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Survey Using Incognito Standardized Patients Shows Poor Quality Care in China’s Rural Clinics

Citation

Sylvia, Sean; Shi, Yaojiang; Xue, Hao; Tian, Xin; Wang, Huan; Liu, Qingmei; Medina, Alexis; & Rozelle, Scott (2015). Survey Using Incognito Standardized Patients Shows Poor Quality Care in China's Rural Clinics. Health Policy and Planning, 30(3), 322-333.

Abstract

Over the past decade, China has implemented reforms designed to expand access to health care in rural areas. Little objective evidence exists, however, on the quality of that care. This study reports results from a standardized patient study designed to assess the quality of care delivered by village clinicians in rural China. To measure quality, we recruited individuals from the local community to serve as undercover patients and trained them to present consistent symptoms of two common illnesses (dysentery and angina). Based on 82 covert interactions between the standardized patients and local clinicians, we find that the quality of care is low as measured by adherence to clinical checklists and the rates of correct diagnoses and treatments. Further analysis suggests that quality is most strongly correlated with provider qualifications. Our results highlight the need for policy action to address the low quality of care delivered by grassroots providers.

URL

http://dx.doi.org/10.1093/heapol/czu014

Reference Type

Journal Article

Year Published

2015

Journal Title

Health Policy and Planning

Author(s)

Sylvia, Sean
Shi, Yaojiang
Xue, Hao
Tian, Xin
Wang, Huan
Liu, Qingmei
Medina, Alexis
Rozelle, Scott