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.authorRannan-Eliya, Ravindra P.
dc.contributor.authorWijemanne, Nilmini
dc.contributor.authorLiyanage, Isuru K.
dc.contributor.authorJayanthan, Janaki
dc.contributor.authorDalpatadu, Shanti
dc.contributor.authorAmarasinghe, Sarasi
dc.contributor.authorAnuranga, Chamara
dc.date.accessioned2015-03-06T18:32:21Z
dc.date.available2015-03-06T18:32:21Z
dc.date.copyright2014
dc.date.issued2014
dc.description.abstractObjective: 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.formatTexten
dc.format.extent1 digital file (p. 1-16)en
dc.format.mimetypeapplication/pdf
dc.identifier.citationRannan-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/czu115en
dc.identifier.urihttp://hdl.handle.net/10625/53831
dc.identifier.urihttp://heapol.oxfordjournals.org/content/early/2014/10/29/heapol.czu115.full.pdf+html?sid=c58c6c9c-f6da-4c34-bcd7-1c1035308f2d
dc.language.isoen
dc.publisherOxford University Pressen
dc.subjectASTHMAen
dc.subjectHOSPITALSen
dc.subjectMATERNAL CAREen
dc.subjectOUTPATIENTSen
dc.subjectPATIENT SATISFACTIONen
dc.subjectPRIVATE SECTORen
dc.subjectQUALITY OF CLINICAL CAREen
dc.subjectQUALITY MEASUREMENTen
dc.subjectSRI LANKAen
dc.subjectHEALTH-CARE DELIVERYen
dc.subjectPUBLIC FACILITIESen
dc.subjectHEALTH SYSTEMen
dc.subjectHEALTH EQUITYen
dc.subjectRIGHT TO HEALTHen
dc.titleQuality 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.typeJournal Article (peer-reviewed)en
idrc.copyright.holderThe Author
idrc.dspace.accessIDRC Onlyen
idrc.noaccessDue 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
idrc.project.componentnumber106439003
idrc.project.number106439
idrc.project.titleEquity in Health and Health Financing: Building and Strengthening Developing Country Networksen
idrc.recordsserver.bcsnumberIC01-4451-57
idrc.rims.adhocgroupIDRC SUPPORTEDen

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