Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India

• 成果类型: Article
• 署名作者: Das, Jishnu; Holla, Alaka; Mohpal, Aakash; Muralidharan, Karthik
• 署名单位: The World Bank; University of Michigan System; University of Michigan; University of California System; University of California San Diego
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20151138
• 发表日期: 2016
• 页码: 3765-3799
• 关键词: DEVELOPING-COUNTRIES; financial incentives; credence goods; services; DISCRIMINATION; competence; vignettes; ECONOMICS; patient; MARKET

摘要

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.