Money for Nothing : The Dire Straits of Medical Practice in Delhi, India
The quality of medical care received by patients varies for two reasons: differences in doctors' competence or differences in doctors' incentives. Using medical vignettes, the authors evaluated competence for a sample of doctors in Delhi. One month later, they observed the same doctors in...
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| Format: | Policy Research Working Paper |
| Language: | English |
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World Bank, Washington, DC
2012
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| Online Access: | http://documents.worldbank.org/curated/en/2005/07/6078943/money-nothing-dire-straits-medical-practice-delhi-india http://hdl.handle.net/10986/8196 |
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okr-10986-81962021-04-23T14:02:43Z Money for Nothing : The Dire Straits of Medical Practice in Delhi, India Das, Jishnu Hammer, Jeffrey ADVERTISING ALTERNATIVE MEDICINE CAPITATION CLINICS COMPETENCE DISCRIMINATION DISPENSARIES DOCTORS EQUILIBRIUM EXPENDITURES FAMILIES GENDER HEALTH CARE HEALTH CARE SERVICES HEALTH CLINICS HEALTH FOR ALL HEALTH OUTCOMES HEALTH SYSTEM HOSPITALS ILLNESSES INCOME INTUITION MEDICAL CARE MEDICAL INSURANCE MEDICAL SERVICES MEDICINES MORAL HAZARD PATIENT CARE PATIENTS PHARMACY PHYSICIANS PLAYING POLICY DISCUSSIONS POLICY RESEARCH PRIMARY HEALTH CARE PRIVATE SECTOR PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SECTOR QUALITY OF HEALTH CARE RECOGNITION SANCTIONS SURGERY URBAN CENTERS WALKING The quality of medical care received by patients varies for two reasons: differences in doctors' competence or differences in doctors' incentives. Using medical vignettes, the authors evaluated competence for a sample of doctors in Delhi. One month later, they observed the same doctors in their practice. The authors find three patterns in the data. First, what doctors do is less than what they know they should do-doctors operate well inside their knowledge frontier. Second, competence and effort are complementary so that doctors who know more also do more. Third, the gap between what doctors do and what they know responds to incentives: doctors in the fee-for-service private sector are closer in practice to their knowledge frontier than those in the fixed-salary public sector. Under-qualified private sector doctors, even though they know less, provide better care on average than their better-qualified counterparts in the public sector. These results indicate that to improve medical services, at least for poor people, there should be greater emphasis on changing the incentives of public providers rather than increasing provider competence through training. 2012-06-15T19:59:58Z 2012-06-15T19:59:58Z 2005-07 http://documents.worldbank.org/curated/en/2005/07/6078943/money-nothing-dire-straits-medical-practice-delhi-india http://hdl.handle.net/10986/8196 English Policy Research Working Paper; No. 3669 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research South Asia India |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
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World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
ADVERTISING ALTERNATIVE MEDICINE CAPITATION CLINICS COMPETENCE DISCRIMINATION DISPENSARIES DOCTORS EQUILIBRIUM EXPENDITURES FAMILIES GENDER HEALTH CARE HEALTH CARE SERVICES HEALTH CLINICS HEALTH FOR ALL HEALTH OUTCOMES HEALTH SYSTEM HOSPITALS ILLNESSES INCOME INTUITION MEDICAL CARE MEDICAL INSURANCE MEDICAL SERVICES MEDICINES MORAL HAZARD PATIENT CARE PATIENTS PHARMACY PHYSICIANS PLAYING POLICY DISCUSSIONS POLICY RESEARCH PRIMARY HEALTH CARE PRIVATE SECTOR PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SECTOR QUALITY OF HEALTH CARE RECOGNITION SANCTIONS SURGERY URBAN CENTERS WALKING |
| spellingShingle |
ADVERTISING ALTERNATIVE MEDICINE CAPITATION CLINICS COMPETENCE DISCRIMINATION DISPENSARIES DOCTORS EQUILIBRIUM EXPENDITURES FAMILIES GENDER HEALTH CARE HEALTH CARE SERVICES HEALTH CLINICS HEALTH FOR ALL HEALTH OUTCOMES HEALTH SYSTEM HOSPITALS ILLNESSES INCOME INTUITION MEDICAL CARE MEDICAL INSURANCE MEDICAL SERVICES MEDICINES MORAL HAZARD PATIENT CARE PATIENTS PHARMACY PHYSICIANS PLAYING POLICY DISCUSSIONS POLICY RESEARCH PRIMARY HEALTH CARE PRIVATE SECTOR PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SECTOR QUALITY OF HEALTH CARE RECOGNITION SANCTIONS SURGERY URBAN CENTERS WALKING Das, Jishnu Hammer, Jeffrey Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| geographic_facet |
South Asia India |
| relation |
Policy Research Working Paper; No. 3669 |
| description |
The quality of medical care received by patients varies for two reasons: differences in doctors' competence or differences in doctors' incentives. Using medical vignettes, the authors evaluated competence for a sample of doctors in Delhi. One month later, they observed the same doctors in their practice. The authors find three patterns in the data. First, what doctors do is less than what they know they should do-doctors operate well inside their knowledge frontier. Second, competence and effort are complementary so that doctors who know more also do more. Third, the gap between what doctors do and what they know responds to incentives: doctors in the fee-for-service private sector are closer in practice to their knowledge frontier than those in the fixed-salary public sector. Under-qualified private sector doctors, even though they know less, provide better care on average than their better-qualified counterparts in the public sector. These results indicate that to improve medical services, at least for poor people, there should be greater emphasis on changing the incentives of public providers rather than increasing provider competence through training. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Das, Jishnu Hammer, Jeffrey |
| author_facet |
Das, Jishnu Hammer, Jeffrey |
| author_sort |
Das, Jishnu |
| title |
Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| title_short |
Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| title_full |
Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| title_fullStr |
Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| title_full_unstemmed |
Money for Nothing : The Dire Straits of Medical Practice in Delhi, India |
| title_sort |
money for nothing : the dire straits of medical practice in delhi, india |
| publisher |
World Bank, Washington, DC |
| publishDate |
2012 |
| url |
http://documents.worldbank.org/curated/en/2005/07/6078943/money-nothing-dire-straits-medical-practice-delhi-india http://hdl.handle.net/10986/8196 |
| _version_ |
1764407469280329728 |