Accessing healthcare facilities is a high involvement process for any individual. A typical care seeker would explore and research before taking any decision regarding the choice of provider, especially if he is looking for a solution for a serious health issue. Th e opinions of influencers like family and friends have always swayed the decision of an individual with regards to which healthcare provider he chooses. However, with more and more people migrating to cities and countries where their social support systems have to be built from scratch, the scenario is changing rapidly. It has become imperative that a care seeker be enabled to make quick judgments from publicly available information sources in order to circumvent the immediate absence of influencers. Furthermore it has become essential that publicly available information sources themselves be reliable, easy to understand and qualified.

It is prudent to have a peek at how a person seeks healthcare before delving into the riddle of ‘quality’ in healthcare. Determinant models of health seeking behavior like Andersen’s Healthcare Utilization Model propose that apart from external factors like social, cultural & environmental factors, the healthcare system itself infl quenches the health seeking behavior of an individual. Th is means that intrinsic elements of healthcare systems and healthcare providers are consciously & subconsciously analyzed by the care seeker before he makes a decision. And it would not be injudicious to presume that quality of healthcare being delivered is an element that would influence the decision of a health seeker.

However, the underlying observation of all health behavior research is that health seeking behavior does not always take ‘the form that scientific medicine thinks is most appropriate’ . What this implies is that people may take treatment from hakims or from super-specialists with equal degree of hope and trust. So is there a way of comparing the ‘quality’ of healthcare being delivered by a hakim and the super-specialist like a cardiologist?

Let us take a break from this confounding ground reality to have a look at how quality of healthcare providers is measured by academicians, regulatory authorities and providers themselves.

Various consultants and accrediting bodies have developed detailed methodologies to assess the quality of healthcare being delivered by health care providers, mainly hospitals. Most of these models are based on research conducted or funded by health regulatory bodies in the Western hemisphere. These models are either based on observation of processes or outcome measures (or both). There are complex models that evaluate both process and outcome measures.

Some of the process based elements of quality are:

1. Access (e.g. ability to get urgent appointments, adequate number of surgeries performed)
2. Chronic Care Processes (e.g. maintenance of long term records, regular review)
3. Emergency Processes (e.g. Aspirin at arrival for acute myocardial infarction)

Some outcome measures used to evaluate quality include:

1. Number of Caesarian Sections per 100 births (high rates indicate inappropriate use of C-sections and hence inferior quality)
2. Number of complications per 100 surgeries
3. Number of nosocomial infections (infections acquired in hospitals)

The above measures are just a tip of the iceberg and there exist hundreds of such measures, each being well thought out and well researched.

Nevertheless, the major drawback in each of these measures is that it requires the health care provider to disclose outcomes and processes transparently. It also requires independent audits by strong, autonomous agencies or regulatory bodies. Moreover, the indicators are not easy to interpret for the lay person.

Which brings us back to the initial enigma of how does the health-seeker compare the quality of two 100 bedded hospitals, let alone deciding between cholecystectomy and olive oil therapy for bladder stones. The answer probably lies not in the methodology of quality analysis but the quality of the source of information itself !!! i.e. the source of information for the health seeker to make his health seeking choices. And in this case quality would be defined by the credibility and trust that the care seeker places on the source.

As mentioned in the beginning of this article, public sources of information, like health websites, are being increasingly relied on. Hence it is essential to invest in maintaining the quality of these sources. To build this credibility the ‘source’ will have to utilize some of the above mentioned measures and indicators to assess a healthcare provider’s quality. But this will not suffice.

It is important that a constant learning process be set in motion with care seekers being able to voice their personal experience about a particular health encounter. It is a movement towards consumer centric health care and patient satisfaction is at the core. After all, beyond all measures and indicators, quality of the health care provider is a sum total of individual experiences of health care seekers.

One such initiative in this direction is www.healthcaremagic.com, which allows care seeker to highlight their opinion about a healthcare provider. It also allows the healthcare seeker to do a live chat with a qualified doctor who can guide the care seeker in identifying the best place for seeking the medical care.

Visit www.healthcaremagic.com !!