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Ulf Gerdtham. Photo.

Ulf Gerdtham

Professor

Ulf Gerdtham. Photo.

Use of simulated patients to assess hypertension case management at public healthcare facilities in South Africa

Author

  • Ronelle Burger
  • Carmen S Christian
  • Ulf G Gerdtham
  • Karel Haal
  • Dumisani M Hompashe
  • Anja Smith
  • Aletta E Schutte

Summary, in English

OBJECTIVE: Our study aims to evaluate hypertensive case management in South Africa's public health sector using simulated patients.

METHOD: Our study describes interactions between hypertensive simulated patients and primary healthcare workers at 39 public sector healthcare facilities in two metropolitan centres in the Eastern and Western Cape Provinces of South Africa. Our analysis focus on 97 interactions where our eight simulated patients tested within range for stage 1 hypertension, that is with SBP 140-159 mmHg and/or DBP 90-99 mmHg. For this subset, we describe how healthcare workers communicated the outcome of the blood pressure test, and whether they follow government guidelines on risk assessment and lifestyle advice.

RESULTS: Healthcare workers highlighted the risks associated with hypertension in one out of three cases and stressed the importance of regular monitoring of blood pressure in less than half of cases. Hypertensive patients received advice on all six lifestyle risk factors in 8% of cases. 39% of patients received no lifestyle advice at all. In one out of four cases, hypertensive patients left the facility without a hypertension diagnosis and with no prospect of a follow-up visit.

CONCLUSION: Simulated patients can assess the quality of hypertension case management, yielding granular and comprehensive information that can help mobilize resources to improve care. The management of hypertension patients in South African public healthcare facilities is critically insufficient. Given that hypertension is responsible for a rising share of deaths in South Africa and many of these deaths are preventable, urgent intervention is needed.

Department/s

  • Health Economics
  • Department of Economics
  • EpiHealth: Epidemiology for Health

Publishing year

2020-02

Language

English

Pages

362-367

Publication/Series

Journal of Hypertension

Volume

38

Issue

2

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Cardiac and Cardiovascular Systems
  • Health Care Service and Management, Health Policy and Services and Health Economy

Status

Published

Research group

  • Health Economics

ISBN/ISSN/Other

  • ISSN: 1473-5598