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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Bibliographic Details
Published in:Health Affairs Vol. 31; no. 12; pp. 2774 - 2784
Main Authors: Das, Jishnu, Holla, Alaka, Das, Veena, Mohanan, Manoj, Tabak, Diana, Chan, Brian
Format: Journal Article
Language:English
Published: United States The People to People Health Foundation, Inc., Project HOPE 01.12.2012
Subjects:
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
Online Access:Get full text
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Summary: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.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0278-2715
2694-233X
1544-5208
2694-233X
DOI:10.1377/hlthaff.2011.1356