Abstract
BackgroundThe perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service settings. However, the factors that affect the responsiveness have been inconclusive so far and measures of improved responsiveness have not always thoroughly considered the factors. The aim of this study was to evaluate both the responsiveness of the healthcare system in Jiangsu Province, China, the factors that influence responsiveness and the measures of improved responsiveness considering it, as determined by a responsiveness survey.MethodsA multistage, stratified random sampling method was used to select 1938 adult residents of Jiangsu Province in 2011. Face-to-face interviews were conducted using a self-designed questionnaire modeled on the World Health Organization proposal. The final analysis was based on 1783 (92%) valid questionnaires. Canonical correlation analysis was used to assess the factors that affect responsiveness.ResultsThe average score of all responsiveness-related domains in the surveyed healthcare system was satisfactory (7.50 out of a maximum 10.0). The two highest scoring domains were dignity and confidentiality, and the two lowest scoring domains choice and prompt attention. The factors affecting responsiveness were age, regional economic development level, and geographic area (urban vs. rural). The responsiveness regarding basic amenities was rated worse by the elderly than by younger respondents. Responsiveness ranked better by those with a poorer economic status. Choice in cities was better than in rural regions.ConclusionsThe responsiveness of the Jiangsu healthcare system was considered to be satisfactory but could be improved by offering greater choice and providing more prompt attention. Perceptions of healthcare system responsiveness differ with age, regional economic development level, and geographic area (urban vs. rural). Measures to increase the perceived level of responsiveness include better service at higher level hospitals, shorter waiting time, more hospitals in rural regions, an improved medical environment, and provision of infrastructures that makes the medical environments more comfortable.
Highlights
The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services
We found that choice in urban regions was better than that in rural regions, which reflected the fact that there are fewer hospitals in the latter areas
We studied the responsiveness of adult residents (18 years of age and older) in three prefectures of Jiangsu Province
Summary
The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Responsiveness is defined as meeting the legitimate expectations of patients and their families regarding non-medical aspects of the healthcare system [2] Of these three goals, responsiveness can be most efficiently manipulated to Responsiveness has been evaluated in several studies [4,5,6,7,8,9], some of which have shown that the levels of. Coulter et al conducted a telephone survey in Europe based on a random sample of 8119 people aged 16 years and over in 2005 They found that many European patients wanted a more autonomous role in healthcare decision making and that policy makers and clinicians should consider measures aimed at narrowing the gap between public expectations and the patient experience [11]. In many developing countries the responsiveness of the healthcare system was ignored and was inadequate to meet patients’ non-medical expectations [17]
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