Can patients improve the quality of care they receive? Experimental evidence from Senegal.
Can patients improve the quality of care they receive? Experimental evidence from Senegal.
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DOI：
10.1016/j.worlddev.2021.105740
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发表时间：
2022-03
影响因子：
6.9
通讯作者：
Cairns J
中科院分区：
文献类型：
--
作者：
Kovacs RJ;Lagarde M;Cairns J
我们使用标准化的患者来测试当患者在塞内加尔农村分享更多信息时，护理质量是否会提高。提供者正确管理在咨询开始时自愿提供更多信息的患者的可能性高出27%。当患者分享较少信息时，表现不佳不是由于提供者缺乏知识或临床技能，而是，低动机可能会限制提供者的能力，使他们的努力适应病人在咨询中的投入。鼓励患者更积极地进行咨询可以提高低收入环境中的医疗质量。许多低收入和中等收入国家（LMIC）的医疗服务提供者往往无法正确诊断和治疗患者，即使他们拥有这样做的临床知识。在许多失败的尝试，以增加提供者的努力的背景下，本研究探讨是否可以通过鼓励患者在咨询过程中更加积极，提高护理质量。我们设计了一个简单的实验，实验对象是卧底标准化患者，他们随机改变自己透露的症状信息。我们发现，与分享较少信息的典型患者相比，提供者在咨询开始时自愿提供其病情的几个关键症状的患者正确管理的可能性高出27%。对照组的低绩效并不是因为提供者缺乏知识，没有能力提出正确的问题，或者对时间或资源限制的反应。相反，提供者的低动机似乎限制了他们的能力，以适应他们的努力，病人的意见，在咨询。我们的研究结果提供了概念验证的证据，即使患者在咨询中更加积极的干预措施可以显着提高中低收入国家的护理质量。
We use standardised patients to test if quality of care increases when patients share more information in rural Senegal Providers are 27% more likely to correctly manage patients who volunteer more information at the start of the consultation Low performance when patients share less information is not due to providers’ lack of knowledge or clinical skills Instead, low motivation may limit providers’ ability to adapt their effort to patients’ inputs in the consultation. Encouraging patients to be more active in consultations could improve the quality of healthcare in low-income settings. Providers in many low and middle-income countries (LMICs) often fail to correctly diagnose and treat their patients, even though they have the clinical knowledge to do so. Against the backdrop of many failed attempts to increase provider effort, this study examines whether quality of care can be improved by encouraging patients to be more active during consultations. We design a simple experiment with undercover standardised patients who randomly vary how much information they disclose about their symptoms. We find that providers are 27% more likely to correctly manage a patient who volunteers several key symptoms of their condition at the start of the consultation, compared to a typical patient who shares less information. Lower performance in the control group is not due to providers’ lack of knowledge, an incapacity to ask the right questions, or a response to time or resource constraints. Instead, providers’ low motivation seems to limit their ability to adapt their effort to patients’ inputs in the consultation. Our findings provide proof-of-concept evidence that interventions making patients more active in their consultations could significantly improve the quality of care in LMICs.
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影响因子：
8.1
作者：
Daniels B;Dolinger A;Bedoya G;Rogo K;Goicoechea A;Coarasa J;Wafula F;Mwaura N;Kimeu R;Das J
通讯作者：
Das J
影响因子：
5.8
作者：
Belloni, Alexandre;Chernozhukov, Victor;Hansen, Christian
通讯作者：
Hansen, Christian
DOI：
10.1016/s1473-3099(15)00077-8
发表时间：
2015-11
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Das J;Kwan A;Daniels B;Satyanarayana S;Subbaraman R;Bergkvist S;Das RK;Das V;Pai M
通讯作者：
Pai M
影响因子：
4.5
作者：
Das A;Gopalan SS;Chandramohan D
通讯作者：
Chandramohan D
影响因子：
10.7
作者：
Das, Jishnu;Holla, Alaka;Muralidharan, Karthik
通讯作者：
Muralidharan, Karthik