Responsiveness of Physical Rehabilitation Centers in Capital of Iran: Disparities and Related Determinants in Public and Private Sectors

Alavi, Manijeh; Khodaie‐Ardakani, Mohammad‐Reza; Moradi‐Lakeh, Maziar; Sajjadi, Homeira; Shati, Mohsen; Noroozi, Mehdi; Forouzan, Ameneh Setareh

doi:10.3389/fpubh.2018.00317

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…The public continue to struggle to engage with the system about their problems and to secure appropriate responses and remedies [7,22,28]. Access to feedback channels and, more importantly, the ability to leverage reaction or response to feedback, is often inequitable, determined by social and educational status and the social capital that can be mustered [28,37,38]yet while responsiveness as a health system goal is intended to draw attention to the needs of the vulnerable, such inequity has received little attention [32,39].…”

Section: Introductionmentioning

confidence: 99%

Health system responsiveness: a systematic evidence mapping review of the global literature

Khan

Kagwanja

Whyle

et al. 2021

Int J Equity Health

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Background The World Health Organisation framed responsiveness, fair financing and equity as intrinsic goals of health systems. However, of the three, responsiveness received significantly less attention. Responsiveness is essential to strengthen systems’ functioning; provide equitable and accountable services; and to protect the rights of citizens. There is an urgency to make systems more responsive, but our understanding of responsiveness is limited. We therefore sought to map existing evidence on health system responsiveness. Methods A mixed method systemized evidence mapping review was conducted. We searched PubMed, EbscoHost, and Google Scholar. Published and grey literature; conceptual and empirical publications; published between 2000 and 2020 and English language texts were included. We screened titles and abstracts of 1119 publications and 870 full texts. Results Six hundred twenty-one publications were included in the review. Evidence mapping shows substantially more publications between 2011 and 2020 (n = 462/621) than earlier periods. Most of the publications were from Europe (n = 139), with more publications relating to High Income Countries (n = 241) than Low-to-Middle Income Countries (n = 217). Most were empirical studies (n = 424/621) utilized quantitative methodologies (n = 232), while qualitative (n = 127) and mixed methods (n = 63) were more rare. Thematic analysis revealed eight primary conceptualizations of ‘health system responsiveness’, which can be fitted into three dominant categorizations: 1) unidirectional user-service interface; 2) responsiveness as feedback loops between users and the health system; and 3) responsiveness as accountability between public and the system. Conclusions This evidence map shows a substantial body of available literature on health system responsiveness, but also reveals evidential gaps requiring further development, including: a clear definition and body of theory of responsiveness; the implementation and effectiveness of feedback loops; the systems responses to this feedback; context-specific mechanism-implementation experiences, particularly, of LMIC and fragile-and conflict affected states; and responsiveness as it relates to health equity, minority and vulnerable populations. Theoretical development is required, we suggest separating ideas of services and systems responsiveness, applying a stronger systems lens in future work. Further agenda-setting and resourcing of bridging work on health system responsiveness is suggested.

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Section: Introductionmentioning

confidence: 99%

Health system responsiveness: a systematic evidence mapping review of the global literature

Khan

Kagwanja

Whyle

et al. 2021

Int J Equity Health

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“…Such differences can be attributed to instabilities caused by the Covid-19 pandemic. [ 21 22 ] The domain of choice of provider was the second domain with the lowest score. This domain is of particular importance as it affects patients’ trust and results in better outcomes.…”

Section: Discussionmentioning

confidence: 99%

Healthcare System Responsiveness in Covid-19: An Experience from Capital City of I.R of Iran

Eftekhari¹,

Mirabzadeh

Falahat³

et al. 2023

International Journal of Preventive Medicine

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Background: As a public health emergency, coronavirus disease 2019 (Covid-19) is a threat to our future; therefore, appropriate health system responsiveness (HSR), as an important criterion, is of crucial importance. This study aimed to evaluate the different dimensions of responsiveness of healthcare centers, both public and private, providing COVID-19 services in Tehran. Methods: Following a cross-sectional design, this study was conducted in Tehran (the capital city of I.R. Iran) from May to November 2020. Data were collected using the World Health Organization (WHO) questionnaire on responsiveness. Two hundred questionnaires were filled out through face-to-face or phone call interviews in two public and private hospitals (100 in each) providing Covid-19 services. Participants were selected using the convenience sampling technique among all those who received Covid-19 services during the past six months in the city of Tehran. Results: The mean age of participants was 45.9 ± 15.9 and 51.5% were female. On an average, 52.6% of the respondents evaluated at least one dimension of responsiveness as appropriate and/or strongly appropriate. Communication obtained the highest score (58.2%), followed by confidentiality (56.5%), dignity (56%), and prompt attention (52%). Meanwhile, autonomy and choice were evaluated as poor (moderate, weak, and strongly weak) by 63.5 and 52.5% of respondents. There was no significant association between the type of healthcare center (i.e., public or private) and responsiveness ( p -value = 0.896). However, there was a significant difference between gender ( p -value = 0.036) and education level ( p -value = 0.014) with responsiveness. According to the respondents, prompt attention and choice were the most and least important dimensions, respectively. Conclusions: Evaluation of HSR in the era of COVID-19 not only provides a tool for qualitative assessment of services but also plays an important role in providing feedback to policymakers to adopt effective policies.

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“…Speed of response and quality of comfort equipment had the lowest scores. Private health centers had better communication, comfort equipment and autonomy maintenance than public health centers [28].…”

Section: Responsivenessmentioning

confidence: 99%

Iran’s Health System Performance in Achieving Goals Based on the World Health Organization’s Framework: A Scoping Review

Negarandeh

Ali²,

Heydari³

2022

J Research Health

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Background: The health system of each country are required to achieve the goals based on appropriate frameworks. Assessment of health system performance provides an opportunity to address the main mission through recognizing new needs and resolving existing gaps. This review study aims to investigate Iran’s health system performance in achieving its goals based on the World Health Organization (WHO)’s conceptual framework. Methods: This scoping review was conducted based on Arksey and O’Malley’s methodological framework. A search in international databases including Web of Science, Scopus, PubMed/Medline and in national databases such as SID, MagIran and IranDoc was conducted using the keywords “health system, Iran”, “disease burden”, “responsiveness” and “financial contribution”, which were used in both English and Persian separately for each variables of health promotion, responsiveness, and fair financial contribution. Retrieved articles were analyzed using qualitative synthesis method. Results: Data extracted from articles categorized into the three groups of “Health” (with sub-categories of epidemiologic and demographic transitions), “Responsiveness” and “Fair financing and financial risk protection”. Synthesis of data revealed that the profiles of diseases has been changed over recent decades in Iran, which has resulted in epidemiologic and demographic transitions. In terms of responsiveness, services provided by the health system had not fulfilled patients’ expectations. Regarding fair financial contribution, synthesis of data showed that people had faced high health costs, with a high amount of out-of-pocket payment. Conclusion: Iran’s health system has not yet achieved the goals recommended by the World Health Organization. Fundamental reforming is required in the health system of this country.

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Responsiveness of Physical Rehabilitation Centers in Capital of Iran: Disparities and Related Determinants in Public and Private Sectors

Cited by 11 publications

References 26 publications

Health system responsiveness: a systematic evidence mapping review of the global literature

Health system responsiveness: a systematic evidence mapping review of the global literature

Healthcare System Responsiveness in Covid-19: An Experience from Capital City of I.R of Iran

Iran’s Health System Performance in Achieving Goals Based on the World Health Organization’s Framework: A Scoping Review

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