Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania.
Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania.
复制标题
DOI：
10.1093/ej/uead075
复制
发表时间：
2024-01
期刊：
影响因子：
3.2
通讯作者：
Goodman, Catherine
中科院分区：
文献类型：
--
作者：
Powell-Jackson, Timothy;King, Jessica J. C.;Makungu, Christina;Quaife, Matthew;Goodman, Catherine
我们测量了坦桑尼亚64个地区的220多家私营营利性和非营利性医疗机构的管理实践，并将这些数据与使用卧底标准化患者和临床观察进行评估的护理质量指标相关联。我们发现，管理更好的卫生设施更有可能根据国家治疗准则提供正确的治疗，遵守基本问题和检查清单，并遵守感染预防和控制做法。从第10百分位数到第90百分位数的管理实践得分与48%的正确治疗增加相关。然后，我们利用国际公认的管理支持干预的大规模实地实验，其中卫生设施根据综合标准进行评估，提供个性化的质量改进计划，并通过培训和指导访问提供支持。我们发现零到小的影响管理分数，这表明在这种情况下，改善管理实践可能是具有挑战性的。
We measure the adoption of management practices in over 220 private for-profit and non-profit health facilities in 64 districts across Tanzania and link these data to process quality-of-care metrics, assessed using undercover standardised patients and clinical observations. We find that better managed health facilities are more likely to provide correct treatment in accordance with national treatment guidelines, adhere to a checklist of essential questions and examinations, and comply with infection prevention and control practices. Moving from the 10th to the 90th percentile in the management practice score is associated with a 48% increase in correct treatment. We then leverage a large-scale field experiment of an internationally recognised management support intervention in which health facilities are assessed against comprehensive standards, given an individually tailored quality improvement plan and supported through training and mentoring visits. We find zero to small effects on management scores, suggesting that improving management practices in this setting may be challenging.
登录
查看更多内容
影响因子：
5
作者：
Leonard, Kenneth L.;Masatu, Melkiory C.
通讯作者：
Masatu, Melkiory C.
影响因子：
3.7
作者：
Bradley, Elizabeth H.;Byam, Patrick;Curry, Leslie A.
通讯作者：
Curry, Leslie A.
影响因子：
13.7
作者：
Bloom, Nicholas;Eifert, Benn;Roberts, John
通讯作者：
Roberts, John
影响因子：
3.2
作者：
Mabuchi S;Sesan T;Bennett SC
通讯作者：
Bennett SC
影响因子：
10.7
作者：
Das, Jishnu;Holla, Alaka;Muralidharan, Karthik
通讯作者：
Muralidharan, Karthik