Public reporting: Has transparency improved outcomes

The purpose of this research was to examine the association between the public reporting of heart failure process measures for South Carolina hospitals and improvements in patient outcomes as evidence by readmission and mortality metrics. During the four-year study period, 2009-2012, South Carolina hospitals' adherence to evidence-based process measures for the treatment of heart failure improved by 4.7%. Improvement was also noted in three of four outcome measurements. There was a 37% reduction in the outcome measure inpatient mortality (death prior to discharge) and a 17% reduction in the outcome measure inpatient mortality index (observed over expected death ratio). The post discharge outcome measure 30-day readmission rate also improved, decreasing by 5.6%. The only outcome measure that did not improve over the study period was 30-day mortality rate, which increased by 7.1%. Although three of the outcome measures did improve over the study period, these improvements could not be correlated statistically with improvements in process measures; therefore, the improvements in outcome measures were most likely the result of a combination of performance improvement efforts within the facilities and not changes in process measures.