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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| Published in: | Health Affairs Vol. 31; no. 12; pp. 2774 - 2784 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
The People to People Health Foundation, Inc., Project HOPE
01.12.2012
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| Subjects: | |
| ISSN: | 0278-2715, 2694-233X, 1544-5208, 2694-233X |
| Online Access: | Get full text |
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| Abstract | 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. |
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| AbstractList | 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.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. 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. 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. [PUBLICATION ABSTRACT] |
| Author | Das, Veena Tabak, Diana Chan, Brian Das, Jishnu Holla, Alaka Mohanan, Manoj |
| Author_xml | – sequence: 1 givenname: Jishnu surname: Das fullname: Das, Jishnu organization: Jishnu Das is a senior economist at the World Bank, in Washington, D.C., and a visiting fellow at the Centre for Policy Research, New Delhi, India – sequence: 2 givenname: Alaka surname: Holla fullname: Holla, Alaka organization: Alaka Holla is an economist in the Chief Economist’s Office of the Human Development Network at the World Bank – sequence: 3 givenname: Veena surname: Das fullname: Das, Veena organization: Veena Das is the Krieger-Eisenhower Professor of Anthropology and a professor of humanities at the Johns Hopkins University, in Baltimore, Maryland – sequence: 4 givenname: Manoj surname: Mohanan fullname: Mohanan, Manoj organization: Manoj Mohanan is an assistant professor of public policy and global health at the Sanford School of Public Policy, Duke University, in Durham, North Carolina – sequence: 5 givenname: Diana surname: Tabak fullname: Tabak, Diana organization: Diana Tabak is a lecturer in the Department of Family and Community Medicine and associate director of the Standardized Patient Program at the University of Toronto, in Ontario – sequence: 6 givenname: Brian surname: Chan fullname: Chan, Brian organization: Brian Chan is a clinical and research fellow in infectious diseases at Massachusetts General Hospital and Brigham and Women’s Hospital, in Boston |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23213162$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright The People to People Health Foundation, Inc., Project HOPE Dec 2012 2012 Project HOPE—The People-to-People Health Foundation, Inc. 2012 |
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| SubjectTerms | 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 |
| Title | In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps |
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