“What is meant by public?”: Stakeholder views on strengthening impacts of public reporting of hospital performance data

Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the ‘public’ is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences. •Public reporting of hospital performance data (PR) in Australia is little researched.•Australian stakeholders lack common understanding of the scope and purpose of PR.•Stakeholders' variable conceptions of ‘public’ contributes to confusion about PR.•This is the first study to explore expert informants' opinions of PR in Australia.•Reshaping the national PR system for different audiences should increase PR impact.