Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies
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{"title"=>"Quality of private and public ambulatory health care in low and middle income countries: Systematic review of comparative studies", "type"=>"journal", "authors"=>[{"first_name"=>"Sima", "last_name"=>"Berendes", "scopus_author_id"=>"37094826200"}, {"first_name"=>"Peter", "last_name"=>"Heywood", "scopus_author_id"=>"7006480784"}, {"first_name"=>"Sandy", "last_name"=>"Oliver", "scopus_author_id"=>"7202288559"}, {"first_name"=>"Paul", "last_name"=>"Garner", "scopus_author_id"=>"7102107652"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-79955509593", "sgr"=>"79955509593", "issn"=>"15491676", "doi"=>"10.1371/journal.pmed.1000433", "pmid"=>"21532746", "isbn"=>"1549-1676 (Electronic)\\n1549-1277 (Linking)", "pui"=>"361688658"}, "id"=>"1ba9bfec-389b-3513-a6fd-3086cddb6862", "abstract"=>"BACKGROUND: In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options.\\n\\nMETHODS AND FINDINGS: We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred.\\n\\nCONCLUSIONS: Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases.", "link"=>"http://www.mendeley.com/research/quality-private-public-ambulatory-health-care-low-middle-income-countries-systematic-review-comparat-8", "reader_count"=>221, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>10, "Librarian"=>4, "Researcher"=>38, "Student > Doctoral Student"=>16, "Student > Ph. D. Student"=>36, "Student > Postgraduate"=>13, "Student > Master"=>58, "Other"=>16, "Student > Bachelor"=>11, "Lecturer"=>7, "Lecturer > Senior Lecturer"=>2, "Professor"=>7}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>10, "Librarian"=>4, "Researcher"=>38, "Student > Doctoral Student"=>16, "Student > Ph. D. Student"=>36, "Student > Postgraduate"=>13, "Student > Master"=>58, "Other"=>16, "Student > Bachelor"=>11, "Lecturer"=>7, "Lecturer > Senior Lecturer"=>2, "Professor"=>7}, "reader_count_by_subject_area"=>{"Unspecified"=>15, "Agricultural and Biological Sciences"=>8, "Arts and Humanities"=>3, "Business, Management and Accounting"=>8, "Computer Science"=>1, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>11, "Engineering"=>2, "Environmental Science"=>1, "Nursing and Health Professions"=>11, "Medicine and Dentistry"=>115, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Psychology"=>4, "Social Sciences"=>38, "Linguistics"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>115}, "Social Sciences"=>{"Social Sciences"=>38}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Psychology"=>{"Psychology"=>4}, "Unspecified"=>{"Unspecified"=>15}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>3}, "Engineering"=>{"Engineering"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>11}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>8}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>11}, "Linguistics"=>{"Linguistics"=>1}}, "reader_count_by_country"=>{"Cameroon"=>1, "United States"=>10, "Japan"=>1, "United Kingdom"=>4, "Ghana"=>1, "Malaysia"=>1, "Kenya"=>1, "India"=>2, "Spain"=>1, "Bangladesh"=>1, "Netherlands"=>2, "China"=>1, "Brazil"=>1, "South Africa"=>1, "Slovenia"=>1, "Indonesia"=>1}, "group_count"=>23}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/783568"], "description"=>"a<p>Includes Europe and Central Asia\n (<i>n = </i>1), Latin America and the\n Caribbean (<i>n = </i>6), the Middle East\n and North Africa (<i>n = </i>7), and\n studies reporting on countries in more than one world region\n (<i>n = </i>4).</p>", "links"=>[], "tags"=>["quantitative", "studies", "comparing", "formal", "providers", "region"], "article_id"=>453930, "categories"=>["Virology"], "users"=>["Sima Berendes", "Peter Heywood", "Sandy Oliver", "Paul Garner"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000433.t002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_quantitative_studies_comparing_public_and_formal____private_providers_by_region____n_8202_8202_80_/453930", "title"=>"Characteristics of quantitative studies comparing public and formal\n private providers by region\n (<i>n = </i>80).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-12 01:05:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/783604"], "description"=>"<p>Quality categories, sub-categories, and indicators used.