INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE最新文献

{"title":"The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran.","authors":"Mohsen Pakdaman,&nbsp;Raheleh Akbari,&nbsp;Hamid Reza Dehghan,&nbsp;Asra Asgharzadeh,&nbsp;Mahdieh Namayandeh","doi":"10.1108/IJHCQA-02-2019-0042","DOIUrl":"https://doi.org/10.1108/IJHCQA-02-2019-0042","url":null,"abstract":"<p><strong>Purpose: </strong>For years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.</p><p><strong>Design/methodology/approach: </strong>In this descriptive-analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.</p><p><strong>Findings: </strong>QALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.</p><p><strong>Originality/value: </strong>This study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-02-2019-0042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38153573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the US hospital reimbursement: how patient satisfaction in HCAHPS reflects lower readmission.","authors":"Hui-Chuan Chen,&nbsp;Tommy Cates,&nbsp;Monty Taylor,&nbsp;Christopher Cates","doi":"10.1108/IJHCQA-03-2019-0066","DOIUrl":"https://doi.org/10.1108/IJHCQA-03-2019-0066","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to examine whether patient readmission rates are associated with patient satisfaction and Medicare reimbursement rates in the US hospitals.</p><p><strong>Design/methodology/approach: </strong>The Hospital Compare database was obtained from the Centers for Medicare and Medicaid Services (CMS) in the US. A total of 2,711 acute care hospitals were analyzed for this present study. The data included patient satisfaction surveys, hospital 30-days readmission ratios for heart failure and pneumonia patients and related payments. Exploratory factor analysis was applied in the first stage to operationalize constructs for scale development. Partial least squares (PLS) modeling analysis via Smart-PLS was utilized for testing the hypotheses.</p><p><strong>Findings: </strong>Results indicated that data provided from the Hospital Compare database for the acute care hospitals accurately reflect quality outcomes. Nevertheless, the Medicare Hospital Readmissions Reduction Program (HRRP) did not penalize the hospitals when patients reported lower satisfaction via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.</p><p><strong>Originality/value: </strong>The findings suggest that a high-readmission rate is not associated with lower payment. Such results appear to conflict with the goals of value-based purchasing programs, which seek to penalize hospitals financially for higher readmission rates.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-03-2019-0066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38132846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction with maternal and birth services: a survey in public hospitals in Turkey.","authors":"Şirin Özkan,&nbsp;Chifa Chiang,&nbsp;Gökhan Aba,&nbsp;Yusuf Çelik","doi":"10.1108/IJHCQA-08-2019-0146","DOIUrl":"https://doi.org/10.1108/IJHCQA-08-2019-0146","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run hospitals in Northwestern Turkey.</p><p><strong>Design/methodology/approach: </strong>This was a cross-sectional study. The sample consisted of 580 women who underwent normal delivery (ND) and 392 who had a C-section (CS). Data were collected using two maternal satisfaction questionnaires, which participants completed right before they were discharged.</p><p><strong>Findings: </strong>More than half of ND (61.7%) and CS (56.9%) participants were satisfied with maternal care. ND participants who had received antenatal training were more satisfied with maternal care than CS participants who had not received antenatal training. Higher income was a significant predictor for reduced satisfaction with maternal care among CS participants (<i>p</i> = 0.031).</p><p><strong>Practical implications: </strong>Hospital administrators and decision-makers should meet women's expectations, provide them with comfort, encourage them for skin-to-skin contact and respect their right to privacy in order to increase their satisfaction with maternal care. Pregnant women should also be encouraged to receive antenatal training offered by hospitals before delivery.</p><p><strong>Originality/value: </strong>The evidence-based results of the study will help hospital administrators to improve healthcare quality and focus on increasing women's satisfaction with maternal care.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"33 4-5","pages":"363-372"},"PeriodicalIF":1.5,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-08-2019-0146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38401562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tool to assess the quality perception of healthcare employees.","authors":"Ajayan Kamalasanan,&nbsp;Gurumoorthy Sathiyamurthi,&nbsp;Arun Vijay Subbarayalu","doi":"10.1108/IJHCQA-01-2020-0008","DOIUrl":"https://doi.org/10.1108/IJHCQA-01-2020-0008","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this project was to determine the validity and reliability of the Healthcare Quality Perception (HQP) questionnaire tool designed to capture employees' perceptions of healthcare quality in Indian hospitals.