In Reply: We agree with Dr Van Spall that the effect of public reporting might be different in the US “market-driven” system compared with the Canadian health care system, although we do not think that a market-driven system is a necessary prerequisite for public reporting to have an effect on quality of care. In both countries, patients with acute cardiac conditions such as acute myocardial infarction are instructed to go to the nearest hospital, and Canadian patients may actually have fewer restrictions (other than geography) in terms of choice of hospital and physicians than US patients.1 Public reporting of hospital and physician performance is much more widespread in the United States than in Canada, but there are relatively few studies evaluating whether it actually improves quality of care in the United States.2
Tu JV, Lee DS, Ko DT. Report Cards for Cardiac Care—Reply. JAMA. 2010;303(14):1367–1368. doi:10.1001/jama.2010.387
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