The Unintended Consequences of Public Reporting

2020 ◽  
pp. 209-216
Author(s):  
Samer A. M. Nashef
Keyword(s):  
Public Reporting ◽  
Unintended Consequences

Effects of the CMS’ Public Reporting Program for Inpatient Psychiatric Facilities on Targeted and Nontargeted Safety: Differences Between For-Profits and Nonprofits

2021 ◽  
pp. 107755872199892
Author(s):  
Morgan C. Shields
Keyword(s):  
Spillover Effect ◽  
Public Reporting ◽  
Unintended Consequences ◽  
Psychiatric Facility ◽  
Quality Reporting ◽  
Performance Reporting ◽  
Reporting Programs ◽  
Using Data ◽  
Inpatient Psychiatric Facility ◽  
Psychiatric Facilities

The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008-2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.

scholarly journals Lifting the veil on stroke outcomes: revisiting stroke centers’ transparency through public reporting of metrics

2018 ◽  
Vol 10 (9) ◽  
pp. 839-842 ◽  
Author(s):  
Kyle M Fargen ◽  
James L West ◽  
J Mocco
Keyword(s):  
Stroke Care ◽  
Public Reporting ◽  
Unintended Consequences ◽  
Stroke Outcomes ◽  
The Public ◽  
Percutaneous Coronary ◽  
Potential Benefits ◽  
The Veil ◽  
Cardiovascular Interventions ◽  
Outcome Metrics

Public reporting of healthcare metrics provides transparency that allows patients and emergency medical providers to make informed decisions about where patients should receive care. Most previous reports about public reporting of health metrics have demonstrated significant improvements in outcome metrics after implementation. However, no mechanism exists, voluntary or otherwise, for the public reporting of outcomes of stroke care. We review the components of public reporting of health outcomes data and its limited history in stroke outcomes. We summarize the literature on public reporting in cardiovascular interventions, particularly percutaneous coronary interventions, as a close corollary to mechanical neurothrombectomy. The benefits, limitations, and controversies associated with reporting of cardiovascular outcomes are reviewed with a focus on the development of risk-avoidant behaviors. This article serves as a primer for discussion of the potential benefits, limitations, and unintended consequences of public reporting of stroke data.

Strategic colorblindness: The paradox of unintended consequences

2007 ◽  
Author(s):  
Evan P. Apfelbaum ◽  
Samuel R. Sommers ◽  
Michael I. Norton
Keyword(s):  
Unintended Consequences

Aviation and the Microbiome

2020 ◽  
Vol 91 (8) ◽  
pp. 651-661
Author(s):  
Joshua T. Davis ◽  
Hilary A. Uyhelji
Keyword(s):  
Psychological Health ◽  
Aviation Safety ◽  
Autism Spectrum ◽  
Unintended Consequences ◽  
Microbial Colonization ◽  
Future Research ◽  
Aerospace Medicine ◽  
Medical Certification ◽  
Physical Disorders ◽  
The Impact

INTRODUCTION: Although the impact of microorganisms on their hosts has been investigated for decades, recent technological advances have permitted high-throughput studies of the collective microbial genomes colonizing a host or habitat, also known as the microbiome. This literature review presents an overview of microbiome research, with an emphasis on topics that have the potential for future applications to aviation safety. In humans, research is beginning to suggest relationships of the microbiome with physical disorders, including type 1 and type 2 diabetes mellitus, cardiovascular disease, and respiratory disease. The microbiome also has been associated with psychological health, including depression, anxiety, and the social complications that arise in autism spectrum disorders. Pharmaceuticals can alter microbiome diversity, and may lead to unintended consequences both short and long-term. As research strengthens understanding of the connections between the microbiota and human health, several potential applications for aerospace medicine and aviation safety emerge. For example, information derived from tests of the microbiota has potential future relevance for medical certification of pilots, accident investigation, and evaluation of fitness for duty in aerospace operations. Moreover, air travel may impact the microbiome of passengers and crew, including potential impacts on the spread of disease nationally and internationally. Construction, maintenance, and cleaning regimens that consider the potential for microbial colonization in airports and cabin environments may promote the health of travelers. Altogether, the mounting knowledge of microbiome effects on health presents several opportunities for future research into how and whether microbiome-based insights could be used to improve aviation safety.Davis JT, Uyhelji HA. Aviation and the microbiome. Aerosp Med Hum Perform. 2020; 91(8):651–661.

A Donor Influenced by Local Dynamics

2016 ◽  
Vol 2 (1) ◽  
pp. 51-69 ◽  
Author(s):  
Setsuko Matsuzawa
Keyword(s):  
Poverty Alleviation ◽  
Rural Poverty ◽  
Unintended Consequences ◽  
Local Dynamics ◽  
Grant Program ◽  
Local Actors ◽  
Research Interviews ◽  
National Model ◽  
Management Project ◽  
Development Discourses

This article explores the relations between a foreign aid donor and local actors in the context of the dissemination of development discourses and practices in an authoritarian context. It addresses the question “To what extent may the local dynamics alter the original goals of a donor and lead to unintended consequences?” Based on archival research, interviews, and secondary literature, this case study examines the Yunnan Uplands Management Project (YUM) in 1990–95, the Ford Foundation's first grant program on rural poverty alleviation in China. While the Foundation did not attain its main goal of making YUM a national model for poverty alleviation, the local actors were able to use YUM to develop individual capacities and to build roles for themselves as development actors in the form of associations and nongovernmental organizations, resulting in further support from the Foundation. The study contributes to our understanding of donor-local actor dynamics by highlighting the gaps between the original goals of a donor and the perspectives and motivations of local actors. The study suggests that local dynamics may influence the goals of donors and the ways they seek to disseminate development discourses and practices to local actors, despite the common conception of donors as hegemonic or culturally imperialistic.

Public Reporting of Cardiovascular Data: Benefits, Pitfalls, and Vision for the Future

2016 ◽  
Vol 10 (1) ◽  
pp. 36
Author(s):  
Gregory J Dehmer ◽  
Keyword(s):  
Clinical Data ◽  
Clinical Status ◽  
Public Reporting ◽  
Professional Organizations ◽  
Healthcare Data ◽  
Outcomes Of Care ◽  
The Future ◽  
Policy Statements ◽  
Quality And Outcomes ◽  
Reporting Programs

Public reporting of healthcare data is not a new concept. This initiative continues to proliferate as consumers and other stakeholders seek information on the quality and outcomes of care. Furthermore, mandates for the development of additional public reporting efforts are included in several new healthcare legislations such as the Affordable Care Act. Many current reporting programs rely heavily on administrative data as a surrogate for true clinical data, but this approach has well-defined limitations. Clinical data are traditionally more difficult and costly to collect, but more accurately reflect the clinical status of the patient, thus enhancing validity of the quality metrics and the reporting program. Several professional organizations have published policy statements articulating the main principles that should establish the foundation for public reporting programs in the future.

Sign in / Sign up

Export Citation Format

Share Document