Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India
Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India
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DOI：
10.1257/aer.20151138
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发表时间：
2016-12-01
影响因子：
10.7
通讯作者：
Muralidharan, Karthik
中科院分区：
文献类型：
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作者：
Das, Jishnu;Holla, Alaka;Muralidharan, Karthik
我们提出了独特的研究证据在印度农村的医疗保健质量，并发现，大多数私人提供者缺乏医疗资格，但完成更多的检查表项目比公共提供者，并建议正确的治疗同样频繁。在公共和私人诊所的医生中，私人诊所的所有质量指标都更高。市场价格与完成检查表和正确治疗呈正相关，但也与不必要的治疗呈正相关。然而，公共部门的工资与质量无关。一个简单的模型有助于解释我们的研究结果：在公共部门的努力是低的，更高的诊断努力在私人提供者的好处可能超过潜在的过度治疗的成本。
We present unique audit-study evidence on health care quality in rural India, and find that most private providers lacked medical qualifications, but completed more checklist items than public providers and recommended correct treatments equally often. Among doctors with public and private practices, all quality metrics were higher in their private clinics. Market prices are positively correlated with checklist completion and correct treatment, but also with unnecessary treatments. However, public sector salaries are uncorrelated with, quality. A simple model helps interpret our findings: Where public-sector effort is low, the benefits of higher diagnostic effort among private providers may outweigh costs of potential overtreatment.