IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v63y2006i9p2330-2340.html
   My bibliography  Save this article

Outpatient process quality evaluation and the Hawthorne Effect

Author

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

Abstract

We examine the evidence that the behavior of clinicians is impacted by the fact that they are being observed by a research team. Data on the quality of care provided by clinicians in Arusha region of Tanzania show a marked fall in quality over time as new patients are consulted. By conducting detailed interviews with patients who consulted both before and after our research team arrived we are able to show strong evidence of the Hawthorne effect. Patient-reported quality is steady before we arrive, rises significantly (by 13 percentage points) at the moment we arrive and then falls steadily thereafter. We show that quality after we arrive begins to look similar to quality before we arrived between the 10th and 15th consultations. Implications for quality measurement and policy are discussed.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:9:p:2330-2340
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(06)00306-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    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. Madden, J. M. & Quick, J. D. & Ross-Degnan, D. & Kafle, K. K., 1997. "Undercover careseekers: Simulated clients in the study of health provider behavior in developing countries," Social Science & Medicine, Elsevier, vol. 45(10), pages 1465-1482, November.
    2. Das, Jishnu & Hammer, Jeffrey, 2005. "Which doctor? Combining vignettes and item response to measure clinical competence," Journal of Development Economics, Elsevier, vol. 78(2), pages 348-383, December.
    3. John DiNardo & Justin L. Tobias, 2001. "Nonparametric Density and Regression Estimation," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 11-28, Fall.
    4. Thaver, Inayat H. & Harpham, Trudy & McPake, Barbara & Garner, Paul, 1998. "Private practitioners in the slums of Karachi: what quality of care do they offer?," Social Science & Medicine, Elsevier, vol. 46(11), pages 1441-1449, January.
    5. Evans, P. J. & Zinkin, P. & Harpham, T. & Chaudury, G., 2001. "Evaluation of community-based rehabilitation for disabled persons in developing countries," Social Science & Medicine, Elsevier, vol. 53(3), pages 333-348, August.
    6. Bradley, Janet E. & Mayfield, Marcia V. & Mehta, Manisha P. & Rukonge, Anatole, 2002. "Participatory evaluation of reproductive health care quality in developing countries," Social Science & Medicine, Elsevier, vol. 55(2), pages 269-282, July.
    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. Nordyke, Robert J., 2002. "Determinants of PHC productivity and resource utilization: a comparison of public and private physicians in Macedonia," Health Policy, Elsevier, vol. 60(1), pages 67-96, April.
    2. Massimiliano BRATTI & Chiara BROCCOLINI & Stefano STAFFOLANI, 2006. "Is '3+2' Equal to 4? University Reform and Student Academic Performance in Italy," Working Papers 251, Universita' Politecnica delle Marche (I), Dipartimento di Scienze Economiche e Sociali.
    3. Alfredo Paloyo & Arndt Reichert, 2017. "Biting Back at Malaria: Assessing Health-service Providers' Compliance with Treatment Guidelines," Review of Development Economics, Wiley Blackwell, vol. 21(3), pages 591-626, August.
    4. Gulati, Namrata & Ray, Tridip, 2016. "Inequality, neighbourhoods and welfare of the poor," Journal of Development Economics, Elsevier, vol. 122(C), pages 214-228.
    5. Hisahiro Naito, 2003. "Atkinson and Stiglitz Theorem with Endogenous Human Capital Accumulation," ISER Discussion Paper 0596, Institute of Social and Economic Research, Osaka University.
    6. Jin, Fangyi, 2011. "Revisiting the composition puzzles of the household portfolio: New evidence," Review of Financial Economics, Elsevier, vol. 20(2), pages 63-73, May.
    7. Chen, Yongmin & Puttitanun, Thitima, 2005. "Intellectual property rights and innovation in developing countries," Journal of Development Economics, Elsevier, vol. 78(2), pages 474-493, December.
    8. 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.
    9. Yo Chul Choi & David Hummels & Chong Xiang, 2006. "Explaining Import Variety and Quality: The Role of the Income Distribution," NBER Working Papers 12531, National Bureau of Economic Research, Inc.
    10. Patrick Sakdapolrak & Thomas Seyler & Christina Ergler, 2013. "Burden of direct and indirect costs of illness: Empirical findings from slum settlements in Chennai, South India," Progress in Development Studies, , vol. 13(2), pages 135-151, April.
    11. O'Neill, Donal & Sweetman, Olive & Van de gaer, Dirk, 2006. "The impact of cognitive skills on the distribution of the black-white wage gap," Labour Economics, Elsevier, vol. 13(3), pages 343-356, June.
    12. 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.
    13. 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.
    14. Emmanuel Skoufias & Vincenzo Di Maro & Teresa González‐Cossío & Sonia Rodríguez Ramírez, 2009. "Nutrient consumption and household income in rural Mexico," Agricultural Economics, International Association of Agricultural Economists, vol. 40(6), pages 657-675, November.
    15. 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.
    16. Kenneth L. Leonard & Melkiory C. Masatu & Alexandre Vialou, 2007. "Getting Doctors to Do Their Best: The Roles of Ability and Motivation in Health Care Quality," Journal of Human Resources, University of Wisconsin Press, vol. 42(3).
    17. Alaka Holla & Jishnu Das & Aakash Mohpal & Karthik Muralidharan, 2015. "Quality and Accountability in Healthcare Delivery: Audit Evidence from Primary Care Providers in India," Working Papers id:7219, eSocialSciences.
    18. Justin L. Tobias, 2003. "Are Returns to Schooling Concentrated Among the Most Able? A Semiparametric Analysis of the Ability–earnings Relationships," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 65(1), pages 1-29, February.
    19. Onji, Kazuki, 2009. "The response of firms to eligibility thresholds: Evidence from the Japanese value-added tax," Journal of Public Economics, Elsevier, vol. 93(5-6), pages 766-775, June.
    20. Auer, Christian & Lagahid, Jaime Y. & Tanner, Marcel & Weiss, Mitchell G., 2006. "Diagnosis and management of tuberculosis by private practitioners in Manila, Philippines," Health Policy, Elsevier, vol. 77(2), pages 172-181, July.

    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:63:y:2006:i:9:p:2330-2340. 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.