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

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dc.contributor.authorRannan-Eliya, Ravindra P.
dc.contributor.authorWijemanne, Nilmini
dc.contributor.authorLiyanage, Isurujith K.
dc.contributor.authorDalpatadu, Shanti
dc.contributor.authorde Alwis, Sanil
dc.contributor.authorAmarasinghe, Sarasi
dc.contributor.authorShanthikumar, Shivanthan
dc.date.accessioned2015-05-05T12:28:50Z
dc.date.available2015-05-05T12:28:50Z
dc.date.copyright2015
dc.date.issued2015
dc.descriptionCo-published with The London School of Hygiene and Tropical Medicineen
dc.description.abstractOBJECTIVE: 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.formatTexten
dc.format.extent1 digital file (p. i46-i58)en
dc.format.mimetypeApplication/pdf
dc.identifier.citationRannan-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/czu062en
dc.identifier.urihttp://hdl.handle.net/10625/54127
dc.identifier.urihttp://heapol.oxfordjournals.org/content/30/suppl_1/i46.full.pdf+html
dc.language.isoen
dc.publisherOxford University Pressen
dc.subjectINPATIENTSen
dc.subjectPATIENT CAREen
dc.subjectHOSPITALSen
dc.subjectHEALTH FACILITIESen
dc.subjectPUBLIC SECTORen
dc.subjectPRIVATE SECTORen
dc.subjectPERFORMANCE INDICATORSen
dc.subjectASTHMAen
dc.subjectHEART DISEASEen
dc.subjectMATERNAL AND CHILD HEALTHen
dc.subjectMEDICAL CAREen
dc.subjectEVALUATIONen
dc.titleQuality of inpatient care in public and private hospitals in Sri Lankaen
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.bcsnumberIC01-4451-80
idrc.rims.adhocgroupIDRC SUPPORTEDen

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