Quality of inpatient care in public and private hospitals in Sri Lanka

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dc.contributor.author Rannan-Eliya, Ravindra P.
dc.contributor.author Wijemanne, Nilmini
dc.contributor.author Liyanage, Isurujith K.
dc.contributor.author Dalpatadu, Shanti
dc.contributor.author de Alwis, Sanil
dc.contributor.author Amarasinghe, Sarasi
dc.contributor.author Shanthikumar, Shivanthan
dc.date.accessioned 2015-05-05T12:28:50Z
dc.date.available 2015-05-05T12:28:50Z
dc.date.copyright 2015
dc.date.issued 2015
dc.identifier.citation Rannan-Eliya, R.P., Wijemanne, N., Liyanage, I.K., Dalpatadu, S. de Alwis, S., et al. (2015). Quality of inpatient care in public and private hospitals in Sri Lanka. Health Policy and Planning, 30(suppl 1), i46–i58. doi:10.1093/heapol/czu062 en
dc.identifier.uri http://hdl.handle.net/10625/54127
dc.identifier.uri http://heapol.oxfordjournals.org/content/30/suppl_1/i46.full.pdf+html
dc.description Co-published with The London School of Hygiene and Tropical Medicine en
dc.description.abstract OBJECTIVE: To compare the quality of inpatient clinical care in public and private hospitals in Sri Lanka. METHODS: A retrospective, cross-sectional comparison was done of inpatient quality, in a sample of 11 public and 10 private hospitals in three of 25 districts. Data were collected for 55 quality indicators from medical records of 2523 public and 1815 private inpatient admissions. These covered treatment of asthma, acute myocardial infarction (AMI), childbirth and five other conditions, along with outcome indicators, and medicine prescribing indicators. RESULTS: Overall quality scores were better in the public sector than the private sector (77 vs 69%). Performance was similar for management of AMI and childbirth and somewhat better in the private sector for management of asthma. The public sector performed better in those indicators that are not constrained by resources (94 vs 81%), but worse in indicators that are highly resource intensive (10 vs 31%). Quality was comparable in assessment and investigation, but the public sector performed better in treatment and management (70 vs 62%) and drug prescribing (68 vs 60%), and modestly worse in terms of outcomes (92 vs 97%). CONCLUSIONS: For a range of indicators where comparisons were possible, quality of inpatient clinical care in Sri Lanka was comparable to levels reported from upper-middle income Asian countries, and often approaches that in developed countries, although the findings cannot be generalized. Quality in the public sector is better than in the private sector in many areas, despite spending being substantially less. Quality in public hospitals is resource constrained, and needs greater government investment for improvement, but when resource limitations are not critical, the public sector appears able to deliver equal or better quality than the private sector. Overall similarities in quality between the two sectors suggest the importance of physician training and other factors. en
dc.format Text en
dc.format.extent 1 digital file (p. i46-i58) en
dc.format.mimetype Application/pdf
dc.language.iso en
dc.publisher Oxford University Press en
dc.subject INPATIENTS en
dc.subject PATIENT CARE en
dc.subject HOSPITALS en
dc.subject PUBLIC SECTOR en
dc.subject PRIVATE SECTOR en
dc.subject ASTHMA en
dc.subject HEART DISEASE en
dc.subject MEDICAL CARE en
dc.subject EVALUATION en
dc.title Quality of inpatient care in public and private hospitals in Sri Lanka 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 IC01-4451-80
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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