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American Economic Review Vol. 106 No. 12 2016

Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India

Jishnu Das1; Alaka Holla1; Aakash Mohpal2; Karthik Muralidharan3

1 The World Bank Group, 1818 H Street NW, Washington, DC 20433 (e-mail: ) · 2 Department of Economics, University of Michigan, 611 Tappan Avenue, Ann Arbor, MI 48104 (e-mail: ) · 3 Department of Economics, University of California, 9500 Gilman Drive, San Diego, CA 92093 (e-mail: )

Abstract

We present unique audit-study evidence on health care quality in rural India, and find that most private providers lacked medical qualifications, but completed more checklist items than public providers and recommended correct treatments equally often. Among doctors with public and private practices, all quality metrics were higher in their private clinics. Market prices are positively correlated with checklist completion and correct treatment, but also with unnecessary treatments. However, public sector salaries are uncorrelated with quality. A simple model helps interpret our findings: Where public-sector effort is low, the benefits of higher diagnostic effort among private providers may outweigh costs of potential overtreatment.

DOI
10.1257/aer.20151138
Volume
106
Issue
12
Pages
3765-3799
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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