IDEAS home Printed from https://ideas.repec.org/a/ucp/ecdecc/y2007v55i3p531-55.html
   My bibliography  Save this article

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

Author

Listed:
  • Leonard, Kenneth L

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.

Suggested Citation

  • Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
  • Handle: RePEc:ucp:ecdecc:y:2007:v:55:i:3:p:531-55
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1086/511192
    Download Restriction: Access to the online full text or PDF requires a subscription.

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, March.
    2. Munshi, Kaivan, 2004. "Social learning in a heterogeneous population: technology diffusion in the Indian Green Revolution," Journal of Development Economics, Elsevier, vol. 73(1), pages 185-213, February.
    3. Besley, T. & Case, A., 1994. "Diffusion as a Learning Process: Evidence from HYV Cotton," Papers 174, Princeton, Woodrow Wilson School - Development Studies.
    4. Kenneth L. Leonard & Joshua Graff Zivin, 2005. "Outcome versus service based payments in health care: lessons from African traditional healers," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 575-593.
    5. Leonard, Kenneth L., 2003. "African traditional healers and outcome-contingent contracts in health care," Journal of Development Economics, Elsevier, vol. 71(1), pages 1-22, June.
    6. repec:pri:rpdevs:besley_case_diffusion is not listed on IDEAS
    7. repec:pri:rpdevs:besley_case_diffusion.pdf is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. Gauthier, Bernard & Wane, Waly, 2011. "Bypassing health providers: The quest for better price and quality of health care in Chad," Social Science & Medicine, Elsevier, vol. 73(4), pages 540-549, August.
    3. 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.
    4. 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.
    5. Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009. "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," Journal of Health Economics, Elsevier, vol. 28(1), pages 20-34, January.
    6. Ziegler Andreas, 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), De Gruyter, vol. 230(5), pages 630-652, October.
    7. 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.
    8. 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.
    9. 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.
    10. Leonard, Kenneth L. & Adelman, Sarah W. & Essam, Timothy, 2009. "Idle chatter or learning? Evidence of social learning about clinicians and the health system from rural Tanzania," Social Science & Medicine, Elsevier, vol. 69(2), pages 183-190, July.
    11. Bloom, Gerald & Standing, Hilary & Lloyd, Robert, 2008. "Markets, information asymmetry and health care: Towards new social contracts," Social Science & Medicine, Elsevier, vol. 66(10), pages 2076-2087, May.
    12. 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.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ucp:ecdecc:y:2007:v:55:i:3:p:531-55. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Journals Division). General contact details of provider: http://www.journals.uchicago.edu/EDCC/ .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.