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Abstract

Objectives
To evaluate the impact of high profile public reporting on utilisation and perceived quality of maternity services in England.

Methods
Analysis of national hospital administrative data using difference in difference models with propensity score matching and analysis of two maternity surveys from 2007 and 2010. Outcomes were counts of women admitted for delivery of a baby and the percentage of women rating their care positively in 2007 and 2010.

Results
Hospitals publicised as providing the best maternity care in England had fewer admissions annually and lower occupancy rates (63.0% vs. 77.3%; p=0.09) than the national comparison group. Hospitals publicised as providing the worst maternity care were predominantly in the greater London area, with more women aged 15-34 years in their catchment areas than the national comparison group. There was no statistically significant change in overall maternity admissions in the best hospitals (+ 2.2%, p=0.40 at six months), or the worst hospitals (- 2.8%, p=0.49 at six months) during any period in the thirty-six months after public reporting relative to baseline. Compared to the national comparison group the worst rated hospitals experienced greater improvements in perceived quality after public reporting but these findings were not maintained in the matched analysis.

Conclusions
High profile public reporting of maternity care in England was not associated with changes in the utilisation of maternity services or improvements in patient reported quality. These findings provide further evidence that public reporting is unlikely to drive major improvements in health system performance through the mechanism of patient choice.

Publication Type:	Article
Additional Information:	Copyright Sage 2015.
Publisher Keywords:	health policy, patient choice, public reporting
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics
Departments:	School of Health & Psychological Sciences
SWORD Depositor:	Symplectic Administrator

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