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Perceived quality of care and choice of healthcare provider in informal settlements
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Conlan, Chris, Cunningham, Teddy, Watson, Sam, Madan, Jason, Sfyridis, Alexandros, Sartori, Jo, Ferhatosmanoglu, Hakan and Lilford, Richard (2023) Perceived quality of care and choice of healthcare provider in informal settlements. PLOS Global Public Health, 3 (2). e0001281. doi:10.1371/journal.pgph.0001281 ISSN 2767-3375.
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Official URL: https://doi.org/10.1371/journal.pgph.0001281
Abstract
When a person chooses a healthcare provider, they are trading off cost, convenience, and a latent third factor: “perceived quality”. In urban areas of lower- and middle-income countries (LMICs), including slums, individuals have a wide range of choice in healthcare provider, and we hypothesised that people do not choose the nearest and cheapest provider. This would mean that people are willing to incur additional cost to visit a provider they would perceive to be offering better healthcare. In this article, we aim to develop a method towards quantifying this notion of “perceived quality” by using a generalised access cost calculation to combine monetary and time costs relating to a visit, and then using this calculated access cost to observe facilities that have been bypassed. The data to support this analysis comes from detailed survey data in four slums, where residents were questioned on their interactions with healthcare services, and providers were surveyed by our team. We find that people tend to bypass more informal local services to access more formal providers, especially public hospitals. This implies that public hospitals, which tend to incur higher access costs, have the highest perceived quality (i.e., people are more willing to trade cost and convenience to visit these services). Our findings therefore provide evidence that can support the ‘crowding out’ hypothesis first suggested in a 2016 Lancet Series on healthcare provision in LMICs.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | |||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Computer Science | |||||||||
| SWORD Depositor: | Library Publications Router | |||||||||
| Library of Congress Subject Headings (LCSH): | Health -- Decision making, Medical care -- Decision making | |||||||||
| Journal or Publication Title: | PLOS Global Public Health | |||||||||
| Publisher: | Public Library of Science | |||||||||
| ISSN: | 2767-3375 | |||||||||
| Official Date: | 14 February 2023 | |||||||||
| Dates: |
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| Volume: | 3 | |||||||||
| Number: | 2 | |||||||||
| Article Number: | e0001281 | |||||||||
| DOI: | 10.1371/journal.pgph.0001281 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Date of first compliant deposit: | 6 March 2023 | |||||||||
| Date of first compliant Open Access: | 7 March 2023 | |||||||||
| RIOXX Funder/Project Grant: |
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