</p><p><strong>Design/methodology/approach: </strong>Two hundred employees in private and public sector hospitals in India were randomly selected and given the HQP tool. It consisted of 38 Likert-scale items and six different subscales: (1) Planning and Documentation (<i>n</i> = 7); (2) Employee Participation in Quality Management Activities (<i>n</i> = 5); (3) Existence of Policies/Procedures/Guidelines (<i>n</i> = 5); (4) Quality and Patient Safety Management (<i>n</i> = 9); (5) Perceived Effect of Quality Improvement (<i>n</i> = 7) and (6) Training and Development Opportunities (<i>n</i> = 5). 156 completed questionnaires were received, demonstrating a 78% response rate. HQP tool subjected to statistical analysis to measure its reliability and validity. A <i>p</i>-value of less than 0.05 was considered as \"significant.\"</p><p><strong>Findings: </strong>Factor analysis pulled out six factors that conjointly demonstrated 66.4 % of the variance in healthcare professionals' (HCPs') perception of healthcare service quality in selected Indian hospitals. The overall Cronbach's alpha coefficient was measured at 0.959 for internal consistency reliability. This study demonstrates that the identified six critical factors are important determinants influencing HCPs' perception of the quality of healthcare services in private and public sector hospitals in India.</p><p><strong>Originality/value: </strong>This study provides evidence for the reliability and validity of the newly developed HCP Scale for the assessment of employee perception of the quality of services offered in selected hospitals in India, with potential applications in other contexts.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-01-2020-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38042563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying contextually relevant improvement measures, illustrated by a case of executive walkrounds.","authors":"Nick J Reed,&nbsp;Natalie Wilson,&nbsp;Kathryn J Hayes","doi":"10.1108/IJHCQA-08-2019-0140","DOIUrl":"https://doi.org/10.1108/IJHCQA-08-2019-0140","url":null,"abstract":"<p><strong>Purpose: </strong>A method to engage salient organisational stakeholders in identifying and ranking measures of healthcare improvement programs is described. The method is illustrated using Executive WalkRounds (EWRs) in a multi-site Australian Health District.</p><p><strong>Design/methodology/approach: </strong>Subject matter experts (SMEs) conducted document analysis, identified potential EWRs measures, created driver diagrams and then eliminated weak measures. Next, a panel of executives skilled in EWRs ranked and ratified the potential measures using a modified Delphi technique.</p><p><strong>Findings: </strong>EWRs measurement selection demonstrated the feasibility of the method. Of the total time to complete the method 79% was contributed by SMEs, 14% by administration personnel and 7% by executives. Document analysis revealed three main EWRs aims. Ten of 28 potential measures were eliminated by the SME review. After repeated Delphi rounds the executive panel achieved consensus (75% cut-off) on seven measures. One outcome, one process and one implementation fidelity metric were selected to measure and monitor the impact of EWRs in the health district.</p><p><strong>Practical implications: </strong>Perceptions of weak relationships between measures and intended improvements can lead to practitioner scepticism. This work offers a structured method to combine the technical expertise of SMEs with the practical knowledge of healthcare staff in selecting improvement measures.</p><p><strong>Originality/value: </strong>This research describes and demonstrates a novel method to systematically leverage formal and practical types of expertise to select measures that are strongly linked to local quality improvement goals. The method can be applied in diverse healthcare settings.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-08-2019-0140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37847713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bureaucracy and the balanced scorecard in health care settings.","authors":"Helena Costa Oliveira,&nbsp;Lúcia Lima Rodrigues,&nbsp;Russell Craig","doi":"10.1108/IJHCQA-07-2019-0121","DOIUrl":"https://doi.org/10.1108/IJHCQA-07-2019-0121","url":null,"abstract":"<p><strong>Purpose: </strong>We explore the relationship between the balanced scorecard (BSC) and neo-bureaucracy by investigating whether the operationalization of the BSC incorporates \"neo-bureaucratic\" ideas and whether the BSC implemented in a Portuguese Local Health Unit (LHU) demonstrates a neo-bureaucratic approach.</p><p><strong>Design/methodology/approach: </strong>We conduct semi-structured interviews with LHU staff and analyse documents to assess whether features of bureaucratic organization were evident in the use of a BSC by the LHU.</p><p><strong>Findings: </strong>We found nine bureaucratic features evident in the LHU's BSC. These were systematization, rationality, authority, jurisdiction, professional qualification, knowledge, discipline, transparency and accountability. The BSC used at the LHU demonstrated a neo-bureaucratic approach.