The Effect of Mandated Quality Reporting on Outcomes and on Reporting: Evidence from Infection Reporting in Pennsylvania
57 Pages Posted: 17 Jul 2010 Last revised: 19 Jan 2014
Date Written: January 17, 2014
We contribute to two literatures. The first involves reputation markets, and whether public reporting of quality measures (here, hospital infection rates) leads to higher quality. The second involves performance reporting, and the impact of reporting rules on reporting. We find evidence of both effects for reporting of central-line associated bloodstream infection (CLABSI) in Pennsylvania.
Our proxy for actual CLABSI rates uses inpatient data, which are not reported and unlikely to be gamed. Inpatient rate trends are similar in Pennsylvania and control states prior to period. During the reporting period, median PA rates drop by 21%, versus 3% in control states. The drop is strongest for hospitals in the top third of reported rates, for whom reporting provides stronger incentives to reduce infections. Publicly reported CLABSI rates fall by far more than inpatient rates. This difference suggests time-inconsistent public reporting and confirms the importance of using non-reported measures to measure the effect of performance reporting on quality.
Keywords: CLABSI, health-care reporting, infection rates, performance measurement
JEL Classification: I18, K32
Suggested Citation: Suggested Citation