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Which doctor? Combining vignettes and item response to measure doctor quality

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Author Info
Das, Jishnu
Hammer, Jeffrey

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Abstract

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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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 3301.

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Date of creation: 01 May 2004
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Handle: RePEc:wbk:wbrwps:3301

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Keywords: Health Monitoring&Evaluation; Disease Control&Prevention; Health Systems Development&Reform; Public Health Promotion; Educational Sciences; Health Monitoring&Evaluation; Educational Sciences; Information and Records Management; Health Systems Development&Reform; Health Economics&Finance;

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Foster, Andrew D, 1995. "Prices, Credit Markets and Child Growth in Low-Income Rural Areas," Economic Journal, Royal Economic Society, vol. 105(430), pages 551-70, May. [Downloadable!] (restricted)
  2. Das, Jishnu & Sanchez-Paramo, Carolina, 2003. "Short but not sweet - new evidence on short duration morbidities from India," Policy Research Working Paper Series 2971, The World Bank. [Downloadable!]
  3. R. Bock & Murray Aitkin, 1981. "Marginal maximum likelihood estimation of item parameters: Application of an EM algorithm," Psychometrika, Springer, vol. 46(4), pages 443-459, December. [Downloadable!] (restricted)
  4. Das, Jishnu & Dercon, Stefan & Habyarimana, James & Krishnan, Pramila, 2004. "When can school inputs improve test scores?," Policy Research Working Paper Series 3217, The World Bank. [Downloadable!]
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  5. Paul Collier & Stefan Dercon & John Mackinnon, 2004. "Density versus Quality in Health Care Provision: Using Household Data to Make Budgetary Choices in Ethiopia," Development and Comp Systems 0409052, EconWPA. [Downloadable!]
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  6. Das, Jishnu & Hammer, Jeffrey, 2005. "Money for nothing : the dire straits of medical practice in Delhi, India," Policy Research Working Paper Series 3669, The World Bank. [Downloadable!]
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Klemick, Heather & Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," Working Papers 6178, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
  2. Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country," Working Papers 42883, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
  3. Das, Jishnu & Hammer, Jeffrey, 2004. "Strained mercy : The quality of medical care in Delhi," Policy Research Working Paper Series 3228, The World Bank. [Downloadable!]
  4. Adelman, Sarah & Essam, Timothy & 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. [Downloadable!]
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