1. Quality Reporting and
Consumer Choice
By Olivia S. Jung
Mentor: Jonathan Kolstad, Ph.D
August 11, 2011

2. Background Study Aim Method Finding Takeaways
2
One purpose of quality reporting is to solve the
problem of information asymmetry.
 Health care report cards publicly report information about physicians,
hospital, and health plan quality.
 Quality information can:
 (1) improve quality of health care organizations.
 (2) motivate consumer participation by enabling them to make
informed choices.
 Thus, public reporting can be used to stimulate transparency and
accountability.
 The Patient Protection Affordability and Care Act even has a specific
provision for quality reporting, mandating disclosure of information of
hospitals and physicians on a website.

3. Background Study Aim Method Finding Takeaways
3
This study aims to determine whether consumers use
quality information and if so, to what magnitude.
Does public reporting
impact consumer
choice?
Despite all efforts, however,
public reporting has not been
shown to be conclusively
effective in aiding patients to
choose their health care provider.
If yes, by how much?

4. Background Study Aim Method Finding Takeaways
4
This study aims to determine whether consumers use
quality information and if so, to what magnitude.
Questions to be
addressed in this study
Does public reporting
impact consumer
choice?
Despite all efforts, however,
public reporting has not been
shown to be conclusively
effective in aiding patients to
choose their health care provider.
If yes, by how much?

5. Background Study Aim Method Finding Takeaways
5
This study employed systematic review of literature
using Google Scholar and PubMed.
 Keywords:
 Quality reporting and consumer choice
 Quality information and choice
 Review only the papers that have
been published in or after 2000.
 Determine: empirical
methodology, finding, magnitude,
shortcoming

6. Background Study Aim Method Finding Takeaways
6
Twenty-four articles were reviewed.

7. Background Study Aim Method Finding Takeaways
7
Summary of finding
58% Quality reports do significantly influence patients’ choice.
11/19
26%
Quality reports do not significantly influence patients’ choice.
5/19
16% Quality reports sometimes do or do not influence patients’ choice.
3/19
***
To reach their finding, papers used one of the two methods:
 Observe change in behavior after introducing quality reports
 Setup models to see if one movement in quality leads to a change of
magnitude in consumes' behavior

8. Background Study Aim Method Finding Takeaways
8
More than 1 in 10 patients (but not more than 1 in 5)
use quality reports to make their decision.

9. Background Study Aim Method Finding Takeaways
9
An increase in quality measure leads to an increase in
choice.
 Because each paper uses a different measure, it's hard to conclude exactly
by how much an increase in quality measure leads to an increase in choice.
 An incremental increase in quality does seem to be related to the
incremental increase in choice (i.e. as quality rating goes up, choice goes
up).

10. Background Study Aim Method Finding Takeaways
10
The magnitude of impact is greater in health care
than in education (1 in 20).

11. Background Study Aim Method Finding Takeaways
11
Limitations with experiments that concern differences in
time (i.e. testing the before and after effects)
• something else could have
Exogenous
influenced patients about the
influence hospital or plan
• Ex) surgeons at poorly performing
Supply-side
hospitals simply choosing to do
factors fewer procedures
These limitations need to be considered because they could invalidate the
results if true.

12. Background Study Aim Method Finding Takeaways
12
SO, does quality reporting impact consumer choice?
If so, by how much?
Quality Has the Are we better
reporting does About 10-20% problem of off as society
impact of patients information because of
consumer respond. asymmetry quality
choice. been solved? reporting?

13. Background Study Aim Method Finding Takeaways
13
SO, does quality reporting impact consumer choice?
If so, by how much?
Quality Has the Are we better
reporting does About 10-20% problem of off as society
impact of patients information because of
consumer respond. asymmetry quality
choice. been solved? reporting?

14. Background Study Aim Method Finding Takeaways
14
SO, does quality reporting impact consumer choice?
If so, by how much?
Quality Has the Are we better
reporting does About 10-20% problem of off as society
impact of patients information because of
consumer respond. asymmetry quality
choice. been solved? reporting?

15. Background Study Aim Method Finding Takeaways
15
SO, does quality reporting impact consumer choice?
If so, by how much?
Quality Has the Are we better
reporting does About 10-20% problem of off as society
impact of patients information because of
consumer respond. asymmetry quality
choice. been solved? reporting?

16. 16

17. Background Study Aim Method Finding Takeaways
17
Lessons Learned
 Finding scholarly articles using PubMed (app on Droid) and
Google Scholar
 Reading scholarly literature
 Need to learn more economic theories/models!
 “What has all of this literature review made you think about?
Do you think quality reporting has solved the problem of
information asymmetry?”
 Research = more than reading and writing literature = more like a
lifelong consulting/problem-solving project

18. Background Study Aim Method Finding Takeaways
18
THANK YOU
Joanne Levy
Prof. Jonathan Kolstad
SUMR Staff: Lissy, Megan, Hoag, and Renee
SUMR Scholars!
Leonard Davis Institute