Background: By early 1994, 38 states had invested in data collection, analysis, and dissemination on the use, cost, effectiveness, and performance of hospitals. States use these data to control costs, encourage prudent purchasing, monitor effectiveness and outcomes of health care, guide health policy, and promote informed decision making. Experience in several states suggests that public release of hospital-specific data influences hospital performance. Issues: The value of state data organizations' databases to address issues of quality and accountability can be strengthened by ensuring the stability and growth of statewide health information systems, supporting research on information dissemination techniques, and promoting comparisons among hospitals. Conclusions: Information to measure provider performance must be placed in the public domain-to help ensure prudent and cost-effective health care purchasing and to give providers comparable information for improvement of care. State-level health databases are an essential component of the information infrastructure needed to support health reform.
