The Effect of Health System Responsiveness on Health Outcome: Evidence from Spain

Abstract

Background For the last two decades, the health system responsiveness has gained attention in the health policy area. However, little is known about its effect within the healthcare system on health outcome. This study aims to investigate the influence of health system responsiveness on self-assessed health. Particularly it examines if self-assessed health is affected by satisfaction with communication, dignity and waiting time.Methods The study used data from the Spanish Health Care Barometer Survey (SHBS) between 2011 and 2013. The Ordered Probit and the Hierarchical Ordered Probit (HOPIT) model was used to model anchoring vignettes and to control the problem of reporting heterogeneity arises from self-reported health.Results The result suggests a strong positive association between reporting very good self-assessed health and most of the domains of health system responsiveness. Specifically, after adjusting for reporting heterogeneity, satisfaction with waiting time and communication were found to be statistically significant and positively associated with reporting better self-assessed health for respondents in primary care and hospital care settings, respectively in Spain. The marginal effect of a one unit increase in satisfaction with waiting time in primary care and communication in hospital care is associated with a 2% and 4% increase in the in the likelihood of reporting very good health status respectively, keeping other variables constant.Conclusions Overall, the result suggests that improving patient’s satisfaction with health systems responsiveness may have a positive influence on patients’ health outcomes.