Although it's become common to make hospital performance data public, it's unclear whether this practice actually improves care. To evaluate the value of publicly providing these data, 86 hospitals in Ontario, Canada, that treat patients with acute myocardial infarction (AMI) and congestive heart failure (CHF) were randomized to one of two groups: hospitals that received early feedback on their performance on quality indicators for AMI and CHF care, and hospitals that received delayed feedback (21 months later than the early group); feedback was in the form of a public report card. Primary outcomes were composite AMI and CHF indicators based on 12 AMI and six CHF indicators of care. In addition, surveys were completed by both groups on quality improvement projects developed in response to the feedback, and hospital mortality rates were measured.

Results show no significant improvement in the early feedback group versus the delayed group for either AMI or CHF composite indicators. Significant improvement was seen in only one indicator for AMI care and one for CHF: mean 30-day AMI mortality rates and average 1-year CHF mortality rates were 2.5% and 2.8% lower, respectively, in the early than in the delayed group. Survey results demonstrated that a greater percentage of hospitals in the early than in the delayed group put initiatives in place to improve AMI care (73% versus 47%) and CHF care (61% versus 50%).

While study results showed that public release of hospital data didn't significantly improve composite indicators of care, it may have prompted hospital-specific changes. The hospital improvements didn't target the specific indicators measured but may have lead to the slightly lower AMI and CHF mortality rates in the early group.