Public disclosure of performance data: learning from the US experience

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Abstract
Several factors have caused this situation to change. A societal trend towards greater openness in public affairs has been fuelled by the ready availability of information in many areas of life outside of the health sector. A slow realisation of wide variation in practice standards1, 2 and occasional dramatic public evidence of deficiencies in quality of care3, 4 have led to demands by the public and government for greater openness from healthcare providers. The availability of computerised data and major advances in methods of measuring quality5 have allowed meaningful performance indicators to be developed for public scrutiny. The result has been advocacy for the use of standardised public reports on quality of care as a mechanism for improving quality and reducing costs.6–8