</p>", "links"=>[], "tags"=>["indicators"], "article_id"=>453975, "categories"=>["Virology"], "users"=>["Sima Berendes", "Peter Heywood", "Sandy Oliver", "Paul Garner"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000433.t001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quality_categories_sub_categories_and_indicators_used_/453975", "title"=>"Quality categories, sub-categories, and indicators used.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-12 01:06:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/393019", "https://ndownloader.figshare.com/files/393053", "https://ndownloader.figshare.com/files/393111", "https://ndownloader.figshare.com/files/393146", "https://ndownloader.figshare.com/files/393173", "https://ndownloader.figshare.com/files/393194", "https://ndownloader.figshare.com/files/393221", "https://ndownloader.figshare.com/files/393274", "https://ndownloader.figshare.com/files/393293", "https://ndownloader.figshare.com/files/393311", "https://ndownloader.figshare.com/files/393341"], "description"=>"<div><h3>Background</h3><p>In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options.</p> <h3>Methods and Findings</h3><p>We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred.</p> <h3>Conclusions</h3><p>Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["ambulatory", "systematic", "comparative", "studies"], "article_id"=>137609, "categories"=>["Cancer"], "users"=>["Sima Berendes", "Peter Heywood", "Sandy Oliver", "Paul Garner"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000433.s001", "https://dx.doi.org/10.1371/journal.pmed.1000433.s002", "https://dx.doi.org/10.1371/journal.pmed.1000433.s003", "https://dx.doi.org/10.1371/journal.pmed.1000433.s004", "https://dx.doi.org/10.1371/journal.pmed.1000433.s005", "https://dx.doi.org/10.1371/journal.pmed.1000433.s006", "https://dx.doi.org/10.1371/journal.pmed.1000433.s007", "https://dx.doi.org/10.1371/journal.pmed.1000433.s008", "https://dx.doi.org/10.1371/journal.pmed.1000433.s009", "https://dx.doi.org/10.1371/journal.pmed.1000433.s010", "https://dx.doi.org/10.1371/journal.pmed.1000433.s011"], "stats"=>{"downloads"=>26, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Quality_of_Private_and_Public_Ambulatory_Health_Care_in_Low_and_Middle_Income_Countries_Systematic_Review_of_Comparative_Studies/137609", "title"=>"Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-04-12 02:06:49"}
  • {"files"=>["https://ndownloader.figshare.com/files/783436"], "description"=>"<p>* See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000433#pmed.1000433.s006\" target=\"_blank\">Table S4</a> for reasons of exclusion; † see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000433#pmed.1000433.s007\" target=\"_blank\">Table\n S5</a> for reasons of exclusion.</p>", "links"=>[], "tags"=>["evidence-based healthcare/health services research and\n economics", "evidence-based healthcare/quality and safety in medical\n practice", "public health and epidemiology/health services research and\n economics"], "article_id"=>453802, "categories"=>["Virology"], "users"=>["Sima Berendes", "Peter Heywood", "Sandy Oliver", "Paul Garner"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000433.g001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Selection_of_studies_/453802", "title"=>"Selection of studies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-04-12 01:03:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/783521"], "description"=>"a<p>Within each comparison, the difference between the public score and the\n private score was calculated. The data in this column are the median of\n these values across all studies. For this reason, they will not\n correspond to an arithmetic difference of the absolute median scores in\n the previous columns.</p>", "links"=>[], "tags"=>["comparative", "and"], "article_id"=>453897, "categories"=>["Virology"], "users"=>["Sima Berendes", "Peter Heywood", "Sandy Oliver", "Paul Garner"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000433.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Overall_level_of_quality_and_comparative_quality_difference_of_public_and____formal_private_providers_/453897", "title"=>"Overall level of quality and comparative quality difference of public and\n formal private providers.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-12 01:04:57"}

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Relative Metric

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