para que los pacientes comparen los resultados de varios centros y elijan entre ellos.

Objetivo

Revisar los resultados de las investigaciones para conocer las ventajas y desventajas de los report cards desde el punto de vista de los pacientes.

Método

Revisión bibliográfica en las bases de datos Medline, Índice Médico Español y revistas especializadas, entre mayo de 1996 y de 2002. Las palabras clave utilizadas fueron: patients, consumers, hospitals, managed care, decision making, outcomes, outcome assessment, compare plans, health plans y report, información al paciente, hospital, elección hospitalaria y resultados. Fueron excluidos los artículos sobre métodos para apoyar la elección de tratamiento médico y sobre cómo realizar “ajustes de riesgo” o calcular índices de mortalidad; y aquellos en idiomas diferentes al inglés o al español.

Resultados

Se han revisado 40 artículos. Aproximadamente un 12,5% examina las razones por las que los report cards son poco utilizados por los pacientes; el 27,5% analiza cómo utilizan los pacientes la información y qué información es más útil y cómo debe presentarse; un 12,5% describe los beneficios y un 15% muestra los inconvenientes; mientras que un 25% plantea la necesidad de personalizar la información en función del receptor.

Discusión

A la vista de los estudios publicados, parece que para que los report cards resulten útiles a los pacientes deben ofrecer pocos datos, centrados en los resultados, pertinentes y fiables, e incluir información relevante para los pacientes. El formato en que se presenta la información afecta en gran medida a su grado de comprensión y determina su utilidad.

Palabras clave:
Evaluación por los pacientes
Difusión de resultados
Medida de calidad asistencial
Report cards
Abstract
Background

Policies of public accountability seek to improve quality of care and patient satisfaction. Report cards are used so that patients can compare the results of different centers and choose among them.

Objective

To review the results of investigations into the advantages and disadvantages of report cards from the point of view of patients.

Method

We performed a search of articles published from May 1996 to May 2002 in Medline, Índice Médico Español and specialized journals. The key words used were: patients, consumers, hospitals, managed care, decision making, outcomes, outcome assessment, compare plans, health plans and report; información al paciente, hospital, elección hospitalaria y resultados. Exclusion criteria were: articles on methods to support the choice of medical treatment and those on how to perform risk adjustment or calculate mortality rates as well as those written in languages other than English or Spanish.

Results

Forty articles were reviewed. Approximately 12.5% examine the reasons why report cards are little used by patients; 27.5% analyze how patients use information, which information is most useful, and how it should be presented; 12.5% describe the advantages of report cards and 15% describe their disadvantages, while 25% describe the need to personalize the information according to the recipient.

Discussion

In view of the studies published, it seems that for report cards to be useful to patients, they should provide a small amount of relevant and reliable data that is focussed on outcomes and should include information relevant to patients. The format in which the information is presented strongly influences patient comprehension and the cards’ utility.

