| Synopsis of the Research Project |
| Title: |
NCCDs in India – A study of the gaps , quality and cost of care |
| Research Organization: |
IMRB International |
| Date of Release : |
January 16, 2009 |
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Continued from Page 1 |
Methodology: |
Research Design: The research is proposed to be conducted in two stages: |
Stage-1: Exploratory Stage: is proposed to understand the critical service parameters and the standards of care for each non-communicable disease. This would be through Secondary -research and in-depth interviews with experts in India.
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Secondary research on available literature is proposed to enable benchmark for chronic diseases - both internationally and nationally. Exhaustive interviews with experts are proposed to formulate the benchmarks for the services available in India. It is proposed to freeze these benchmarks in consultation with an expert panel (Medical Advisory Board of CCF). The services available in each of the selected Primary sampling units would then be compared with the identified benchmarks. |
Stage-2: Survey Stage: is proposed to assess the extent of service availability, the depth and the quality of care available across the four regions in India. This stage is proposed to be conducted through a survey of the facilities and collection of information from the beneficiaries. Facility Survey would cover Government as well as private centers and the beneficiary survey would assess the levels of availing the services and key triggers and barriers for the service usage. |
| Target Groups: for the study would be: |
Medical Service Providers (from government and non-government health institutions): This would include doctors who attend specific non-communicable diseases (CKD, CVD & Diabetes) and also a small sample of those who attend to all kinds of medical complaints in the selected units of study (PSUs – Primary Sampling Units- either a village or a ward). The sample for the study would include service delivery points at primary, secondary & tertiary levels at each of the selected PSUs. |
Beneficiaries: Patients affected with any of the three non-communicable diseases (Diabetes, CKD & CVD) would be interviewed in the selected PSUs. |
Geographical Coverage and the Sample Size: The study is proposed to be conducted across all four regions of India (North, East, and West & South) and would cover three geographic levels – urban, semi-urban and rural. The sampling of the PSUs is proposed with the help of Census of India and as there is no legal definitions of ‘semi-urban’ in the Census, the differentiation between ‘urban’ and ‘semi-urban’ would be taken into consideration with the help of POPs data. This POPs data will facilitate the sampling in urban wards according to the population statistics and would help to cover areas with different levels of population. The analysis of the data can also be done with this stratification. |
Sample Size for Healthcare facilities: For a holistic coverage across the regions, the study would cover 90 PSUs in each region. These 90 PSUs in each region would be a proportionate mix of villages and urban wards. In total 360 PSUs would be covered across India. |
Sample Size for Beneficiaries: The beneficiaries would be afflicted households (with any of these three chronic diseases) and it is proposed to cover 5 afflicted households per PSU. In total 1800 beneficiaries would be covered across India. Proposed Stages for the survey: |
| Preparatory Stage: |
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Exploratory Research consisting collection of Secondary data, review of available literature and depth interviews with experts. |
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Preparation and pretesting of Research tools, and their translation into regional languages after pretesting |
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Sampling and selecting the PSU through Census (wards & villages selected with the size of population) within each region (North, East, West & South) |
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a. For facilities: Census of all medical facilities in each PSU and |
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b. For beneficiaries: Sampling of the beneficiaries in the PSU |
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Training and briefing of the Field Team. |
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| Execution Stage: |
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Collection of data from: |
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a. Facilities: Availability and type of services offered for three chronic diseases at the medical facility within the selected PSUs, together with the assessment of cost of care. |
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b. Beneficiaries: Information on type of initial disease suffered, treatment sought, level of satisfaction from the medical facility for prevention, diagnosis, treatment, & rehabilitation and assessment of the cost of care –direct as well as indirect. |
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Data entry and analysis |
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Evaluation and assessment of services and quality of care provided in each facility vis-à-vis to those as benchmarked by expert panel. |
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Report on critical indicators and explanatory variables, along with the measures on the critical indicators for each group. Indicators are expected for each region, rural-urban, service type, service level for all the Target Groups that are covered in that region. |
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Detailed draft report on the basis of the above. |
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Final report with both qualitative and quantitative findings together with all additional analysis required and as suggested by expert panel. |
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