“…As an emerging area of research, recent studies on health system responsiveness have focused on validating study instruments and its domains [53–55]. A few studies were conducted to assess the HSR on specific health conditions, such as the patients with heart failures [56], hospitalized patients [17], health insurance users [57] and women who gave birth at a hospital [15], and used different methods and showed varying results.…”
BackgroundHealth system responsiveness measures (HSR) the non-health aspect of care relating to the environment and the way healthcare is provided to clients. The study measured the HSR performance and correlates of HIV/AIDS treatment and care services in the Wolaita Zone of Ethiopia.MethodsA cross-sectional survey across seven responsiveness domains (attention, autonomy, amenities of care, choice, communication, confidentiality and respect) was conducted on 492 people using pre-ART and ART care. The Likert scale categories were allocated percentages for analysis, being classified as unacceptable (Fail) and acceptable (Good and Very Good) performance.ResultsOf the 452 (91.9%) participants, 205 (45.4%) and 247 (54.6%) were from health centers and a hospital respectively. 375 (83.0%) and 77 (17.0%) were on ART and pre-ART care respectively. A range of response classifications was reported for each domain, with Fail performance being higher for choice (48.4%), attention (45.5%) and autonomy (22.7%) domains. Communication (64.2%), amenities (61.4%), attention (51.4%) and confidentiality (50.1%) domains had higher scores in the ‘Good’ performance category. On the other hand, ‘only respect (54.0%) domain had higher score in the ‘Very Good’ performance category while attention (3.1%), amenities (4.7%) and choice (12.4%) domains had very low scores. Respect (5.1%), confidentiality (7.6%) and communication (14.7%) showed low proportion in the Fail performance. 10.4 and 6.9% of the responsiveness percent score (RPS) were in ‘Fail’ and Very Good categories respectively while the rest (82.7%) were in Good performance category. In the multivariate analysis, a unit increase in the perceived quality of care, satisfaction with the services and financial fairness scores respectively resulted in 0.27% (p < 0.001), 0.48% (p < 0.001) and 0.48% (p < 0.001) increase in the RPS. On the contrary, visiting traditional medicine practitioner before formal HIV care was associated with 2.1% decrease in the RPS.ConclusionThe health facilities performed low on the autonomy, choice, attention and amenities domains while the overall RPS masked the weaknesses and strengths and showed an overall good performance. The domain specific responsiveness scores are better ways of measuring responsiveness. Improving quality of care, client satisfaction and financial fairness will be important interventions to improve responsiveness performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2224-1) contains supplementary material, which is available to authorized users.
“…As an emerging area of research, recent studies on health system responsiveness have focused on validating study instruments and its domains [53–55]. A few studies were conducted to assess the HSR on specific health conditions, such as the patients with heart failures [56], hospitalized patients [17], health insurance users [57] and women who gave birth at a hospital [15], and used different methods and showed varying results.…”
BackgroundHealth system responsiveness measures (HSR) the non-health aspect of care relating to the environment and the way healthcare is provided to clients. The study measured the HSR performance and correlates of HIV/AIDS treatment and care services in the Wolaita Zone of Ethiopia.MethodsA cross-sectional survey across seven responsiveness domains (attention, autonomy, amenities of care, choice, communication, confidentiality and respect) was conducted on 492 people using pre-ART and ART care. The Likert scale categories were allocated percentages for analysis, being classified as unacceptable (Fail) and acceptable (Good and Very Good) performance.ResultsOf the 452 (91.9%) participants, 205 (45.4%) and 247 (54.6%) were from health centers and a hospital respectively. 375 (83.0%) and 77 (17.0%) were on ART and pre-ART care respectively. A range of response classifications was reported for each domain, with Fail performance being higher for choice (48.4%), attention (45.5%) and autonomy (22.7%) domains. Communication (64.2%), amenities (61.4%), attention (51.4%) and confidentiality (50.1%) domains had higher scores in the ‘Good’ performance category. On the other hand, ‘only respect (54.0%) domain had higher score in the ‘Very Good’ performance category while attention (3.1%), amenities (4.7%) and choice (12.4%) domains had very low scores. Respect (5.1%), confidentiality (7.6%) and communication (14.7%) showed low proportion in the Fail performance. 10.4 and 6.9% of the responsiveness percent score (RPS) were in ‘Fail’ and Very Good categories respectively while the rest (82.7%) were in Good performance category. In the multivariate analysis, a unit increase in the perceived quality of care, satisfaction with the services and financial fairness scores respectively resulted in 0.27% (p < 0.001), 0.48% (p < 0.001) and 0.48% (p < 0.001) increase in the RPS. On the contrary, visiting traditional medicine practitioner before formal HIV care was associated with 2.1% decrease in the RPS.ConclusionThe health facilities performed low on the autonomy, choice, attention and amenities domains while the overall RPS masked the weaknesses and strengths and showed an overall good performance. The domain specific responsiveness scores are better ways of measuring responsiveness. Improving quality of care, client satisfaction and financial fairness will be important interventions to improve responsiveness performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2224-1) contains supplementary material, which is available to authorized users.
“…These non-medical domains are important to all human beings (4,5). These can further be categorized into 2 major domains: "Respect for human rights": containing of the domains dignity, autonomy, confidentiality, and communication and "Clientorientation": containing of the domains choice, prompt attention, quality of basic amenities, and social support (6).…”
Background: One of the 3 main goals of any health system is to meet the non-medical expectations of individuals while interacting with health system. The purpose of this study is to evaluate the health system responsiveness before and after the implementation of the health transformation plan (HTP) in Iran. Methods: In this longitudinal study, a household survey was conducted at the district 17 of Tehran, Iran in 2003, 2008. A sample of 600 families was selected using a two-stage cluster sampling approach. Data were collected using a questionnaire and face-to-face interview. Chi square and One Way Anova were used to analyze the data in the SPSS 16. Results: The importance of all dimensions of responsiveness has decreased compared to previous years in 2015. Dignity (83.46%) had the best performance (high score) and choice (69.23%) had the worst performance (low score) in outpatient services. The best performance score was confidentiality (81.7%) in inpatient services and the worst was autonomy (67.76%). Private centers performed better than other centers in all dimensions of responsiveness. This difference was statistically significant in outpatient services (P value < 0.05) and was significant in inpatient services only in 2001. Principal component analysis found for out-patient care responsiveness are 2 main factors explaining 69.5% of the variance and for in-patient care responsiveness 1 factor explaining 91.7% of the variance. Overall responsiveness level has increased. Conclusions: Given the increasing level of responsiveness in outpatient and inpatient services after the implementation of the HTP, it can be concluded that this plan has been effective. Interaction of patients and service providers is an issue that should be addressed by health sector reform.
“…McDonald et al. (, p. 6) provide the following broad definition: Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities and is often managed by the exchange of information among participants responsible for different aspects of care.…”
While the nurse is the optimal provider for this position, the nurse's defined role in this process is not always clear. This article focuses on the term care coordination, which includes the definitions of care coordination, impact on nursing, attributes, antecedents, consequences, and empirical referents for this term. Care coordination is also differentiated from case management to add clarity to the role.
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