In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps

This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers....

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Vydáno v:	Health Affairs Ročník 31; číslo 12; s. 2774 - 2784
Hlavní autoři:	Das, Jishnu, Holla, Alaka, Das, Veena, Mohanan, Manoj, Tabak, Diana, Chan, Brian
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States The People to People Health Foundation, Inc., Project HOPE 01.12.2012
Témata:	Angina pectoris Attitude of Health Personnel Checklists Clinical Competence - statistics & numerical data Clinics Continuing education Developing countries Education Education policy Education, Medical, Graduate - organization & administration Educational programs Female Health care Health care industry Health education Health services Health status Households Humans India LDCs Low income groups Male Medical education Medical equipment Medical personnel Medical records Medical schools Medicine Needs Assessment Patients Physicians Policy making Practice Patterns, Physicians' - standards Practice Patterns, Physicians' - trends Primary care Primary Health Care - standards Primary Health Care - trends Private Practice - standards Private Practice - trends Professional education Professional training Public health Qualifications Quality of care Quality of Health Care Recall Recruitment Rural areas Rural communities Rural health care Rural Health Services - standards Rural Health Services - trends Rural urban differences Standardized patients Studies Surgery Training Treatment methods Urban health care Urban Health Services - standards Urban Health Services - trends India
ISSN:	0278-2715, 2694-233X, 1544-5208, 2694-233X
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Shrnutí:	This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers. We found low overall levels of medical training among health care providers; in rural Madhya Pradesh, for example, 67 percent of health care providers who were sampled reported no medical qualifications at all. What's more, we found only small differences between trained and untrained doctors in such areas as adherence to clinical checklists. Correct diagnoses were rare, incorrect treatments were widely prescribed, and adherence to clinical checklists was higher in private than in public clinics. Our results suggest an urgent need to measure the quality of health care services systematically and to improve the quality of medical education and continuing education programs, among other policy changes.
Bibliografie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	0278-2715 2694-233X 1544-5208 2694-233X
DOI:	10.1377/hlthaff.2011.1356