Abstract：
BACKGROUND: Global spending on health was continuing to rise over the past 20 years. To reduce the growth rates, alleviate information asymmetry, and improve the efficiency of healthcare markets, global health systems have initiated price and quality transparency tools in the hospital industry in the last two decades. OBJECTIVE : The objective of this review is to synthesize whether, to what extent, and how hospital price and quality transparency tools affected 1) the price of healthcare procedures and services, 2) the payments of consumers, and 3) the premium of health insurance plans bonding with hospital networks.
METHODS: A literature search of EMBASE, Web of Science, Econlit, Scopus, Pubmed, CINAHL, and PsychINFO was conducted, from inception to Oct 31, 2021. Reference lists and tracked citations of retrieved articles were hand-searched. Study characteristics were extracted, and included studies were scored through a risk of bias assessment framework. This systematic review was reported according to the PRISMA guidelines and registered in PROSPERO with registration No. CRD42022319070.
RESULTS: Of 2157 records identified, 18 studies met the inclusion criteria. Near 40 percent of studies focused on hospital quality transparency tools, and more than 90 percent of studies were from the US. Hospital price transparency reduced the price of laboratory and imaging tests except for office-visit services. Hospital quality transparency declined the level or growth rates of healthcare spending, while it adversely and significantly raised the price of healthcare services and consumers\' payment in higher-ranked or rated facilities, which was referred to as the reputation premium in the healthcare industry. Hospital quality transparency not only leveraged private insurers bonding with a higher-rated hospital network to increase premiums, but also induced their anticipated pricing behaviors.
CONCLUSIONS: Hospital price and quality transparency was not effective as expected. Future research should explore the understudied consequences of hospital quality transparency programs, such as the reputation/rating premium and its policy intervention.
METHODS: A literature search of EMBASE, Web of Science, Econlit, Scopus, Pubmed, CINAHL, and PsychINFO was conducted, from inception to Oct 31, 2021. Reference lists and tracked citations of retrieved articles were hand-searched. Study characteristics were extracted, and included studies were scored through a risk of bias assessment framework. This systematic review was reported according to the PRISMA guidelines and registered in PROSPERO with registration No. CRD42022319070.
RESULTS: Of 2157 records identified, 18 studies met the inclusion criteria. Near 40 percent of studies focused on hospital quality transparency tools, and more than 90 percent of studies were from the US. Hospital price transparency reduced the price of laboratory and imaging tests except for office-visit services. Hospital quality transparency declined the level or growth rates of healthcare spending, while it adversely and significantly raised the price of healthcare services and consumers\' payment in higher-ranked or rated facilities, which was referred to as the reputation premium in the healthcare industry. Hospital quality transparency not only leveraged private insurers bonding with a higher-rated hospital network to increase premiums, but also induced their anticipated pricing behaviors.
CONCLUSIONS: Hospital price and quality transparency was not effective as expected. Future research should explore the understudied consequences of hospital quality transparency programs, such as the reputation/rating premium and its policy intervention.
摘要：
背景：过去20年来，全球卫生支出持续增长。为了降低增长率，缓解信息不对称，提高医疗市场的效率，在过去的二十年中，全球卫生系统在医院行业启动了价格和质量透明度工具。目的：这篇综述的目的是综合，到什么程度,以及医院价格和质量透明度工具如何影响1)医疗保健程序和服务的价格，2）消费者的支付，3)与医院网络相结合的医疗保险计划的保费。
方法：EMBASE的文献检索，WebofScience,Econlit,Scopus,Pubmed,CINAHL,进行了心理信息，从成立到2021年10月31日。手动搜索检索到的文章的参考列表和跟踪引用。提取了研究特征，纳入的研究通过偏倚风险评估框架进行评分.该系统评价是根据PRISMA指南报告的，并在PROSPERO中注册，注册编号：CRD42022319070。
结果：在确定的2157条记录中，18项研究符合纳入标准。近40%的研究集中在医院质量透明度工具上，超过90%的研究来自美国。医院价格透明度降低了实验室和影像学检查的价格，除了办公室访问服务。医院质量透明度下降了医疗保健支出的水平或增长率，虽然它不利地和显著地提高了医疗服务的价格和消费者在较高排名或评级机构的支付，这被称为医疗保健行业的声誉溢价。医院质量透明度不仅利用私人保险公司与较高评级的医院网络相结合来提高保费，而且也诱发了他们预期的定价行为。
结论：医院的价格和质量透明度没有预期的效果。未来的研究应该探索医院质量透明度计划的未充分研究的后果，如声誉/评级溢价及其政策干预。
方法：EMBASE的文献检索，WebofScience,Econlit,Scopus,Pubmed,CINAHL,进行了心理信息，从成立到2021年10月31日。手动搜索检索到的文章的参考列表和跟踪引用。提取了研究特征，纳入的研究通过偏倚风险评估框架进行评分.该系统评价是根据PRISMA指南报告的，并在PROSPERO中注册，注册编号：CRD42022319070。
结果：在确定的2157条记录中，18项研究符合纳入标准。近40%的研究集中在医院质量透明度工具上，超过90%的研究来自美国。医院价格透明度降低了实验室和影像学检查的价格，除了办公室访问服务。医院质量透明度下降了医疗保健支出的水平或增长率，虽然它不利地和显著地提高了医疗服务的价格和消费者在较高排名或评级机构的支付，这被称为医疗保健行业的声誉溢价。医院质量透明度不仅利用私人保险公司与较高评级的医院网络相结合来提高保费，而且也诱发了他们预期的定价行为。
结论：医院的价格和质量透明度没有预期的效果。未来的研究应该探索医院质量透明度计划的未充分研究的后果，如声誉/评级溢价及其政策干预。
