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• W2152003611 abstract "OBJECTIVE: The Fertility Clinic Success Rate and Certification Act of 1992 made dissemination of information on outcomes mandatory for ART providers. The purpose of this study is to determine whether patients use this information when choosing among clinics. DESIGN: We compared the relationship between clinic market share and measures of clinic performance before and after mandatory public reporting. MATERIALS AND METHODS: We use clinic-level data from 1993 to 2003 that we obtained directly from SART for the years prior to 1995 and from the CDC website for subsequent years. We examined three measures of clinic performance: birth rates, multiple birth rates, and patient age mix. Due to the 2-year lag between the time that care is delivered and the public release of the outcome data, we calculated performance with a 3-year lag using a within-market z-score for each measure to calculate performance relative to competitors. We used measures of 1-year lagged performance, which were not publicly disseminated to consumers, to control for the potential effects of information from sources other than the report card. We estimated multivariate linear regression models in which the dependent variable was the logarithm of a clinic's market share and the independent variables were measures of clinic performance and other clinic and market-level control variables. RESULTS: Clinics with higher 3-year lagged birth rates than their competitors had greater market share after, but not before, the introduction of public reporting. The magnitude of this effect is quantitatively important; an improvement in a clinic's birthrate Z-score from the 25th to the 75th percentile was associated with a 12% increase in market share after public reporting. As expected, the effect of the 1-year lagged birth rate did not change after public reporting. After public reporting, clinics treating a greater proportion of younger patients than their competitors had lower market share, suggesting that patients accounted for patient mix when evaluating clinic birth rates. While a negative correlation between multiple rates and market share dissipated after the introduction of public reporting, the magnitude of the positive effect of multiple birth rates on market share is small relative to that of birth rates. CONCLUSIONS: Patients respond to information in public reports on birth rates, multiple birth rates, and patient mix when choosing among clinics providing ART, providing support for efforts to improve the data available to the public." @default.
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• W2152003611 date "2008-09-01" @default.
• W2152003611 modified "2023-09-27" @default.
• W2152003611 title "Effects of public reporting of ART outcomes on fertility clinic market share" @default.
• W2152003611 doi "https://doi.org/10.1016/j.fertnstert.2008.07.507" @default.
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