An Evaluation of Medicare's Hospital Compare as a Decision-Making Tool for Patients and Hospitals

ABSTRACT:Medicare's Hospital Compare aims to assist patients to make informed decisions about their choice of care through its star rating systems and side-by-side comparison of hospitals. Despite the use of the rating system by hospitals as an endorsement of quality, it is not clear whether the information helps consumers make choices specific to certain diseases. Moreover, the system also does not provide any guidance to hospitals as to which quality improvements lead to better outcome and why. Using data from 4793 hospitals, this research explores the relationship using the triad of structure, process, and outcome. Our results show that the star rating system is inadequate for making disease-specific decision. More importantly, there is little evidence linking the structure and process related variables with disease specific clinical quality outcomes.