Do Patients Value High-Quality Medical Care? Experimental Evidence from Malaria Diagnosis and Treatment 2016
Mali, 2016 - 2017
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MLI_2016_RDTM_v01_M
Do Patients Value High-Quality Medical Care? Experimental Evidence from Malaria Diagnosis and Treatment 2016
| Name | Country code |
|---|---|
| Mali | MLI |
Other Household Health Survey [hh/hea]
This data accompanies a paper that reports the effects on diagnosis and treatment of malaria, as well as patient satisfaction with the quality of care, from a randomized experiment conducted at public clinics in Mali. In this experiment, health providers and patients received tailored information about the importance of rapid diagnostic tests (RDTs) for malaria.
Can information about the value of diagnostic tests improve provider practice and help patients recognize higher quality of care? In a randomized experiment at public clinics in Mali, health providers and patients received tailored information about the importance of rapid diagnostic tests (RDTs) for malaria. The provider training increased provider reliance on RDTs, improving the match between a patient's malaria status and treatment with antimalarials by 15-30 percent. Nonetheless, patients were significantly less satisfied with the care they received, driven by those whose prior beliefs did not match their true malaria status. The patient information intervention did not affect treatment outcomes or patient satisfaction and reduced malaria testing. These findings are consistent with highly persistent patient beliefs that translate into low demand for diagnostic testing and limit patients' ability to recognize improved quality of care.
Sample survey data [ssd]
- Health providers
- Patients
Version
2024-01-22
Scope
The datasets (in Stata format) cover the following:
- LSS_info_CSComCensus_clean.dta: A census of the clinics included in the study, carried out in May 2016. Includes information on total reported caseloads, malaria caseloads, clinic testing, and pharmacy capabilities.
- LSS_info_CSComs_Agent_Training_corrected.dta: Dataset that includes the number of staff per clinic who attended the training (administrative records).
- LSS_info_DocPat_analysis_datasets_allcont.dta: Dataset used in the main analysis (at the patient level), collected in enumerator clinic visits (6 per clinic). It includes:
a. Day-of clinic records: clinic information filled out by the enumerator in the morning of the visit.
b. In-clinic patient survey: entry and exit interviews with patients at the clinic.
c. Home survey: home follow-up with subset of patients.
d. Intervention schedule: treatment assignment for each clinic-day (“official schedule”) (variables with suffix _os). - LSS_info_DoctorEndlineInterview_allcont.dta: Endline interview with up to three providers (including head of the clinic) treating patients at the clinic that day, carried out after the intervention was concluded in December 2016/January 2017.
- LSS_info_PreTest_Doctors_individual_level_allcont.dta: We administered a pre-training test to all healthcare providers who attended the training. The test included questions on the providers' knowledge of topics covered in the basic training, such as recommended malaria treatments and symptoms of severe malaria.
- LSS_info_PostTest_Doctors_individual_level_allcont.dta: In addition to the variables in “LSS_info_PreTest_Doctors_individual_level_allcont”, the post-training test included topics covered only in the “extended training” treatment.
Coverage
Our study was conducted in the capital city of Bamako and a nearby suburb.
Producers and sponsors
| Name | Affiliation |
|---|---|
| Carolina Lopez | Development Research Group, World Bank |
| Anja Sautmann | Development Research Group, World Bank |
| Simone Schaner | University of Southern California |
| Name |
|---|
| ESRC/DFID Development Frontiers |
Sampling
Our enumerators logged 2753 clinic visits during the clinic survey. Our analysis sample includes patients/respondents who met the following criteria: consented to the survey (2 observations excluded), the patient was present at the clinic (0 observations excluded), the clinic visit was for an acute illness (neither preventive care nor follow-up visit for earlier treatment, 442 observations excluded), and the patient had at least one of the following symptoms: fever; chills and/or excessive sweating; nausea, vomiting or diarrhea; poor appetite, unwilling to eat or to breastfeed; headache; cough; weakness, fatigue, or reduced consciousness (31 observations excluded). In addition, we only include in the analysis those observations that satisfy the following: complete clinic intake interview (61 observations excluded), the name of the respondent from the intake interview was confirmed in the exit interview (5 observations excluded), and the respondent was available to continue with the clinic exit interview (157 observations excluded). In addition, we excluded observations from two clinics in one stratum where one of the clinics had to be replaced after the training period ended, leaving a final sample of 58 clinics in 29 strata. This leaves us with a final clinic survey sample of N=1973.
Data collection
| Start | End |
|---|---|
| 2016-05-01 | 2017-01-06 |
- Face-to-face [f2f]
Data Access
Open access.
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Carolina Lopez | Development Research Group, World Bank | carolina_lopez@worldbank.org |
| Anja Sautmann | Development Research Group, World Bank | asautmann@worldbank.org |
Metadata production
DDI_MLI_2016_RDTM_v01_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Data Group | The World Bank | Documentation of the DDI |
2024-01-26
Metadata version
Version 01 (January 2024)