</p><p><strong>Originality/value: </strong>Our study helps to demystify bureaucracy and overcome prevailing prejudices regarding some of its principles. Health care managers should recognize and endorse neo-bureaucratic principles in developing a BSC. They should recognize the BSC as involving a neo-bureaucratic approach. The BSC is a valuable management tool that hospital managers should find useful in fostering flexibility, collaboration, innovation and adaptation - all of which should help lead to improved healthcare outcomes.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-07-2019-0121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two fall-risk assessment tools used in a long-term care facility.","authors":"Anat Glass,&nbsp;Gad Mendelson,&nbsp;Merav Ben Natan","doi":"10.1108/IJHCQA-03-2019-0065","DOIUrl":"https://doi.org/10.1108/IJHCQA-03-2019-0065","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to compare the ability of the Morse Fall Scale (MFS) and Farmer's fall-risk assessment tool (FFAT) to identify correlations between risk factors and falls among older adult long-term care (LTC) facility residents.</p><p><strong>Design/methodology/approach: </strong>This was a correlational retrospective study. 200 medical records of older adults hospitalized in a LTC facility in central Israel, from January 2017 to January 2018, were examined.</p><p><strong>Findings: </strong>Of all the residents, 75% and 99.5% of the residents were identified as having a high fall risk according to the MFS and FFAT, respectively. Only 12.5% of residents actually fell. MFS score was weakly correlated with actual falls (odds ratio = 1.035). It was also found that all fallers fell during their first week at the facility.</p><p><strong>Research limitations/implications: </strong>Future research should explore the ability of the tools to capture changes in the fall risk by repeat assessments, as this has not been examined in the present study.</p><p><strong>Practical implications: </strong>The MFS and FFAT tool may have little value in assessing fall risk in older adult LTC facility residents. Therefore, nurses should perform a clinical evaluation of each individual patient. In addition, nurses should place a particular emphasis on fall risk and prevention during the first week following admission.</p><p><strong>Originality/value: </strong>The findings of the present study raise doubts regarding the utility of the common practice of assessing fall risk in older adult LTC facility residents using the tools MFS and the FFAT, thus emphasizing the need to adopt a different approach.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-03-2019-0065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37762591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing inpatient colonoscopy preparations improves quality and provider satisfaction.","authors":"Brian Sullivan,&nbsp;Cecelia Zhang,&nbsp;Kara Wegermann,&nbsp;Tzu-Hao Lee,&nbsp;David A Leiman","doi":"10.1108/IJHCQA-11-2019-0186","DOIUrl":"https://doi.org/10.1108/IJHCQA-11-2019-0186","url":null,"abstract":"<p><strong>Purpose: </strong>Inpatient colonoscopy bowel preparation quality is frequently suboptimal. This quality improvement (QI) intervention is focused on regimenting this process to impact important outcomes.</p><p><strong>Design/methodology/approach: </strong>Define, Measure, Analyze, Improve and Control (DMAIC) methodology was employed, including generating a root-cause analysis to identify factors associated with inpatient bowel quality. These findings motivated the creation of a standardized electronic health record (EHR)-based order set with consistent instructions and anticipatory guidance for administering providers.</p><p><strong>Findings: </strong>There were 264 inpatient colonoscopies evaluated, including 198 procedures pre-intervention and 66 post-intervention. The intervention significantly improved the adequacy of right colon bowel preparations (75.0 percent vs 86.9 percent, <i>p</i> = 0.04) but not overall preparation quality (73.7 percent vs 80.3 percent, <i>p</i> = 0.22). The intervention led to numerical improvement in the proportion of procedures in which the preparation quality interfered with making a diagnosis (10 percent-6 percent, <i>p</i> = 0.29) or resulted in an aborted procedure (3.5 percent-1.5 percent, <i>p</i> = 0.39). After the intervention, provider satisfaction with the ordering process significantly increased (23.3 percent vs 61.1 percent, <i>p</i> < 0.001).</p><p><strong>Practical implications: </strong>The QI intervention significantly reduced the number of inpatient colonoscopies with inadequate preparation in the right colon, while also modestly improving the diagnostic yield and proportion of aborted procedures. Importantly, the standardized EHR order set substantially improved provider satisfaction, which should justify broader use of such tools.