Key words:
Consumer evaluation
Public accountability
Quality of care measurement
Report cards
El Texto completo está disponible en PDF
Bibliografía
[1.]
J.J. Mira, J.A. Buil, S. Lorenzo, E. Sitges, J. Aranaz.
Márketing de servicios en la organización sanitaria: Una herramienta para la mejora de la calidad de la asistencia.
Cir Esp, 67 (2000), pp. 180-183
[2.]
J.P. Kassier.
Incorporating patients’ preferences into medical decisions.
N Engl J Med, 330 (1994), pp. 1895-1896
http://dx.doi.org/10.1056/NEJM199406303302611 | Medline
[3.]
J.J. Mira, J. Rodríguez-Marín.
Análisis de las condiciones en las que los pacientes toman decisiones responsables.
Med Clin (Barc), 116 (2001), pp. 104-110
[4.]
M.N. Marshall, J. Hisock, B. Sibbaud.
Attitudes to the public release of comparative information on the quality of general practice care: qualitative study.
BMJ, 325 (2002), pp. 1278-1283
[5.]
S. Nutley, P. Smith.
League tables for performance improvement in health care.
J Health Serv Res Policy, 3 (1998), pp. 50-57
Medline
[6.]
DC: US Dept of Health an Human Servicies, (1987),
[7.]
E.K. Wicks, J.A. Meyer.
Making report cards work.
Health Affairs, 18 (1999), pp. 152-155
Medline
[8.]
J.E. Fielding, C.E. Sutherland, N. Halfon.
Comunity health report cards.
Am J Preventive Med, 17 (1999), pp. 7986
[9.]
H.T.O. Davies.
Public release of performance data and quality improvement: internal responses to external data by US health care providers.
Quality Health Care, 10 (2001), pp. 104-110
[10.]
J.W. Thompson, J. Bost, F. Ahmed, C.E. Ingalls, C. Sennet.
The NCQA quality compass: evaluating managed care in the United Estates.
Health Affairs, 17 (1998), pp. 152-158
Medline
[11.]
J.B. Fowles, E.A. Kind, B.L. Braun, D.J. Knutson.
Consumers responses to health plan report cards in two markets.
Med Care, 38 (2000), pp. 469-481
Medline
[12.]
M.N. Marshall, P. Shekekke, S. Leatherman, R.H. Brook.
What do we expect to gain from the public release of performance data?.
A review of the evidence. JAMA, 283 (2000), pp. 1866-1874
[13.]
S. O’Malley.
Report cards: how relevant are they for patients?.
The Quality Letter, (1997), pp. 12-15
[14.]
J.H. Hibbard, J.J. Jewett.
What type or quality information do consumers want in a health care report cards?.
Med Care, 53 (1996), pp. 28-47
[15.]
J.H. Hibbard, J.J. Jewet.
Will quality report cards help consumers?.
Health Affairs, 16 (1997), pp. 218-228
Medline
[16.]
J.H. Hibbard.
Use outcomes data by purchases and consumers: new strategies and new dilemmas.
Internacional J Quality Health Care, 10 (1998), pp. 503-508
[17.]
M. Hochhauser.
Why patients have little patience for report cards.
Managed Care, (1998), pp. 34-41
[18.]
S. Edhman-Levitan, P.D. Cleary.
What information do consumers want and need?.
Health Affairs, 15 (1996), pp. 41-56
[19.]
J.H. Hibbard.
Choosing health plan: do large employers use the data?.
Health Affairs, 16 (1997), pp. 172-180
Medline
[20.]
Davies H.T.O
[21.]
J.H. Hibbard, L. Harris-Jojetin, J.L. Mullin, Garfinkel.
Increasing the impact on health plan report cards by addressing consumers ´concerns.
Health Affairs, 19 (2000), pp. 138-143
Medline
[22.]
J.H. Hibbard, P. Slovic, E. Peters, M.L. Finucane.
Strategies for reporting health plan performance information to consumers: evi- dence from controlled studies.
Health Services Res, 37 (2002), pp. 291-313
[23.]
C.I. Ireson, M.A. Ford, J. Hower, R.W. Schwatz.
Outcome report cards.
Arch Surg, 137 (2002), pp. 46-51
Medline
[24.]
H.T.O. Davies, K. Crombie.
Interpreting health outcomes.
J Evaluation Clin Pract, 3 (1997), pp. 187-199
[25.]
J.A. Rainwater, P.S. Romano, D.M. Antonius.
The California Hospital Outcomes Proyect: How Useful Is California’s Report Card for Quality Improvement.
J Quality Improv, 24 (1998), pp. 31-39
[26.]
T.P. Hofer, R.A. Hayward, S. Greenfield, E.H. Wagner, S.H. Kaplan, W.G. Manning.
The unreliability of individual physician “report cards” for assessing the costs and quality of care of a chronic disease.
JAMA, 281 (1999), pp. 2098-2105
Medline
[27.]
H.T.O. Davies, A.E. Washington, A.B. Bindman.
Health care report cards: implications for vulnerable patient groups and the organizations Providing them care.
J Health Polit Policy Law, 27 (2002), pp. 379-399
Medline
[28.]
M.D. Josephson, A.W. Agger, C.L. Bennett, M. Ullman, P.M. Arnow.
Performance measurement in neumonia care: beyond report cards.
Mayo Clin Proc, 73 (1998), pp. 5-9
http://dx.doi.org/10.1016/S0025-6196(11)63612-4 | Medline
[29.]
R.M. Poses, J.A. Berlin, H. Noveck, V.A. Lawrence, R.K. Spence, A. Duff.
How you look determines what you find: seven of illness and variation in blood transfusion for hip fracture.
Am J Med, 105 (1998), pp. 198-206
Medline
[30.]
J. Chen, M.J. Radford, Y. Wang, T.A. Marciniak, H.M. Krumholz.
Performance of the “100 top hospitals”: what does the report card report?.
Health Affairs, 18 (1999), pp. 53-68
Medline
[31.]
J.B. Saaddine, M.M. Engelgau, G. Beckles, E. Gregg, T.J. Thompson, K.M. Venkat.
A diabetes report card for the United States: quality of care in the 1990s.
An Intern Med, 136 (2002), pp. 565-574
[32.]
A.M. Epstein.
