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Open Access Research article

P.Re.Val.E.: outcome research program for the evaluation of health care quality in Lazio, Italy

Danilo Fusco1*, Anna P Barone1, Chiara Sorge1, Mariangela D'Ovidio1, Massimo Stafoggia1, Adele Lallo1, Marina Davoli1 and Carlo A Perucci2

Author Affiliations

1 Department of Epidemiology, Regional Health Service-Lazio Region, via Santa Costanza 53, Rome, 00198, Italy

2 National Agency of Regional Health Services, via Puglie 23, Rome, 00187, Italy

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BMC Health Services Research 2012, 12:25  doi:10.1186/1472-6963-12-25

Published: 27 January 2012



P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public.

The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance data to the public.


P.Re.Val.E. included 54 outcome/process indicators encompassing many different clinical areas. Crude and adjusted rates were estimated for the 2006-2009 period. Multivariate regression models and direct standardization procedures were used to control for potential confounding due to individual characteristics. Variable life-adjusted display charts were developed, and 2008-2009 results were compared with those from 2006-2007.


Results of 54 outcome indicators were published online at webcite.

Public disclosure of the indicators' results caused mixed reactions but finally promoted discussion and refinement of some indicators.

Based on the P.Re.Val.E. experience, the Italian National Agency for Regional Health Services has launched a National Outcome Program aimed at systematically comparing outcomes in hospitals and local health units in Italy.


P.Re.Val.E. highlighted aspects of patient care that merit further investigation and monitoring to improve healthcare services and equity.