Evaluation of primary care responsiveness by people with mental illness in Spain

Valle Coronado-Vázquez,Eva Rodríguez-Eguizábal,María Josefa Gil-De-Gómez,Juan Gómez-Salgado,María Antonia Sánchez-Calavera,Bárbara Oliván-Blázquez,Rosa Magallón-Botaya

doi:10.1186/s12913-022-07516-2

Abstract

BackgroundThe health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive. The aim of this study is to assess primary care responsiveness as seen by people with mental illness and to analyse the factors associated with poor responsiveness.MethodsCross-sectional descriptive study on 426 people with mental illness who had attended primary care consultations at least once in the previous 12 months. The responsiveness of the health system was determined through the short questionnaire “Multi-country Survey Study on Health and Health Systems Responsiveness”. Differences in responsiveness by sociodemographic characteristics were compared through the Chi-squared test. Logistic regression identified the factors associated with poor responsiveness.ResultsOverall responsiveness was measured as good by 77.4% of patients, being this probability higher in the domains: dignity, confidentiality, and communication. The most valued domains by people with mental illness were prompt attention (42.4%), dignity (30.1%), and communication (17%). Only prompt attention scored high importance and poor responsiveness. In patients with an income lower than 900 euros per month and low level of studies, the probability of poor confidentiality responsiveness was multiplied by 3 and 2.7 respectively.ConclusionsPeople with mental illness perceive good responsiveness from primary care in terms of dignity, confidentiality, and communication. Prompt attention, as the domain of greatest importance and worst valuation, should be prioritised through the implementation of organisational measures in health centres to reduce waiting times, especially in urban areas.

Highlights

The health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive
Studies on the responsiveness of primary care have generally focused on specific population groups, as in the case of those developed by Kerssens et al on a sample of fragile patients [9]
The objective of this study was to evaluate the responsiveness of the health system in primary care, both globally and for each of the domains, as valued by people with mental illness, with or without other chronic diseases, and to identify socioeconomic variables associated with poor responsiveness

Summary

Introduction

The health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive. The concept was developed by the World Health Organization to assess the response to legitimate patient expectations for nonmedical aspects of health care [2]. Mainly focused on the clinical care received, responsiveness is oriented to the health system as a whole. Studies on the responsiveness of primary care have generally focused on specific population groups, as in the case of those developed by Kerssens et al on a sample of fragile patients [9]. Research has been aimed at comparing public with private services, as well as urban services with rural ones [10]

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