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Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania

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  • Kenneth L. Leonard

Abstract

Learning is an important force for progress in developing countries and may represent a significant underutilized resource in health care. Using data from rural Tanzania, we show that households value quality at health facilities and that the value they place on at least two aspects of quality is increasing with the tenure of the clinician. The fact that patients increasingly prefer good clinicians and avoid bad clinicians as time passes and that the value they place on quality plateaus after about 5 years is strong evidence for learning. The fact that they increasingly choose better clinicians suggests that learning improves outcomes.

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File URL: http://www.journals.uchicago.edu/cgi-bin/resolve?id=doi:10.1086/511192
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Bibliographic Info

Article provided by University of Chicago Press in its journal Economic Development and Cultural Change.

Volume (Year): 55 (2007)
Issue (Month): ()
Pages: 531-555

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Handle: RePEc:ucp:ecdecc:v:55:y:2007:p:531-555

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Cited by:
  1. Jann Lay, 2010. "MDG Achievements, Determinants, and Resource Needs: What Has Been Learnt?," GIGA Working Paper Series 137, GIGA German Institute of Global and Area Studies.
  2. Leonard, David K. & Bloom, Gerald & Hanson, Kara & O’Farrell, Juan & Spicer, Neil, 2013. "Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor," World Development, Elsevier, vol. 48(C), pages 71-87.
  3. Sandra G. Sosa-Rubi & Omar Galarraga & Jeffrey E. Harris, 2007. "Heterogeneous Impact of the "Seguro Popular" Program on the Utilization of Obstetrical Services in Mexico, 2001-2006: A Multinomial Probit Model with a Discrete Endogenous Variable," NBER Working Papers 13498, National Bureau of Economic Research, Inc.
  4. Leonard, Kenneth L., 2009. "The cost of imperfect agency in health care: Evidence from rural Cameroun," Journal of Development Economics, Elsevier, vol. 88(2), pages 282-291, March.
  5. Heather Klemick & Kenneth L. Leonard & Melkiory C. Masatu, 2007. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 91(2), pages 347-358.
  6. Adelman, Sarah W. & Essam, Timothy M. & Leonard, Kenneth L., 2008. "Idle Chatter or Learning? Evidence from Rural Tanzania of Social Learning about Clinicians and the Health System," Working Papers 42884, University of Maryland, Department of Agricultural and Resource Economics.
  7. Andreas Ziegler, 2010. "Z-Tests in Multinomial Probit Models under Simulated Maximum Likelihood Estimation: Some Small Sample Properties," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), Justus-Liebig University Giessen, Department of Statistics and Economics, vol. 230(5), pages 630-652, October.
  8. Adelman, Sarah, 2013. "Keep your friends close: The effect of local social networks on child human capital outcomes," Journal of Development Economics, Elsevier, vol. 103(C), pages 284-298.
  9. Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March.

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