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Some studies show that care providers tend to improve their care performance when that performance is reported to the public in "report cards." But we don't know whether care performance information is directly useful to purchasers or consumers who are making decisions about providers and health plans. Carolyn M. Clancy, M.D., Director of AHRQ, addresses this topic in an editorial that appears in the December 2004 issue of Health Services Research.
Dr. Clancy points to the lack of reliable measures for many clinical domains (for example, mental health and maternal and child health) and our inability to predict how a provider's performance in one clinical area is related to performance in other areas. Indeed, a common complaint of clinicians is that what is measurable isn't always what's most important. Also, what's important to clinicians isn't always what's important to patients or employers. For example, few studies have examined the relationship between health outcomes and lost time from work.
Collaboration within the health care research community can speed the move from information about quality to quality information for decisionmaking, according to Dr. Clancy. For example, one study of the impact of use of highly active antiretroviral therapy (HAART) on a nationally representative sample of adults with HIV showed that HAART increased the probability of their remaining employed and the number of hours worked within 6 months of treatment. Resulting increases in income compared favorably with the cost of treatment.
This kind of information is relevant to both employers and individuals. Another study examined the impact of diabetes on adults' workforce participation as they made the transition from active work to retirement over an 8-year period. It revealed an estimated $60 billion in lost productivity associated with diabetes. A third study examined the impact of grandparents' caregiving for grandchildren on their own depressive symptoms. The period that one or more grandchildren resided with the grandparent corresponded with a significant increase in the grandparent's depressive symptoms.
See "From information on quality to quality information," by Dr. Clancy, in the December 2004 Health Services Research 39(6), Part I, pp. 1631-1634. Reprints (AHRQ Publication No. 05-R023) are available from the AHRQ Publications Clearinghouse.
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