IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v181y2017icp54-65.html
   My bibliography  Save this article

Changing health care provider performance through measurement

Author

Listed:
  • Leonard, Kenneth L.
  • Masatu, Melkiory C.

Abstract

Can the quality of care be improved by repeated measurement? We show that measuring protocol adherence repeatedly over ten weeks leads to significant improvements in quality immediately and up to 18 months later without any additional training, equipment, supplies or material incentives. 96 clinicians took part in a study which included information, encouragement, scrutiny and repeated contact with the research team measuring quality. We examine protocol adherence over the course of the study and for 45 of the original clinicians 18 months after the conclusion of the project. Health workers change their behavior significantly over the course of the study, and even eighteen months later demonstrate a five percentage point improvement in quality. The dynamics of clinicians’ reactions to this intervention suggest that quality can be improved by the repeated measurement by external peers in a way that provides reminders of expectations.

Suggested Citation

  • Leonard, Kenneth L. & Masatu, Melkiory C., 2017. "Changing health care provider performance through measurement," Social Science & Medicine, Elsevier, vol. 181(C), pages 54-65.
    • Handle: RePEc:eee:socmed:v:181:y:2017:i:c:p:54-65
    DOI: 10.1016/j.socscimed.2017.03.041
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617301958
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2017.03.041?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

