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health; medical care; quality; standardized patients; universal health coverage

Delivering quality health services: A patient’s perspective

Cecilia Rodríguez's picture

The vignette below was originally published in a new joint report from the World Bank, WHO and OECD, Delivering quality health services: A global imperative for universal health coverage.  

Eight years ago, when she was diagnosed with rheumatoid arthritis, an autoimmune disease that causes inflammation, swelling and acute pain in the joints, Cecilia Rodriguez was Director of a primary health care facility. “I had very bad rheumatoid arthritis and spent a lot of time in bed,” says Rodriguez, who was in her thirties when she first experienced the painful symptoms. “I realized that what I had been promoting as a health administrator was very different from what I needed as a patient.” 

Shocking facts about primary health care in India, and their implications

Adam Wagstaff's picture

There’s nothing quite like a cold shower of shocking statistics to get you thinking. A paper that came out in Health Affairs today, written by my colleague Jishnu Das and his collaborators, is just such a cold shower.

Fake patients
Das and his colleagues spent 150 hours training each of 22 Indians to be credible fake patients. These actors were then sent into the consulting rooms of 305 medical providers – some in rural Madhya Pradesh (MP), others in urban Delhi – to allow the study team to assess the quality of care that the providers were delivering.

A lot of thought went into just what conditions the fake patients should pretend to have. The team wanted the conditions to be common, and to be ones that had established medical protocols with government-provided treatment checklists. The fake patients shouldn’t be subjected to invasive exams, and they needed to be able to be able to credibly describe invisible symptoms.