Roling down the runway.
The challenges ahead for quality reports cards. JAMA, 279 (1998), pp. 1691-1696
[33.]
P.E. Dans.
Caveat doctor: how to analyze claims-based report cards.
J Qual Improv, 24 (1998), pp. 21-30
[34.]
S. Peiró, S. Lorenzo.
La difusión a los ciudadanos de los resultados de la asistencia sanitaria.
Rev Calidad Asistencial, 15 (2000), pp. 391-393
[35.]
A. Sainz, C. Humet.
Jornada INSALUD-Sociedad Española de Calidad Asistencial 2000.
Rev Calidad Asistencial, 15 (2000), pp. 448-451
[36.]
J.G. Kaplan, J.C. Bauers, S. Beloff, W.N. Tidall.
Managed care report cards: evaluating tose who evaluate physician.
Managed Care Interface, (2000), pp. 88-94
[37.]
R. Sokorin.
Alternative explanations for poor report card performance.
Eff Clin Pract, 3 (2000), pp. 25-30
Medline
[38.]
M.R. Chassin, E.L. Hannan, B.A. DeBuono.
Benefits and hazards of reporting medical outcomes publicly.
N Engl J Med, 334 (1996), pp. 394-398
http://dx.doi.org/10.1056/NEJM199602083340611 | Medline
[39.]
J. Greene, N. Wintfield.
Report cards on cardiac surgeons: assessing New York State’s approach.
N Engl J Med, 332 (1996), pp. 1229-1232
http://dx.doi.org/10.1056/NEJM199505043321812 | Medline
[40.]
E.A. McGlynn.
The outcomes utility index: will outcomes data tell us what we want to know?.
Int J Qual Health Care, 10 (1998), pp. 485-490
Medline
[41.]
J.V. Tu, M.J. Schull, L.E. Ferris, J.E. Hux, D.A. Redelmeter.
Problems for clinical judgement: 4. Surviving in the report cards era.
CMAJ, 164 (2001), pp. 1709-1712
Medline
[42.]
D.B. Mukamel, A.I. Mushlin.
Quality of care information makes a difference An analysis of market share and price changes after publication of the New York State Cardiac Sugery Mortality Reports.
Med Care, 36 (1997), pp. 945-954
Medline
[43.]
S.L. Isaac.
Consumers’ information needs: results of a National Survey.
Health Affairs, 15 (1996), pp. 31-41
Medline
[44.]
S. Edgman, P.D. Cleary.
What information do consumers want and need?.
Health Affairs, 15 (1996), pp. 42-56
Medline
[45.]
C. Solodky, H. Chen, P. Jones, W. Katcher, D. Neuhauser.
Patients as partners in clinical research.
Med Care, 36 (1998), pp. AS13-AS20
Medline
[46.]
D.R. Nerena.
Using outcomes data to compare plans., networks., and providers: what is he state or the art?.
Int J Qual Health Care, 10 (1998), pp. 463-465
Medline
[47.]
D. Lansky.
Measuring what matters to the public.
Health Aff (Millwood), 17 (1998), pp. 40-41
[48.]
C.S. Kim, R.J. Kristopaitis, E. Stone, M. Pelter, M. Sandu, S.R. Weingarten.
Physician education and report cards: do the make the grade? Results from a randomised controlled trial.
Am J Med, 107 (1999), pp. 556-560
Medline
[49.]
H.T.O. Davies, A.E. Washington, A.B. Bindman.
Health care report cards: implications for vulnerable patient groups and the organizations providing them care.
J Health Polit Policy Law, 27 (2002), pp. 379-399
Medline
[50.]
R. Thompson, A. Bowling, F. Moss.
Engagiong patients in decisions: a challenge to health care delivery abnd public health.
Qual Health Care, 10 (2001), pp. i1
Medline
[51.]
M.J. Crawford, D. Rutter, C. Manley, T. Weaver, K. Bhui, N. Fulop.
Systematic review of involving patients in the planning and development of health care.
BMJ, 325 (2002), pp. 1263-1268
Medline
[52.]
R. Meneu.
Top be or not top be.
Rev Calidad Asistencial, 16 (2001), pp. 83-85
[53.]
L. García-Eroles, C. Illa, A. Arias, M. Casas.
Los top 20 2000: objetivos., ventajas y limitaciones del método.
Rev Calidad Asistencial, 16 (2001), pp. 107-118
[54.]
S. Peiró.
Los mejores hospitales. Entre la necesidad de información comparativa y la confusión.
Rev Calidad Asistencial, 16 (2001), pp. 119-130
[55.]
L. Levknecht, J. Schriefer, J. Schriefer, B. Maconis.
Combining case management., pathways., and report cards for secondary cardiac prevention.
J Qual Improv, 23 (1997), pp. 162-174
[56.]
E. Peterson, E. DeLong, L. Muhlbaier, A. Rosen, H. Buell, C. Kiefe.
Challenges in comparing risk-adjusted bypass surgery mortality results.
J Am Coll Cardiol, 36 (2000), pp. 2174-2184
Medline
[57.]
L. Lezzoni.
The risks of risk adjustment.
JAMA, 19 (1997), pp. 1600-1607
[58.]
E.C. Schneider, T. Leiberman.
Publicly disclosed information about the quality of health care: response of the US public.
Qual Health Care, 10 (2001), pp. 96-103
Medline
[59.]
E.C. Schneider, A.M. Epstein.
Use of the public performance reports.
JAMA, 279 (1998), pp. 1238-1242
[60.]
D.B. Mukamel, A.L. Mushin.
Quality care information makes a difference. An analysis of market share and price changes after publication of the New York State cardiac surgery mortality reports.
Med Care, 36 (1998), pp. 945-954
Medline
Copyright © 2003. Sociedad Española de Calidad Asistencial

Suscríbase a la newsletter

Historial de la publicación
Continuada como Journal of Healthcare Quality Research
Journal of Healthcare Quality Research/></div></a> </div> </div> </div><div id=
Herramientas
Revista de Calidad Asistencial se adhiere a los principios y procedimientos dictados por el Committee on Publication Ethics (COPE)
www.publicationethics.org.
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos