ArticleBMJ global health2022
Tuberculosis diagnosis and management in the public versus private sector: a standardised patients study in Mumbai, India.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Article
- Enhancing tuberculosis care in the private sector: Role of innovative private sector engagement model under programmatic settings in India.PLOS global public health · 2026Article
- Delays in tuberculosis diagnosis and treatment in India: A patient journey analysis from Mumbai and Patna during the COVID-19 Pandemic.PLOS global public health · 2026Article
- Prevalence of Multidrug-Resistant Tuberculosis and Its Association With Previous Treatment History in Adults.Cureus · 2025Article
- Experience of health care utilization for inpatient and outpatient services among older adults in India.Public health in practice (Oxford, England) · 2024Article
- Comparing the Quality of Direct-to-Consumer Telemedicine Dominated and Delivered by Public and Private Sector Platforms in China: Standardized Patient Study.Journal of medical Internet research · 2024Article
- General dentists' treatment plans in response to cosmetic complains; a field study using unannounced-standardized-patient.Heliyon · 2024Article
- Mapping Patient Pathways in Tuberculosis Care: Insights From Gujarat and Jharkhand States of India.Cureus · 2024Article
- Private Doctors' Perspective towards "Patient First" in TB Diagnostic Cascade, Hisar, India.Diagnostics (Basel, Switzerland) · 2024Article
- Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China.BMC health services research · 2024Article
- Impact of the COVID-19 pandemic on quality of tuberculosis care in private facilities in Bandung, Indonesia: a repeated cross-sectional standardized patients study.BMC public health · 2024Article
- Exploring private sector perspectives on barriers and facilitators in availing tuberculosis care cascade services: a qualitative study from the Indian state.BMC primary care · 2024Article
- Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study.PLOS global public health · 2024Article
- Tuberculosis diagnosis and management in the public versus private sector: a standardised patients study in Mumbai, India.BMJ global health · 2022Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are few rigorous studies comparing quality of tuberculosis (TB) care in public versus private sectors.
methodsWe used standardised patients (SPs) to measure technical quality and patient experience in a sample of private and public facilities in Mumbai.
resultsSPs presented a 'classic, suspected TB' scenario and a 'recurrence or drug-resistance' scenario. In the private sector, SPs completed 643 interactions. In the public sector, 164 interactions. Outcomes included indicators of correct management, medication use and client experience. Public providers used microbiological testing (typically, microscopy) more frequently, in 123 of 164 (75%; 95% CI 68% to 81%) vs 223 of 644 interactions (35%; 95% CI 31% to 38%) in the private sector. Private providers were more likely to order chest X-rays, in 556 of 639 interactions (86%; 95% CI 84% to 89%). According to national TB guidelines, we found higher proportions of correct management in the public sector (75% vs 35%; (adjusted) difference 35 percentage points (pp); 95% CI 25 to 46). If X-rays were considered acceptable for the first case but drug-susceptibility testing was required for the second case, the private sector correctly managed a slightly higher proportion of interactions (67% vs 51%; adjusted difference 16 pp; 95% CI 7 to 25). Broad-spectrum antibiotics were used in 76% (95% CI 66% to 84%) of the interactions in public hospitals, and 61% (95% CI 58% to 65%) in private facilities. Costs in the private clinics averaged rupees INR 512 (95% CI 485 to 539); public facilities charged INR 10. Private providers spent more time with patients (4.4 min vs 2.4 min; adjusted difference 2.0 min; 95% CI 1.2 to 2.9) and asked a greater share of relevant questions (29% vs 43%; adjusted difference 13.7 pp; 95% CI 8.2 to 19.3).
conclusionsWhile the public providers did a better job of adhering to national TB guidelines (especially microbiological testing) and offered less expensive care, private sector providers did better on client experience.
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