Quality of outpatient primary care in public and private sectors in Sri Lanka : how well do patient perceptions match reality and what are the implications?

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dc.contributor.author Rannan-Eliya, Ravindra P.
dc.contributor.author Wijemanne, Nilmini
dc.contributor.author Liyanage, Isuru K.
dc.contributor.author Jayanthan, Janaki
dc.contributor.author Dalpatadu, Shanti
dc.contributor.author Amarasinghe, Sarasi
dc.contributor.author Anuranga, Chamara
dc.date.accessioned 2015-03-06T18:32:21Z
dc.date.available 2015-03-06T18:32:21Z
dc.date.copyright 2014
dc.date.issued 2014
dc.identifier.citation Rannan-Eliya, R.P., Wijemanne, N., Liyanage, I.K., Jayanthan, J., Dalpatadu, S., Amarasinghe, S., et al. (2014). The quality of outpatient primary care in public and private sectors in Sri Lanka—how well do patient perceptions match reality and what are the implications?. Health Policy and Planning, 1-16. doi:10.1093/heapol/czu115 en
dc.identifier.uri http://hdl.handle.net/10625/53831
dc.identifier.uri http://heapol.oxfordjournals.org/content/early/2014/10/29/heapol.czu115.full.pdf+html?sid=c58c6c9c-f6da-4c34-bcd7-1c1035308f2d
dc.description.abstract Objective: To compare the quality of clinical care and patient satisfaction in public and private outpatient primary care services in Sri Lanka. Methods: A prospective, cross-sectional comparison was done by direct observation of patient encounters and exit interviews of outpatients in 10 public hospital general outpatient clinics and 66 private practitioner clinics in three districts of Sri Lanka. A total of 1027 public sector patients and 944 private sector patients were surveyed. Data were collected for 39 quality indicators covering diarrhoea, cough, hypertension, diabetes, asthma, upper respiratory tract infections (URTI) and five other conditions, along with prescribing indicators. The exit interviews collected data for 10 patient satisfaction indicators. Results: The public sector performed better for some conditions (diarrhoea, cough and asthma) and the private sector performed better for others (hypertension, diabetes, URTI and tonsillitis). Overall quality was similar between the sectors in the domains of history taking, examination and investigations and management, but the private sector performed much better on patient education (57 vs 12%). Overall patient satisfaction was high in both sectors (98%), although the private sector performed much better in interpersonal satisfaction (94 vs 84%) and system-related indicators (95 vs 84%). Comparisons with studies from other countries suggest that both sectors perform considerably better than India, and similarly in many indicators to high-income countries. Conclusions: Quality of outpatient primary care in Sri Lanka is generally high for a lower-middle income developing country. The public and private sectors perform similarly, except that private sector patients have longer consultations, are more likely to receive education and advice, and obtain better interpersonal satisfaction. The public system, with its limited funding, is able to deliver care in diagnosis and management that is similar to the private sector, while private sector patients, who spend more on their healthcare receive better quality care in non-clinical areas. en
dc.format Text en
dc.format.extent 1 digital file (p. 1-16) en
dc.format.mimetype application/pdf
dc.language.iso en
dc.publisher Oxford University Press en
dc.subject ASTHMA en
dc.subject HOSPITALS en
dc.subject MATERNAL CARE en
dc.subject OUTPATIENTS en
dc.subject PATIENT SATISFACTION en
dc.subject PRIVATE SECTOR en
dc.subject QUALITY OF CLINICAL CARE en
dc.subject QUALITY MEASUREMENT en
dc.subject SRI LANKA en
dc.subject HEALTH-CARE DELIVERY en
dc.subject PUBLIC FACILITIES en
dc.subject HEALTH SYSTEM en
dc.subject HEALTH EQUITY en
dc.subject RIGHT TO HEALTH en
dc.title Quality of outpatient primary care in public and private sectors in Sri Lanka : how well do patient perceptions match reality and what are the implications? en
dc.type Journal Article (peer-reviewed) en
idrc.project.number 106439
idrc.project.componentnumber 106439003
idrc.project.title Equity in Health and Health Financing: Building and Strengthening Developing Country Networks en
idrc.copyright.holder The Author
idrc.dspace.access IDRC Only en
idrc.rims.adhocgroup IDRC SUPPORTED en
idrc.recordsserver.bcsnumber IC01-4451-57
idrc.noaccess Due to copyright restrictions the full text of this research output is not available in the IDRC Digital Library or by request from the IDRC Library. / Compte tenu des restrictions relatives au droit d'auteur, le texte intégral de cet extrant de recherche n'est pas accessible dans la Bibliothèque numérique du CRDI, et il n'est pas possible d'en faire la demande à la Bibliothéque du CRDI. en


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