| People: Insurance plan beneficiaries, birthing mothers, GPs Settings (countries and clinical settings): United States, Canada, South Korea, Netherlands, China / Community, primary care and hospitals Intervention: Public release of performance data Comparison: No public reporting |
| Changes in healthcare utilisation by consumers | Public release of performance data may make little or no difference to long‐term healthcare utilisation by consumers. However, two studies (one cNRT and one ITS) found that some population subgroups might be influenced by public release of performance data. | 18,294 insurance plan beneficiariesa (3: 1 cRT, 1 cNRT, 1 ITS) | ⊕⊕⊝⊝
low |
| Changes in healthcare decisions taken by healthcare providers (professionals and organisations) | Public release of performance data may make little or no difference to decisions taken by healthcare professionals. Two studies (2 cRTs) found that some decisions might be affected by public release of performance data. One study (ITS) found that decisions might be influenced by the initial release of data, but that subsequent releases might have less impact. | 3,000,000 birthsb and 67 healthcare providers (4: 2 RTs, 2 ITS) | ⊕⊕⊝⊝
lowc |
| Changes in the healthcare utilisation decisions of purchasers | No studies reported this outcome. | ‐ | ‐ |
| Changes in provider performance | Public release of performance data may make little or no difference to objective measures of provider performance. | 82 healthcare providers (1 cRT) | ⊕⊕⊝⊝
lowd |
| Changes in patient outcome | Public release of performance data may slightly improve patient outcomes. | 315,092 hospitalisations and 7503 healthcare providers (5: 1 RT, 3 ITS, 1 CBA) | ⊕⊕⊝⊝
lowe |
| Adverse effects | No studies reported this outcome. | ‐ | ‐ |
| Impact on equity | Public release of performance data may have a greater effect on provider choice among advantaged populations. | Unknown (1 ITS) | ⊕⊕⊝⊝
low |
| EPOC adapted statements for GRADE Working Group grades of evidence
High‐certainty. This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different† is low.
Moderate‐certainty. This research provides a good indication of the likely effect. The likelihood that the effect will be substantially different† is moderate.
Low‐certainty. This research provides some indication of the likely effect. However, the likelihood that it will be substantially different† is high.
Very low‐certainty. This research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially different† is very high. † Substantially different = a large enough difference that it might affect a decision |
| a Number was based only on Farley 2002a and Farley 2002b studies, as the total number of cases analysed in Romano 2004 was unclear b Number of participants in Jang 2011 (3,000,000) estimated from data presented in Chung 2014 c Downgraded one level for inconsistency as effect shown by Zhang 2016, but not IkkersheJang 2011, Ikkersheim 2013, or Flett 201511 d Downgraded two levels for risk of bias, as there was attrition of participating hospitals, evidence of contamination of the intervention across intervention and control hospitals, and blinding was not possible given the nature of the intervention e Downgraded two levels for inconsistency, as there was marked disagreement between studies, with two showing improvements in patient outcome (LiuTu 2009; Liu 20179), and three showing no such improvements (DeVoRinke 2015; DeVore 2016; Joynt 201615) |
