In most countries, health care providers are not adequately held accountable for the quality of care they provide. One approach to improve provider accountability—which is being debated and implemented in some developed countries and a smaller group of developing countries—is provider-specific report cards that compare providers' performance with similar providers.
Peggy McNamara, M.S.P.H., of the Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality reviewed the relevant literature and found evidence of provider-specific comparative reporting in several developing country contexts. A wide range of provider-specific indicators are already being used in several developing countries to track quality of care. For instance, pioneering communities in countries such as India and the Philippines have successfully implemented provider-specific report cards using data from patient satisfaction surveys. Uganda provides a more comprehensive model of performance monitoring and public disclosure.
Provider reports cards are not a panacea for all quality problems. However, they are one of several approaches that, in some country and community contexts, might be pursued to complement and enhance regulatory, payment, and training activities as part of an overall strategy to improve quality, suggests the researcher.
More details are in "Provider-specific report cards: A tool for health sector accountability in developing countries," by Ms. McNamara, in the March 2006 Health Policy and Planning 21(2), pp. 101-109. Reprints (AHRQ Publication No. 06-R023) are available from AHRQ Clearinghouse.