Consumer reports can change how healthcare facilities do business and improve the services they provide, a study published Nov. 19 in the Journal of the American Medical Association said.
The study looked at how hospitals and doctors responded to consumer reports comparing obstetrical services at 90 hospitals in Missouri. In April 1994 the state Department of Health published the Show Me Buyer's Guide: Obstetrical Services, the first of a series of consumer guides.
Daniel Longo, a professor at the University of Missouri who co-wrote the JAMA article, said his study documents "a new era in medicine of increased public accountability. The evidence is mounting that when comparative reports about hospital behavior are published, they are not only read by consumers, they're read by doctors and hospitals. When problems are identified, (providers) make changes -- for better patient outcomes, increasing services and better availability. All that means better value for the consumer. This is not only good business sense, it's also good medicine."
Hospitals with low or average patient quality indicators were more likely to improve. Hospitals with competition nearby were twice as likely to improve their quality indicators as were those in one-hospital towns.
Longo's study found, among other things, that 43% of hospitals that did not require infants to go home in a safety seat subsequently instituted that policy. One-third of hospitals that didn't have nurse educators to advise about breast feeding soon started that service.
The report notes that dissemination of the Buyer's Guide in the popular media "served to highlight deviation from the standard of care, especially in such well-recognized areas as Caesarean deliveries."
The Kansas City Star, for one, ran a lengthy article and chart from the Buyer's Guide on May 21, 1994, comparing quality indicators at 13 local hospitals. The chart showed that North Kansas City Hospital had by far the highest C-section rate, 29.3%.
That prompted North Kansas City Hospital administrators to ask their physicians to alter their practice styles to lower the C-section rate.
The medical staff and the hospital brought in a consultant from Chicago who made some suggestions, and doctors acted on them.
The hospital's C-section rate today is almost half what it used to be, said Nettie Agnew, senior vice president. "Our January to June 1997 C-section rate is 18.3%. In August, we were down to 16.9%. We're very pleased with what our medical staff has been able to accomplish," she said.