Public reporting in healthcare

Presentation approaches of comparative healthcare information on the Internet differ widely between countries, according to a publication of researchers of NIVEL (Netherlands institute for health services research) in the Journal of Medical Internet Research.

NIVEL reviewed 42 websites from 10 different countries that publish comparative healthcare information. The general conclusion is that the sites use a wide variety of presentation approaches. In particular, websites use different symbols and bar charts, and different drill down paths. There is no standard approach for presenting different types of information to consumers either. The researchers distinguished three information types: 1) information about healthcare providers and their services; 2) quality information based on performance indicators; and 3) quality information based on healthcare user experiences. On some websites the different types of information are not integrated at all, while on other websites all types of information are presented in one table.

Although many different presentation formats have been found, some standard elements emerged as well. Most websites use tabular formats presenting providers in rows and indicators in columns. In addition, websites often provide options to select a subset of healthcare providers based on, for example, region or specific diseases. Information on websites is generally presented hierarchically. It starts with an overview to get an overall sense of performance of each provider and then provide options to get more detailed information. This is necessary to deal with the large amount of healthcare information that is available.

The number of websites providing public reports on healthcare performance will most likely increase in the near future, given the developments in many health systems to more regulated competition. In addition, existing websites offer information about more different healthcare sectors. Given this rapidly growing movement, it is necessary to reflect on the presentation approaches used. So far, it is unclear how the general structure of the information and selection options support consumers’ choices in healthcare. The results of the current study are a good starting point for further discussions about how comparative healthcare information should be presented to consumers, and whether more uniformity is needed.