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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? |
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Ravindra P Rannan-Eliya*, Nilmini Wijemanne, Isuru K Liyanage, Janaki Jayanthan, Shanti Dalpatadu, Sarasi Amarasinghe and Chamara Anuranga
1 Mar 2015
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Abstract: 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.
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. |
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