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Commentary: public disclosure in the health field: is there a relevant option?

Steadily increasing numbers of private, not-for-profit, and public agencies are releasing quality of care and financial information to enhance the market power of those purchasing America's health services. These sources range widely from the Health Plan Employer Data and Information Set (HEDIS) to the federal Securities and Exchange Commission (SEC). A growing interest in publicly disclosing performance information that concerns providers, as recently recommended by the Institute of Medicine (IOM) report on patient safety, until now has only achieved a modest impact. A major exception is in those metropolitan areas where acute-care facilities experience intense competition for patient admissions. Although the comparative quality and cost information currently available is for the most part in the public interest, it is concluded that, in the foreseeable future, these report cards as now structured will not result in any significant enhancement in access, improvement in quality, or reduction in cost. Options to encourage more public disclosure explored in this paper are Congress potentially passing legislation (a) to establish a Center for Patient Safety within the US Department of Health and Human Services as recommended by the recent Institute of IOM study, or (b) empowering the SEC beyond its current mandate to collect and disseminate all pertinent quality of care and cost information on every provider in the United States. The latter alternative would include user-friendly, comparative analyses to be provided on the Internet and elsewhere and would make readily available information from HEDIS, the Joint Commission on the Accreditation of Healthcare Organization (JCAHO), coronary artery bypass graft (CABG) surgery studies, cost comparisons based on Medicare cost reports and SEC filings, and other similar sources.

Consumer Advocacy↗
PubMed1993

Update: TB regulations from California.

As might be expected, the California Occupational Safety and Health Administration (Cal OSHA) has taken the lead in issuing regulations to protect healthcare workers from occupational TB infection. CHEM believes the Cal OSHA regulations will provide a template for the general shape of regulations that will be issued by other states and federal OSHA. Therefore, the regulations are printed here in full, along with the resolution of the California State Assembly that empowered Cal OSHA to issue the regulations. Some references to other sections of the California Code of Regulations have been deleted. CHEM's comments are at the end.

California↗