Public Reporting in Cardiac Surgery in the United Kingdom and United States

• In Event: 360 - Section on Medical Sociology Paper Session. Ethnography and Health Quality in a Global Context

Abstract

Public reporting of clinical performance is increasingly used in many countries to improve quality and enhance accountability. The assumption is that greater transparency will stimulate improvements by clinicians in response to peer pressure, patient choice or competition. Growing evidence suggests that peer pressure has the most potent effect of public reporting. Despite the international diffusion of public reporting, it is likely that national contexts (including health system imperatives, professional power, culture etc) will shape its form and impact. It is therefore instructive to compare the USA and UK. The USA was arguably the first country to adopt public reporting systematically in the late 1980s, now with over two decades of experience.. The UK is a more recent adopter; cardiac surgery was the first specialty to make these data transparent but it now being widely adopted through the National Health Service (NHS). Drawing on interview and observational data from both countries, this paper examines the public reporting at three levels (micro, meso and macro). The paper draws conclusions about the role of the medical profession (specifically cardiac surgery) in explaining the observed patterns.

Authors

• Mark Exworthy, University of Birmingham

• Jonathan Gabe, University of London

• Ian Rees Jones, Cardiff University