Hospital discharge databases allow states to track the services of licensed acute care hospitals. Beyond surveillance, these databases contain clinical care elements for patients that span all payer types, making them ideal sources from which to produce quality report cards for consumers. However, of 48 states with discharge data reporting, California is the only one that does not collect physician identifying information and is therefore unable to produce physician-level quality reports from this data set.

In a 2010 report commissioned by CHCF, the National Association of Health Data Organizations (NAHDO) underscored that discharge data, provided by hospitals to state health entities, could also be used to report on the quality of care and procedural volume of attending or operating physicians during hospital encounters.

In a 2013 report also funded by CHCF, the RAND Corporation explored issues associated with requiring physician identifiers in the California hospital discharge data set and the potential use of physician-identified data by the state and others.

Key findings include:

• California's Office of Statewide Health Planning and Development (OSHPD) has the statutory authority to add physician identifiers as a required element to the hospital discharge data set.
• All California stakeholders interviewed for the report saw some potential benefits associated with collecting and mining physician-level data.
• Some concerns that emerged included the accuracy of the physician identifiers, the need to risk-adjust outcome measures, the best way to presentthe data, and the interpretation of results by consumers.
• Stakeholders agreed that identifying a responsible physician would be straightforward for the operating physician but more challenging for the attending physician.

The NAHDO and RAND reports are available on their respective sites through the External Links below.