The quality divide: patient and staff perceptions of care quality in private and public hospitals in India

Background/Aims Private healthcare facilities are often believed to provider better quality services than public healthcare facilities. This study compared perceived quality of care received at public and private hospitals among nurses and patients in Ranchi, India. Methods A cross-sectional design was deployed, including 37 hospitals (25 private, 12 public). Structured questionnaires were distributed to patients and nurses to assess perceptions of care quality across four dimensions: safety, patient-centredness, effectiveness and efficiency. Items were scored on a 5-point Likert scale. Scores above and below the 75th percentile were characterised as indicating ‘good’ and ‘bad’ quality respectively. Results were analysed using multiple linear regression and Z tests of proportions to compare public and private hospitals. Results Regression analysis showed no significant differences in care quality scores given by patient participants between public and private hospitals after adjusting for patient characteristics and competitive landscape. However, Z tests showed statistically significant differences, with patients and staff in private hospitals more likely to rate their service as ‘good’ compared to those in public hospitals. Conclusions This study suggests that private hospitals do not necessarily provide better quality care than public hospitals in this region, although both patients and staff were more likely to rate private facilities as ‘good’, reflecting the complex nature of quality perception. Increasing healthcare quality and access is crucial to achieving universal health coverage. Implications for practice Healthcare leaders and policymakers should focus on enhancing care quality in both the public and private sector, prioritising broad strategies that can enhance care quality in both types of facility. This should include implementing robust measures for quality control across the healthcare system.