Impact assessment of accreditation in primary and secondary public Healthcare Institutions in the State of Kerala, India

Objectives This study examines the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare facilities in Kerala, India. Study Design A cross-sectional study. Setting Kerala State, India Participants Participants are the in-patients (621) who are admitted in medical wards at accredited (312) and non-accredited (309) public healthcare facilities. Main Outcome Measures Ten constructs used in the study, overarching the quality healthcare delivery, adapting previous studies, SERVQUAL, and Donabedian’s SPO models, are Physical Facility, Admission Services, Patient centeredness, Accessibility of Medical Care, Financial Factors, Professionalism, Staff Services, Medical Quality, Diagnostic Services, and Patient Satisfaction. Methods The study employed a positivist approach using a survey questionnaire. The study was conducted from July 2017 to July 2018, using stratified random sampling consists of the four strata; GHs, W&C hospitals, THQHs/THs and CHCs. Results Accreditation has a positive impact on patient satisfaction and other quality dimensions, overarching structural and procedural quality in primary healthcare facilities under the public sector in Kerala. Conversely, accreditation has not improved the quality dimensions in secondary healthcare facilities and thereby, the satisfaction of patients. Conclusions It cannot be assumed that accreditation is always associated with quality care in primary healthcare facilities. The implementation process must be systematic and must be regularly monitored to make it useful. Mere structural transformation through accreditation alone cannot guarantee patient satisfaction. Secondary healthcare facilities must be transformed into quality care centres through rhetoric action of the authorities concerned through organized efforts.