RESUMO
Measuring value (quality and cost) continues to be a major challenge in health care as providers respond to societal pressures (primarily from the payer) to standardize processes and patients assume the role of consumer. Relatively few studies report the extent to which report cards affect patient outcomes of care. Survey results indicate high levels of public distrust in report cards. The information that patients desire often is not what is reported because traditional indicators of quality often serve institutional needs rather than patient needs. Patients understand and value information framed as risk avoidance more so than as an opportunity for better health. Effective report cards are brief and simple. The model surgical report card for patients suggested herein includes ratings for patient satisfaction, functional status and well-being, specific symptom assessment, biologic indicators of disease progress, and costs. Successful report cards strike a balance between quality and cost that meets the needs of the stakeholder for whom they are intended.