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The authors declare that they have no competing interests.
DF conceived the idea, participated in the design, analysis, interpretation of data and have been involved in drafting the manuscript. APB participated in the design, interpretation of data and contributed to the manuscript preparation.
CS conducted the statistical analysis, provided technical support and contributed to the manuscript preparation. MD made substantial contributions to perform the statistical analysis. MS conducted the statistical analysis and provided technical support. AL conducted the statistical analysis and provided technical support. MD participated in the design and interpretation of data. CAP participated in the design, coordination and interpretation of data. All authors read and approved the final manuscript.
P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public.
The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance data to the public.
P.Re.Val.E. included 54 outcome/process indicators encompassing many different clinical areas. Crude and adjusted rates were estimated for the 2006-2009 period. Multivariate regression models and direct standardization procedures were used to control for potential confounding due to individual characteristics. Variable life-adjusted display charts were developed, and 2008-2009 results were compared with those from 2006-2007.
Results of 54 outcome indicators were published online at http://www.epidemiologia.lazio.it/prevale10/index.php.
Public disclosure of the indicators' results caused mixed reactions but finally promoted discussion and refinement of some indicators.
Based on the P.Re.Val.E. experience, the Italian National Agency for Regional Health Services has launched a National Outcome Program aimed at systematically comparing outcomes in hospitals and local health units in Italy.
P.Re.Val.E. highlighted aspects of patient care that merit further investigation and monitoring to improve healthcare services and equity.