How Can We Evaluate and Enhance the Impact of Third-Party Public Reporting on Quality Improvement for Health Care in the Province of Ontario, Canada? Public Deposited

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Last Modified
  • March 20, 2019
Creator
  • Wojtak, Anne
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Abstract
  • Mandated public reporting on health care performance at the level of individual health care institutions and providers has been in place in most Western countries for at least three decades. The capacity to evaluate and report on quality of care is widely regarded as critical for system-wide improvement of health care delivery and patient health outcomes. However, evidence from the literature indicates that evaluation of the effectiveness of public reporting is scant. The purpose of this research is to propose an approach to evaluate the impact of third-party public reporting on improving quality of health care in the province of Ontario, Canada. Canada has a universal health care system and similar to other Canadian provinces, Ontario’s provincial government is responsible for publicly-funded health care. Public reports in Ontario come in various formats and are used for multiple purposes, including for promoting accountability, transparency, quality improvement, consumer choice, and research. The array of uses for public reporting makes it challenging to understand its impact. Starting with the research question ‘How can we evaluate and enhance the impact of third-party public reporting on quality improvement for health care’, the researcher used an explanatory sequential mixed-methods design to assess the current state of public reporting in Ontario and identify opportunities to improve its effectiveness for quality improvement. Through analysis of provincial-level publicly-reported measures, the researcher found that performance results are improving for about one-third of the measures; however, where public reporting is combined with other accountability mechanisms, such as funding agreements or legislation, there is greater indication of improvement and/or sustained improvement over time. The researcher concluded that there is insufficient evidence that public reporting improves health care quality; however, public reporting can be effective when bundled with other improvement mechanisms. The researcher identified a number of opportunities to improve the effectiveness of public reporting in Ontario based on literature evidence and the research findings. The findings may be applicable to Canada as a whole and to other countries that have nationalized health care or any large-scale health system.
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  • In Copyright
Advisor
  • Ricketts, Thomas C.
  • Babich, Suzanne
  • Brown, Adalsteinn
  • Leatherman, Sheila
  • Pink, George
Degree
  • Doctor of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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