Undercover careseekers: Simulated clients in the study of health provider behavior in developing countries
Undercover careseekers: Simulated clients in the study of health provider behavior in developing countries
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DOI：
10.1016/s0277-9536(97)00076-2
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发表时间：
1997-11-01
影响因子：
5.4
通讯作者：
Kafle, KK
中科院分区：
文献类型：
--
作者：
Madden, JM;Quick, JD;Kafle, KK
模拟客户端方法（SCM）已经使用了20多年，以第一手的方式研究医疗保健提供者的行为，同时最大限度地减少观察偏差。在发展中国家，它已被证明是有用的医生，药品零售商和计划生育服务的研究。在供应链管理中，研究助理与虚构的情况下（或与稳定的条件或真正感兴趣的服务）访问供应商，并要求他们的援助。提供者不知道这些客户参与研究。模拟客户稍后报告他们访问的事件，并对这些数据进行分析。本文回顾了23个发展中国家的医生，药品零售和计划生育服务的研究，以得出以下结论：（1）该方法的优点和局限性;（2）设计和实施模拟客户研究的考虑因素;（3）有效性和可靠性;（4）伦理问题。还从工业化国家、相关方法学和非卫生领域中抽取了一些例子，以说明围绕供应链管理的问题。基于这一审查，我们的结论是，通过使用模拟客户端收集的信息是独特的和有价值的管理者，干预计划和评估，社会科学家，监管机构，和其他人。在今后的工作中需要探索的领域包括：如何确保数据的有效性和可靠性;对其他类型的提供者和保健需求的研究;以及使该技术适应日常使用。(C)1997 Elsevier Science Ltd.
The simulated client method (SCM) has been used for over 20 years to study health care provider behavior in a first-hand way while minimizing observation bias. In developing countries, it has proven useful in the study of physicians, drug retailers, and family planning services. In SCM, research assistants with fictitious case scenarios (or with sable conditions or a genuine interest in the services) visit providers and request their assistance. Providers are not aware that these clients are involved in research. Simulated clients later report on the events of their visit and these data are analyzed. This paper reviews 23 developing country studies of physician, drug retail, and family planning services in order to draw conclusions about (1) the advantages and limitations of the method; (2) considerations for design and implementation of a simulated client study; (3) validity and reliability; and (4) ethical concerns. Examples are also drawn from industrialized countries, related methodologies, and non-health fields to illustrate the issues surrounding SCM. Based on this review, we conclude that the information gathered through the use of simulated clients is unique and valuable for managers, intervention planners and evaluators, social scientist, regulators, and others. Areas that need to be explored in future work with this method include: ways to ensure data validity and reliability; research on additional types of providers and health care needs; and adaptation of the technique for routine use. (C) 1997 Elsevier Science Ltd.