Mapping Regulatory Effectiveness and Ethical Violations in ART Clinics: A Comparative Study of Two Districts in the State of West Bengal
DOI:
https://doi.org/10.37591/m5463636Keywords:
Regulatory performance, malpractices, informed consent, ART clinics, patient satisfaction, ownership of health care.Abstract
The type of research is a cross-sectional research on regulatory compliance, ethical practice, and patient experience in 76 Assisted reproductive technology (ART) clinics in South 24 Parganas and North 24 Parganas, West Bengal. Using mixed method analysis (defining the data and analysis using descriptive statistics, correlation matrices, and multivariate regression analysis) we find that while both districts have similar clinic density, South 24 Parganas has better patient safeguards (100% adherence to written consent vs. 78.9% in North 24 Parganas), higher levels of satisfaction and fewer diagnoses of billing irregularities. Although both systems are inspected equally, the South 24 Parganas system is more privatized and is linked to superior outcomes during regulation as compared to North 24 Parganas that has stronger NGO influence and greater ethical breaches. Regression models reveal that the frequency of inspection and reduced levels of ethical violations are highly important predictors of the increased level of regulatory effectiveness (R2= 0.86), whereas the understanding of consent and absence of additional fees are the largest predictors of patient satisfaction ―not only receipt of consent. Marquardt also adds that more violations of ethical behavior are reported in licensed clinics but that is likely just because they are better reporters and not necessarily bad in terms of their behavior." The protective nature of the structured oversight is reflected by the strong negative correlations between regulatory effectiveness and ethical violations (r = -0.79). These findings suggest that the process of guaranteeing the quality of clinics and patient confidence in the Indian ART industry occurs via formal licensure, active inspections and open communication (as compared to the ownership type).
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