Use of standardised patients for healthcare quality research in low- and middle-income countries

Ada Kwan; Benjamin Daniels; Sofi Bergkvist; Veena Das; Madhukar Pai; Jishnu Das

doi:10.1136/bmjgh-2019-001669

Use of standardised patients for healthcare quality research in low- and middle-income countries

BMJ Glob Health. 2019 Sep 12;4(5):e001669. doi: 10.1136/bmjgh-2019-001669. eCollection 2019.

Authors

Ada Kwan¹, Benjamin Daniels², Sofi Bergkvist³, Veena Das⁴, Madhukar Pai⁵, Jishnu Das^{2

6}

Affiliations

¹ School of Public Health, University of California Berkeley, Berkeley, California, USA.
² McCourt School of Public Policy and School of Foreign Service, Georgetown University, Washington, District of Columbia, USA.
³ ACCESS Health International, New York City, New York, USA.
⁴ Department of Anthropology, Johns Hopkins University, Baltimore, Maryland, USA.
⁵ Department of Epidemiology & Biostatistics, and McGill International TB Centre, McGill University, Montreal, Quebec, Canada.
⁶ Center for Policy Research, Delhi, India.

Abstract

The use of standardised patients (SPs)-people recruited from the local community to present the same case to multiple providers in a blinded fashion-is increasingly used to measure the quality of care in low-income and middle-income countries. Encouraged by the growing interest in the SP method, and based on our experience of conducting SP studies, we present a conceptual framework for research designs and surveys that use this methodology. We accompany the conceptual framework with specific examples, drawn from our experience with SP studies in low-income and middle-income contexts, including China, India, Kenya and South Africa, to highlight the versatility of the method and illustrate the ongoing challenges. A toolkit and manual for implementing SP studies is included as a companion piece in the online supplement.

Keywords: health care providers; quality of care; standardized patients.

Publication types

Review