Concern over the quality of health care services in Bangladesh has led to loss of faith in low utilization of public health facilities, and increasing outflow of Bangladeshi patients to private hospitals. The public health sector is plagued by uneven demand and perceptions of poor quality. Countrywide, the underutilization of available facilities is of significant concern. For example, one study shows that the overall utilization rate for public health care services is as low as 30% (Ricardo et al. 2004).
Moreover, the trend of utilization of public health care services has been declining between 1999 and 2003, while the rate of utilization of private health care facilities for the same period has been increasing (CIET Canada 2003). The unavailability of doctors and nurses, as well as their negative attitudes and behaviors, are major hindrances to the utilization of public hospitals.
The situation is further compounded by lack of drugs, and long travel and waiting times (HEU 2003a). What is particularly disturbing is the lack of empathy of the service providers, their generally callous and casual demeanor, their aggressive pursuit of monetary gains, their poor levels of competence and, occasionally, their disregard for the suffering that patients endure without being able to voice their concerns—all of these service failures are reported frequently in the print media.
Such failures can play a powerful role in shaping patients’ negative attitudes and dissatisfaction with health care service providers and health care itself. The private health care sector also deserves close scrutiny as about 70% of the patients seek medical care from this sector (World Bank 2003). Between 1996 and 2000, private hospitals grew around 15% per annum (HEU 2003b).
Benefits of going to private hospitals than public hospitals:
1. Reliability: Reliability refers to providers’ ability to perform the promised service dependably and accurately. Private hospitals provides good compatible doctors in some cases they have foreign physicians or specialist, who gives treatment here in visiting basis. They have high-tech machineries which gives accurate and precise results. Supervision of patients is also good for patients who are admitted here. Where public hospital mostly runs with inter doctors who newly started their work. Their medical tests are not that much reliable, as due to inefficient staff and back-dated machinery.
2. Responsiveness: Private hospital staffs respond promptly when needed. The requirement equipments are available, functional and able to provide quick diagnoses of diseases. Also prescribed drugs are available and properly administered. But in public hospitals the response is not that much quick, with lack of proper equipments. The prescribed drugs are not that much available.
3. Assurance: here in private hospitals, with knowledge, skill and courtesy of the doctors and nurses can provide a sense of assurance that they have the patient’s best interest in mind. They deliver their services with integrity, fairness and beneficence. In the health care system, assurance is embodied in service providers who correctly interpret laboratory reports, diagnose the disease competently, provide appropriate explanations to queries, and generate a sense of safety. But the public hospitals give a totally opposite impression.
4. Discipline: In Private hospitals the doctors maintain proper visiting schedules and that there are structured visiting hours for relatives, friends, etc. A clean and organized appearance of a hospital, its staff, its premises, restrooms, equipment, wards and beds are visible. The practices of paying ‘Baksheesh’ (an informal but small facilitation payment) are strictly prohibited here.
This contention was largely supported since private hospitals obtained better ratings than public hospitals on most of the measures of responsiveness, communication, and discipline. These differences suggest that private hospitals are playing a meaningful role in society, justifying their existence, continuation.