India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State
This study investigates the impact of a health systems development project in Uttar Pradesh, India, on utilization of health services and patient satisfaction for the poor and lower caste members. The project began in July 2000, and introduced a ra...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2004/10/5371195/india-equity-effects-quality-improvements-health-service-utilization-patient-satisfaction-uttar-pradesh-state http://hdl.handle.net/10986/13792 |
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okr-10986-137922021-04-23T14:03:09Z India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State Peters, David Rao, Krishna Ramana, G.N.V. ACCESS TO HEALTH SERVICES BEDS CHILD HEALTH CHILD HEALTH SERVICES CITIES CLINICS COMMUNITY HEALTH DEATHS DISCRIMINATION DISTRICTS ECONOMIC STATUS ESSENTIAL DRUGS EXERCISES EXPENDITURES FAMILY HEALTH GENDER HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CONDITIONS HEALTH FACILITIES HEALTH OUTCOMES HEALTH REFORM HEALTH SERVICES HEALTH SURVEYS HEALTH SYSTEMS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS INCOME INFANT MORTALITY INFANT MORTALITY RATE INTERVENTION MEASUREMENTS MEDICAL CARE NUTRITION NUTRITIONAL STATUS OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PROJECT IMPLEMENTATION PUBLIC HEALTH PUBLIC HEALTH INFRASTRUCTURE PUBLIC HEALTH SERVICES QUALITY OF CARE RADIO REHABILITATION RURAL AREAS This study investigates the impact of a health systems development project in Uttar Pradesh, India, on utilization of health services and patient satisfaction for the poor and lower caste members. The project began in July 2000, and introduced a range of reforms including management training, new staffing and service patterns, provision of essential drugs, and repair of equipment and facilities. The study uses a quasi-experimental design to compare changes in new outpatient visits and patient satisfaction at project and non-project health facilities. All public health facilities were scored according to health and economic conditions of the population and physical conditions of the facility, with the poorest scoring facilities selected for the project. A survey of service utilization, user perceptions, and economic status was conducted in 1999 at project facilities and an equal number of randomly selected control sites, stratified by level of facility: district and women's hospitals, community health centers (CHCs) and primary health centers (PHCs). A subsequent survey conducted in 2003 assessed changes in a systematically selected subset of the baseline sites. There was a consistent increase in mean monthly outpatient visits at all levels of project sites compared to controls, indicating that the project has improved overall utilization levels. Although patients from the poorest 40 percent of the population increased utilization at all types of facilities except the women's hospitals, the wealthiest 40 percent had larger increases at each level of facility. Lower caste members gained at all facilities relative to higher caste members. The project had a significantly positive impact on patient satisfaction at lower levels of facilities (CHCs and PHCs), but not for patients from the poorest 40 percent. 2013-06-05T18:36:00Z 2013-06-05T18:36:00Z 2004-10 http://documents.worldbank.org/curated/en/2004/10/5371195/india-equity-effects-quality-improvements-health-service-utilization-patient-satisfaction-uttar-pradesh-state http://hdl.handle.net/10986/13792 English en_US HNP Discussion Paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research South Asia India |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ACCESS TO HEALTH SERVICES BEDS CHILD HEALTH CHILD HEALTH SERVICES CITIES CLINICS COMMUNITY HEALTH DEATHS DISCRIMINATION DISTRICTS ECONOMIC STATUS ESSENTIAL DRUGS EXERCISES EXPENDITURES FAMILY HEALTH GENDER HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CONDITIONS HEALTH FACILITIES HEALTH OUTCOMES HEALTH REFORM HEALTH SERVICES HEALTH SURVEYS HEALTH SYSTEMS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS INCOME INFANT MORTALITY INFANT MORTALITY RATE INTERVENTION MEASUREMENTS MEDICAL CARE NUTRITION NUTRITIONAL STATUS OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PROJECT IMPLEMENTATION PUBLIC HEALTH PUBLIC HEALTH INFRASTRUCTURE PUBLIC HEALTH SERVICES QUALITY OF CARE RADIO REHABILITATION RURAL AREAS |
| spellingShingle |
ACCESS TO HEALTH SERVICES BEDS CHILD HEALTH CHILD HEALTH SERVICES CITIES CLINICS COMMUNITY HEALTH DEATHS DISCRIMINATION DISTRICTS ECONOMIC STATUS ESSENTIAL DRUGS EXERCISES EXPENDITURES FAMILY HEALTH GENDER HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CONDITIONS HEALTH FACILITIES HEALTH OUTCOMES HEALTH REFORM HEALTH SERVICES HEALTH SURVEYS HEALTH SYSTEMS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS INCOME INFANT MORTALITY INFANT MORTALITY RATE INTERVENTION MEASUREMENTS MEDICAL CARE NUTRITION NUTRITIONAL STATUS OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PROJECT IMPLEMENTATION PUBLIC HEALTH PUBLIC HEALTH INFRASTRUCTURE PUBLIC HEALTH SERVICES QUALITY OF CARE RADIO REHABILITATION RURAL AREAS Peters, David Rao, Krishna Ramana, G.N.V. India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| geographic_facet |
South Asia India |
| relation |
HNP Discussion Paper; |
| description |
This study investigates the impact of a
health systems development project in Uttar Pradesh, India,
on utilization of health services and patient satisfaction
for the poor and lower caste members. The project began in
July 2000, and introduced a range of reforms including
management training, new staffing and service patterns,
provision of essential drugs, and repair of equipment and
facilities. The study uses a quasi-experimental design to
compare changes in new outpatient visits and patient
satisfaction at project and non-project health facilities.
All public health facilities were scored according to health
and economic conditions of the population and physical
conditions of the facility, with the poorest scoring
facilities selected for the project. A survey of service
utilization, user perceptions, and economic status was
conducted in 1999 at project facilities and an equal number
of randomly selected control sites, stratified by level of
facility: district and women's hospitals, community
health centers (CHCs) and primary health centers (PHCs). A
subsequent survey conducted in 2003 assessed changes in a
systematically selected subset of the baseline sites. There
was a consistent increase in mean monthly outpatient visits
at all levels of project sites compared to controls,
indicating that the project has improved overall utilization
levels. Although patients from the poorest 40 percent of the
population increased utilization at all types of facilities
except the women's hospitals, the wealthiest 40 percent
had larger increases at each level of facility. Lower caste
members gained at all facilities relative to higher caste
members. The project had a significantly positive impact on
patient satisfaction at lower levels of facilities (CHCs and
PHCs), but not for patients from the poorest 40 percent. |
| format |
Publications & Research :: Working Paper |
| author |
Peters, David Rao, Krishna Ramana, G.N.V. |
| author_facet |
Peters, David Rao, Krishna Ramana, G.N.V. |
| author_sort |
Peters, David |
| title |
India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| title_short |
India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| title_full |
India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| title_fullStr |
India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| title_full_unstemmed |
India : Equity Effects of Quality Improvements on Health Service Utilization and Patient Satisfaction in Uttar Pradesh State |
| title_sort |
india : equity effects of quality improvements on health service utilization and patient satisfaction in uttar pradesh state |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2004/10/5371195/india-equity-effects-quality-improvements-health-service-utilization-patient-satisfaction-uttar-pradesh-state http://hdl.handle.net/10986/13792 |
| _version_ |
1764424259152642048 |