A Study On The Physician Quality Information Public Reporting System With The Info-ecology Theory

[Purpose] This paper introduces the information ecology theory to analyze the factors such as the public reporting subject,the public reporting content and the public reporting environment in the physicians’ quality information public reporting system.Construct the framework of the physician quality information public reporting system and analyze the current situation of the physician information public reporting in China.[Methods] Based on the theory of information ecology,this paper defines the related concepts of physician quality information public reporting,it is the foundation for the research of physician quality information public reporting system,and constructs the framework of physician quality information public reporting system through literature analysis and focus group discussion method.Using the case study method,and take the Physician compare website of the USA as an example,to learn more about the framework of the US physician quality information disclosure system under the guide of the established physician quality information public reporting system theory.At the same time,through the search of domestic and foreign databases,and the official website of CMS,Healthgrades and other related information.Systematically collecting and sorting the US physician quality information related literature and policy information,get acknowledged of public reporting subject,content and environment of American Physican Compare website.Using PEST analysis to learn the external environment and conditions of Physician Comparewebsite.Use literature study and focus group discussion method to develop a series of indicators which can measure the transparency of hospitals’ status of public reporting physician information online.In addition,nine representative cities,in east region(Beijing,Shanghai,Guangzhou),central region(Wuhan,Changsha,Zhengzhou),western region(Xi’an,Chengdu,Chongqing),were selected from the list of public hospitals included in the "Hospital Information Collection Center Network".According to the hospital class level,we randomly selected 8 hospitals each from evey A-class hospitals,B-class hospitals,C-class medical institutions(every two take one),That is,24 cities per city,a total of 216 hospitals.Using the content analysis method to classify and excavate the physician quality information in the hospital website,and form the research on the status of the China domestic physician quality information public reporting.[Results] 1.Information ecology theory is fitable in the physician quality information public reporting system.2.Physician quality information public reporting of the ecosystem composed of three elements: public reporting subject(including public reporting information producer,distributor,consumers and decomposer),public reporting environment and public reporting information(resources),all theelements in the systemare interact and stay in a dynamic balance of diversity,complexity.The elements in the information public reporting ecosystem,continu to be effective operated,promote to be optimized,and keep in a dynamic balance of continuous evolution.In addition,the physician quality information public reporting ecosystem not only includes the production,circulation and balance control and consumption function,it also has certain social service and resource integration function,in ensuring the whole system can continue to optimize and efficient operation.3.There are numbers of physician quality information public reporting website in the United States,showing a diversified development trend.The US Physician Compare website discloses the general information of doctors,participation in quality project information,the information of physician quality performance indicators and patient satisfaction scores.Its public reporting ecosystem contains multi-stakehodlers to participate,they all enrolled in the optimization of public reporting quality information;as well Physician Compare website has a more favorable public reporting environment.So that the entire Physician Compare website of the public reporting information ecosystem can continue to communicate in the continuous co-evolution,and better for public service.4.This study summarizes the transparent measurement of the information under the basis of in the previous research foundation our team,and determines integrity,timeliness and accessibilit as three dimensions to evaluate the transparency of the medical institutions disclose physicians’ information.Evaluate the public reporting status from the aspects of medical service and doctor’s diagnosis,the treatment results,the update time of public reporting information,and whether the public website is set up for medical search.5.The study found that: 92.1 %(199)medical institutions have disclosed the doctor information online,17 hospitals have not disclosed.In the aspect of the degree of disclose doctors,there are few medical institutions that disclose the information of all doctors,most medical institutions only disclose doctors who are Associate chief physicians and above.(42.13%)The score of the basic information of doctors’ information disclosure shows that there are totally 12 indicators of public reporting integrity and most websites have less personnal Certificate qualification,contact information and patient satisfaction information of physicians.Specialty and job title information are most popular in the diaclosure.More than 25.66%(29)within three months to update the doctor information,which mostly are A-class medical institutions,they are updated very timely.a total of 20 medical institutions update their information of physicians very unseasonal(more than 24 months),11 of them are C-class medical institutions;In addition,only 38.43%(83)of the medical institutions’ websites have physician information search function,including only 10 C-class hospitals.6.The score of the public integrity score was 7.45(total 12 points),and the score was equal to the score of 3.07(total 5 points).The results of the scoring showed that there were no significant differences in the scores of physician information public reproting among the regions,the types,the number of beds.The completeness,accessibility and timeliness grade among different classes of medical institutions have significant differences,and the highest grades belong to A-class hospitals,the lowest are C-class medical institutions.Multiple comparisons showed that institutions among each class all have differences in the integrity,accessibility grades.Separate analysis of the integrity indicators of the physician’s qualification,service information and patient satisfaction,we found that the class level of hospitals,whether affiliated hospitals,are related to the physician information;the the class level of hospitals,the regions,and the affiliated hospital are related to the service information(P<0.05).While,the grade of healthcare consequence(patient satisfaction)shares no statistical difference in any factor.In the analysis of the relevant factors,it is found that the class level of medical institutions is an important factor influencing the integrity and accessibility(P<0.05).And the level of accessibility of the physician information improves 3.108 times higher(P<0.05);Within every class level of the hospital improves.And “the affiliated medical institutions” is important factor that affects the disclosure timeliness(P<0.05).[Conclusions]In the system of physician quality information public reporting,public reporting information is spreading by a two-way channel,the relationship between public reporting subjects are interdependent chain-mode relationship.In addition,the public reporting subjects also has symbiosis,mutual cooperation,competition and other relations exist.the structure of the physician quality information disclosure is the summation of the elements formed by the interaction in a certain time and space constitutes.The development of physician quality information disclosure system in USA is diversification and synergistic developed.Physician compare website has appropriate public reporting contents,and technology support,with a well-developed public reporting producer,publishers,consumers and decomposer mechanism.Since it is a complete public chain of Physician Compare,its system operation mode can take reference for our country.In China,the public reporting of information is not complete,not timely and difficult to obtain and the reporting information is not standardized,not unified;the grade of public reporting indicators has significant differences among different class levels of medical institutions.This situation is urging to be improved.Thus,introducing the public reporting information system of USA can provide a physician quality public reporting reference for China.