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

    References listed on IDEAS

    as
    1. Leonard, Kenneth & Masatu, Melkiory C., 2006. "Outpatient process quality evaluation and the Hawthorne Effect," Social Science & Medicine, Elsevier, vol. 63(9), pages 2330-2340, November.
    2. Canice Prendergast, 2007. "The Motivation and Bias of Bureaucrats," American Economic Review, American Economic Association, vol. 97(1), pages 180-196, March.
    3. J. Michelle Brock & Andreas Lange & Kenneth L. Leonard, 2016. "Generosity and Prosocial Behavior in Healthcare Provision: Evidence from the Laboratory and Field," Journal of Human Resources, University of Wisconsin Press, vol. 51(1), pages 133-162.
    4. Jonathan T. Kolstad, 2013. "Information and Quality when Motivation is Intrinsic: Evidence from Surgeon Report Cards," NBER Working Papers 18804, National Bureau of Economic Research, Inc.
    5. Grant Miller & Kimberly Singer Babiarz, 2013. "Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs," NBER Working Papers 18932, National Bureau of Economic Research, Inc.
    6. Das, Jishnu & Hammer, Jeffrey, 2007. "Money for nothing: The dire straits of medical practice in Delhi, India," Journal of Development Economics, Elsevier, vol. 83(1), pages 1-36, May.
    7. Josse Delfgaauw, 2007. "Dedicated Doctors: Public and Private Provision of Health Care with Altruistic Physicians," Tinbergen Institute Discussion Papers 07-010/1, Tinbergen Institute, revised 17 Sep 2007.
    8. Jonathan T. Kolstad, 2013. "Information and Quality When Motivation Is Intrinsic: Evidence from Surgeon Report Cards," American Economic Review, American Economic Association, vol. 103(7), pages 2875-2910, December.
    9. Kenneth L. Leonard & Melkiory C. Masatu, 2010. "Professionalism and the know‐do gap: exploring intrinsic motivation among health workers in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1461-1477, December.
    10. Campbell, Donald T., 1979. "Assessing the impact of planned social change," Evaluation and Program Planning, Elsevier, vol. 2(1), pages 67-90, January.
    11. György Bèla Fritsche & Robert Soeters & Bruno Meessen, 2014. "Performance-Based Financing Toolkit [Boîte à outils : Financement basé sur la performance]," World Bank Publications - Books, The World Bank Group, number 17194.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. J. Michelle Brock & Andreas Lange & Kenneth L. Leonard, 2016. "Generosity and Prosocial Behavior in Healthcare Provision: Evidence from the Laboratory and Field," Journal of Human Resources, University of Wisconsin Press, vol. 51(1), pages 133-162.
    2. Okeke, Edward N., 2022. "Playing defense? Health care in the era of Covid," Journal of Health Economics, Elsevier, vol. 85(C).
    3. Bauhoff,Sebastian Peter Alexander & Kandpal,Eeshani, 2021. "Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts," Policy Research Working Paper Series 9687, The World Bank.
    4. Brock, J. Michelle & Lange, Andreas & Leonard, Kenneth L., 2015. "Esteem and social information: On determinants of prosocial behavior of clinicians in Tanzania," Journal of Economic Behavior & Organization, Elsevier, vol. 118(C), pages 85-94.
    5. Olivella, Pau & Siciliani, Luigi, 2017. "Reputational concerns with altruistic providers," Journal of Health Economics, Elsevier, vol. 55(C), pages 1-13.
    6. Simona Grassi & Ching-to Albert Ma, 2016. "Information acquisition, referral, and organization," RAND Journal of Economics, RAND Corporation, vol. 47(4), pages 935-960, November.
    7. Pablo A. Celhay & Paul J. Gertler & Paula Giovagnoli & Christel Vermeersch, 2019. "Long-Run Effects of Temporary Incentives on Medical Care Productivity," American Economic Journal: Applied Economics, American Economic Association, vol. 11(3), pages 92-127, July.
    8. Pedersen, Line Bjørnskov & Andersen, Merethe Kirstine Kousgaard & Jensen, Ulrich Thy & Waldorff, Frans Boch & Jacobsen, Christian Bøtcher, 2018. "Can external interventions crowd in intrinsic motivation? A cluster randomised field experiment on mandatory accreditation of general practice in Denmark," Social Science & Medicine, Elsevier, vol. 211(C), pages 224-233.
    9. Bonfrer, Igna & Van de Poel, Ellen & Van Doorslaer, Eddy, 2014. "The effects of performance incentives on the utilization and quality of maternal and child care in Burundi," Social Science & Medicine, Elsevier, vol. 123(C), pages 96-104.
    10. Bernal, Pedro & Martinez, Sebastian, 2020. "In-kind incentives and health worker performance: Experimental evidence from El Salvador," Journal of Health Economics, Elsevier, vol. 70(C).
    11. Duchoslav, Jan & Cecchi, Francesco, 2019. "Do incentives matter when working for god? The impact of performance-based financing on faith-based healthcare in Uganda," World Development, Elsevier, vol. 113(C), pages 309-319.
    12. Raf Van Gestel & Tobias Müller & Johan Bosmans, 2018. "Learning from failure in healthcare: Dynamic panel evidence of a physician shock effect," Health Economics, John Wiley & Sons, Ltd., vol. 27(9), pages 1340-1353, September.
    13. Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2022. "Well-Informed Choices? Effects of Information Interventions in Primary Care on Care Quality," Working Papers 2022:2, Lund University, Department of Economics.
    14. Michael Geruso & Timothy Layton, 2020. "Upcoding: Evidence from Medicare on Squishy Risk Adjustment," Journal of Political Economy, University of Chicago Press, vol. 128(3), pages 984-1026.
    15. Diane Alexander, 2017. "How do Doctors Respond to Incentives? Unintended Consequences of Paying Doctors to Reduce Costs," Working Paper Series WP-2017-9, Federal Reserve Bank of Chicago.
    16. Lohmann, Julia & Houlfort, Nathalie & De Allegri, Manuela, 2016. "Crowding out or no crowding out? A Self-Determination Theory approach to health worker motivation in performance-based financing," Social Science & Medicine, Elsevier, vol. 169(C), pages 1-8.
    17. Anna D Gage & Margaret E Kruk & Tsinuel Girma & Ephrem T Lemango, 2018. "The know-do gap in sick child care in Ethiopia," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-10, December.
    18. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    19. Michele Fioretti, 2022. "Caring or Pretending to Care? Social Impact, Firms' Objectives, and Welfare (former title: Social Responsibility and Firm's Objectives)," SciencePo Working papers hal-03393065, HAL.
    20. Richards-Shubik, Seth & Roberts, Mark S. & Donohue, Julie M., 2022. "Measuring quality effects in equilibrium," Journal of Health Economics, Elsevier, vol. 83(C).

    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:eee:socmed:v:181:y:2017:i:c:p:54-65. See general information about how to correct material in RePEc.

    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 bibliographic 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.