Can information about the value of diagnostic tests improve provider practice and help patients recognize higher quality of care? In a randomized experiment at public clinics in Mali, health providers and patients received tailored information about the importance of rapid diagnostic tests (RDTs) for malaria. The provider training increased provider reliance on RDTs, improving the match between a patient's malaria status and treatment with antimalarials by 15-30 percent. Nonetheless, patients were significantly less satisfied with the care they received, driven by those whose prior beliefs did not match their true malaria status. The patient information intervention did not affect treatment outcomes or patient satisfaction and reduced malaria testing. These findings are consistent with highly persistent patient beliefs that translate into low demand for diagnostic testing and limit patients' ability to recognize improved quality of care.
Authors
- Acknowledgements & Disclosure
- We thank the staff of IPA Mali and especially Alassane Koulibaly for expert field coordination. This project would not have been possible without the advice and support of Dr. Seydou Doumbia and Dr. Issaka Sagara (Malaria Research and Training Center, University of Bamako) as well as Dr. Seydou Fomba (Programme National de Lutte contre le Paludisme (PNLP)). We thank the Ministry of Health and the participating community clinics for allowing us to conduct this research. The study was funded by ESRC/DFID Development Frontiers Award ES/N00583X/1. The research protocol was approved by the IRB of La Faculté de Médecine de Pharmacie et d'Odontostomatologie de Bamako (FMPOS) (protocol No. 2016/47/CE/FMPOS) and registered in the AEA RCT registry at https://www.socialscienceregistry.org/trials/1707. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent. All errors are our own. None of the authors on this paper have any material or financial relationships to disclose. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
- DOI
- https://doi.org/10.3386/w32075
- Published in
- United States of America
