• Cristina Renzi, Federica Asta, Danilo Fusco, Nera Agabiti, Marina Davoli, and Carlo Alberto Perucci.
• Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy.
• Int J Qual Health Care. 2014 Jun 1; 26 (3): 223-30.

ObjectiveTo evaluate whether public reporting of performance data was associated with a change over time in quality indicators for acute myocardial infarction (AMI) in Italian hospitals.DesignPre-post evaluation of AMI indicators in the Lazio region, before and after disclosure of the Regional Outcome Evaluation Program, and a comparative evaluation versus other Italian regions not participating in the program.Setting/Data SourcesNationwide Hospital Information System and vital status records.Participants24 800 patients treated for AMI in Lazio and 39 350 in the other regions.InterventionPublic reporting of the Regional Outcome Evaluation Program in the Lazio region.Main Outcome MeasureRisk-adjusted indicators for AMI.ResultsThe proportion of ST-segment elevation myocardial infarction (STEMI) patients treated with percutaneous coronary interventions (PCI) within 48 h in Lazio changed from 31.3 to 48.7%, before and after public reporting, respectively (relative increase 56%; P < 0.001). In the other regions, the proportion increased from 51.5 to 58.4% (relative increase 13%; P < 0.001). Overall 30-day mortality and 30-day mortality for patients treated with PCI did not improve during the study period. The 30-day mortality for STEMI patients not treated with PCI in Lazio was significantly higher in 2009 (29.0%) versus 2006/07 (24.0%) (P = .002).ConclusionsPublic reporting may have contributed to increasing the proportion of STEMI patients treated with timely PCI. The mortality outcomes should be interpreted with caution. Changes in AMI diagnostic and coding systems should also be considered. Risk-adjusted quality indicators represent a fundamental instrument for monitoring and potentially enhancing quality of care.© The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

21 keywords...

hide…