Is More Information Better? The Effects of “Report Cards” on Health Care Providers
研究医疗报告卡（公开医生和医院的患者健康结果）对医疗服务提供者的影响，发现纽约和宾夕法尼亚州的心脏手术报告卡导致医生筛选病人和患者与医院匹配改善，但总体上增加了资源使用并恶化了健康结果，尤其对重症患者，短期内降低了患者和社会福利。
Health care report cards–public disclosure of patient health outcomes at the level of the individual physician and/or hospital–may address important informational asymmetries in markets for health care, but they may also give doctors and hospitals incentives to decline to treat more difficult, severely ill patients. Whether report cards are good for patients and for society depends on whether their Þnancial and health beneÞts outweigh their costs in terms of the quantity, quality, and appropriateness of medical treatment that they induce. Using national data on Medicare patients at risk for cardiac surgery, we Þnd that cardiac surgery report cards in New York and Pennsylvania led both to selection behavior by providers and to improved matching of patients with hospitals. On net, this led to higher levels of resource use and to worse health outcomes, particularly for sicker patients. We conclude that, at least in the short run, these report cards decreased patient and social welfare. 1