</p><p><strong>Originality/value: </strong>Novel clinical outcomes such as ability to answer diagnostic questions were improved using this intervention. The results align with strategic goals to enhance provider experience and continuously improve quality of patient care.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-11-2019-0186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37719013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing skin staining: an effective iron infusion protocol.","authors":"Clare Margaret Crowley,&nbsp;Gabriela McMahon,&nbsp;Joanna Desmond,&nbsp;Mendinaro Imcha","doi":"10.1108/IJHCQA-10-2019-0177","DOIUrl":"https://doi.org/10.1108/IJHCQA-10-2019-0177","url":null,"abstract":"<p><strong>Purpose: </strong>To implement a safe and effective intravenous iron infusion protocol to prevent skin staining.</p><p><strong>Design/methodology/approach: </strong>Mixed methods approach was utilised including education, auditing, self-reported survey, patient information leaflet and patient feedback. In total 25 healthcare professionals completed the survey and 15 patients provided feedback.</p><p><strong>Findings: </strong>No skin staining or severe adverse reactions were observed over eight weeks. Audit results found 53 per cent of staff were compliant with the recommended IV iron infusion protocol and 46 per cent informed patients of skin staining risk. Self-report surveys indicated 92 per cent flushed the cannula with sodium chloride before starting the infusion, 88 per cent flushed the cannula after the infusion and 76 per cent informed patients of skin staining risk. Patient feedback was largely positive and constructive.</p><p><strong>Research limitations: </strong>Limitations include self-reported bias, short audit time interval, missing data and discrepancy between audit and survey results.</p><p><strong>Originality/value: </strong>This quality improvement project was developed following two skin staining incidences at our maternity hospital. Although rare, skin staining after intravenous iron infusion is potentially permanent and may be distressing for some patients. Intravenous iron is considered safe and effective to treat anaemia during pregnancy and is often prescribed for this patient cohort. To avoid medicolegal action and patient dissatisfaction, it is essential that patients are informed of potential skin staining and an evidence-based administration protocol is utilised.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-10-2019-0177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37730490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal health outcomes of socially marginalized groups in India.","authors":"Arvind Kumar Yadav,&nbsp;Pabitra Kumar Jena","doi":"10.1108/IJHCQA-08-2018-0212","DOIUrl":"https://doi.org/10.1108/IJHCQA-08-2018-0212","url":null,"abstract":"<p><strong>Purpose: </strong>The present study delves into the health inequalities between the two most socially deprived groups namely Scheduled Tribes (STs) and Scheduled Castes (SCs) in rural India.</p><p><strong>Design/methodology/approach: </strong>This study used health-specific three rounds of National Sample Survey Office (NSSO) unit-level data for analyses. Probit model has been used to predict the differences in access to maternal healthcare services. Blinder-Oaxaca decomposition method is used to explore the inequality in health of rural population in India and assess the estimated relative contribution of socioeconomic and demographic factors to inequalities in maternal health.</p><p><strong>Findings: </strong>The study establishes that STs women often perform poorly compared to SCs in terms of maternal health such as antenatal care, postnatal care and institutional delivery. Blinder-Oaxaca decomposition method shows that there exist health inequalities between STs and SCs women. Difference in household income contributes 21-34 percent and women's education 19-24 percent in the gap of utilization of maternal healthcare services between SCs and STs women. A substantial part of this difference is contributed by availability of water at home and geographical region. Finally, the study offers some policy suggestions in order to mitigate the health inequalities among socially marginalized groups of SCs and STs women in rural areas.</p><p><strong>Originality/value: </strong>This study measures and explains inequalities in maternal health variables such as antenatal care, postnatal care and institutional delivery in rural India. Research on access to maternal healthcare facilities is needed to improve the health of deprived sections such as STs and SCs in India. The results of this study pinpoint the need for public health decision-makers in India to concentrate on the most deprived and vulnerable sections of the society. This study thus makes a detailed and tangible contribution to the current knowledge of health inequalities between the two most deprived social groups, i.e., SCs and STs.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":"ahead-of-print ahead-of-print","pages":"0"},"PeriodicalIF":1.5,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-08-2018-0212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37703846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}