A dynamic model of quality assurance in primary healthcare in developing countries

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International Journal of Healthcare Management


dynamic investment, dynamic optimization, healthcare, Hotelling, Quality assurance, spillover effects


© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. Purpose: This study aims to examine the impact of investments in Quality Assurance (QA) within the primary healthcare industry in developing countries using a dynamic economic model. Study design: The study deviates from a static framework to examine the case where healthcare quality is a dynamic stock, which increases over time due to investments in quality assurance by healthcare providers and deteriorates due to resources being overused or becoming obsolete. Dynamic optimization is used to examine the behaviour of a representative primary healthcare (PHC) provider and the implications for other healthcare providers in the field. Findings: The study supports the argument for long term benefits of quality assurance investments. At least two stable steady state paths were revealed. In one case, healthcare providers experience a period of decreasing healthcare quality and the need for increased investment in quality assurance. This is typical of the healthcare industry in many developing countries where the focus has been on amassing production inputs. The second path is characterized by increasing healthcare quality over time without the need for additional investment in quality assurance as the healthcare providers enjoy sustained returns on their initial investment in quality assurance. Implications: Policymakers are advised to monitor their current level of healthcare quality provided to their clients. They should be proactive in their approach to elevating the quality of healthcare. Once the focus changes from that of stockpiling healthcare inputs to one of investment in quality assurance, not only will the quality of healthcare improve, but it will be sustainable as the healthcare industry will reap the lasting returns on their investment in quality assurance.

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