Do Patients Value High-Quality Medical Care ? Experimental Evidence from Malaria Diagnosis and Treatment (English)

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.