As a result of pressures from patients, payers, and providers, mechanisms that measure and publicly report surgical outcomes have emerged rapidly over the last two decades. This growing movement is the result of an increasing demand for transparency and accountability. Processes that generate these outcomes reports, however, are challenged by issues related to accuracy and bias. Furthermore, the impact of reports on behaviors within the healthcare marketplace is complicated. In order to better understand the current state and future of public reporting within the United States, a brief review of the history of this movement is warranted. Also, the mechanics of the data gathering/analysis that drives public reports is described in order to understand potential barriers to accurate measurement and analysis. The movement toward public reporting should be guided by maximizing the benefits and minimizing the collateral consequences that are inherent in the public release of surgical outcomes data.
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