Community Health Centers' Responsiveness and Its Associated Factors Among Outpatients in Southeast China: A Cross-Sectional Study.

Abstract

The responsiveness of community health centers can reflect the soft capacity of medical institutions and is related to the improvement of health outcome indicators. This study is aimed at assessing the level and distribution of community health centers' responsiveness and its associated factors among outpatients under the health-oriented integrated healthcare system in China. A total of 634 outpatients were recruited from six community health centers in Zhejiang Province, China, in July 2022. SPSS software was used to conduct the analysis (version 23.0). Health system responsiveness was used as a measure of outpatient responsiveness to health care services through a self-administered questionnaire. Determinants of community health centers' responsiveness were determined by using a multiple linear regression model at a p-value <0.05. The total score of community health centers responsiveness was 8.25±1.01, and the Gini coefficient is 0.027. Within these domains, social support and dignity received the highest scores, while choice of providers and autonomy scored the lowest. Age group between 60-74 years (β: 0.129; 95% CI: 0.042-0.529), ≥75 years (β: 0.095; 95% CI: 0.006-0.707), monthly income with 8000 RMB and above (β: 0.098; 95% CI: 0.035-0.653), having a family doctor (β: 0.124; 95% CI: 0.096-0.410), and satisficing with community health service (β: 0.298; 95% CI: 0.848-1.428) were significant predictors of community health centers' responsiveness. The Chinese community health centers show high responsiveness, indicating that the construction of a health-oriented integrated healthcare system has been effective. The family doctor contract service is important and should continually enhance both technical proficiency and health promotion capabilities. Encourage residents to actively participate in their treatment process is also essential.