Which Doctor? Combining Vignettes and Item Response to Measure Doctor Quality

The authors develop a method in which vignettes-a battery of questions for hypothetical cases-are evaluated with item response theory to create a metric for doctor quality. The method allows a simultaneous estimation of quality and validation of the test instrument that can be used for further refinements. The authors apply the method to a sample of medical practitioners in Delhi, India. The method gives plausible results, rationalizes different perceptions of quality in the public and private sectors, and pinpoints several serious problems with health care delivery in urban India. The findings confirm, for instance, that the quality of private providers located in poorer areas of the city is significantly lower than those in richer neighborhoods. Surprisingly, similar results hold for providers in the public sector, with important implications for inequities in the availability of health care.

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Bibliographic Details
Main Authors: Hammer, Jeffrey, Das, Jishnu
Language:English
en_US
Published: World Bank, Washington, D.C. 2004-05
Subjects:ABSTRACTING, ABSTRACTION, ALTERNATIVE MEDICINE, BENCHMARK, CERTIFICATION, CLASSIFICATION, CLASSIFYING, COMPETENCE, COMPETENCIES, CONDITIONING, DEATHS, DEPRESSION, DISCRIMINATION, DISPENSARIES, DOCTORS, EXPENDITURES, GRADING, HEALTH CARE, HEALTH INSURANCE, HEALTH OUTCOMES, HEALTH SERVICES, HEALTH STATUS, HOMEOPATHY, HOSPITALS, INCOME, LEARNING, LOW-INCOME COUNTRIES, MEDICAL CARE, MEDICAL PERSONNEL, MEDICAL SUPPLIES, MEDICAL SYSTEMS, MEDICINES, MOTIVATION, NOTATION, PATIENTS, PHYSICIANS, PREGNANCY, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE SECTOR, PROBABILITY, PUBLIC SECTOR, RECOGNITION, SELECTION BIAS, SEXUALLY TRANSMITTED DISEASES, STANDARDIZATION, SURGERY, THERAPY, WALKING FAMILY HEALTH, HEALTH CARE CENTERS, HEALTH CARE DELIVERY, HEALTH CARE PROVIDERS, HEALTH FACILITIES, DOCTOR PATIENT RELATIONSHIP, QUALITY OF CARE,
Online Access:http://documents.worldbank.org/curated/en/2004/05/4966960/doctor-combining-vignettes-item-response-measure-doctor-quality
https://hdl.handle.net/10986/14032
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