Monday, December 16, 2019

Perceptions of healthcare quality in Georgia

Affordable healthcare remains one of the main national issues for people in Georgia: 18% of people considered it one of the most important issues in the July 2019 CRRC and NDI survey. The salience of this issue was at its highest in 2012 (35%), and has decreased over the years, particularly in light of the passage of the universal health insurance program. Nonetheless, affordable healthcare remains one of the most important issues for the public and particularly the cost of medicine, which is one of the three largest costs for over a third of families in Georgia. In this regard, it is unsurprising that over half of the population name the cost of medicine or the cost of care/doctor visits as the largest ones facing the healthcare system in Georgia. The second most common issue, which 24% of respondents named on the question about issues in the healthcare system, was a concern over the lack of professionalism of doctors and medical personnel, something associated with the quality of care.

At some level, people have contradictory attitudes towards the quality of care in Georgia. For instance, the majority of people in Georgia (71%) are satisfied with the quality of healthcare. Moreover, the majority of the population (79%) trusts the medical diagnoses that doctors give in Georgia.  At the same time, every other person reports that if they were in need of complicated surgery or treatment, they would prefer to have it done abroad instead of in Georgia.

Further analysis of the above questions suggests that assessments of the universal healthcare program, ethnicity, and age are related to people’s satisfaction with quality of care. People who assess the universal healthcare program positively are more likely to be satisfied with the quality of healthcare in Georgia. Similarly, ethnic minorities and people between the ages of 35 and 54 are more likely to be satisfied than ethnic Georgians and younger people (18-34). Aside from demographics, people who do not trust diagnoses are more likely to be dissatisfied with the quality of the healthcare as are people who report that they felt like doctors prescribed medicine for personal financial gain.

 As with the previous analyses, a number of factors predict whether or not someone wants to seek treatment abroad, including education level, wealth, ethnicity, and age. Wealthier people are more likely to prefer to have surgery done abroad than in Georgia. Ethnic Georgians, young people, and people who have higher than secondary education are also more likely to prefer having surgery done abroad. As in the previous analysis, attitudes like trust in diagnoses and satisfaction with healthcare quality are also associated with preferences for treatment/surgery abroad. People who distrust diagnoses that doctors give in Georgia and people who are not satisfied with the quality of healthcare in Georgia are more likely to report that they would prefer surgery to be done abroad. The same is true of people who felt that doctors prescribed medicine they did not need for personal financial gain.

The above analyses lead to a number of conclusions. First, people’s satisfaction with the quality of healthcare is associated with their attitudes towards other aspects of the healthcare system in Georgia. Second, ethnic Georgians, wealthy people, and young people perceive a lower quality of healthcare. Third, people’s views are contradictory. On the one hand, they express satisfaction with the quality of care, while related questions suggest there are issues with healthcare quality.

Note: The data in the above analysis and replication code for the above analysis is available here and here. The analysis uses a logistic regression, which includes the variables depicted in the graphs above.

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