J. Multidiscip. Res. Healthcare

Evolution of Responsiveness of Health System

Meenakshi Sood and Preethi Pradhan

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  • DOI Number
    https://doi.org/10.15415/jmrh.2016.31004
KEYWORDS

Responsiveness, Health Systems, Elements of Responsiveness

PUBLISHED DATE October 2016
PUBLISHER The Author(s) 2016. This article is published with open access at www.chitkara.edu. in/publications
ABSTRACT

Responsiveness is concerned with meeting the legitimate non health expectations of patients. The paper tries to explain the concept, domains and evolution of responsiveness. WHO concept of responsiveness has been criticized for using a single composite score for comparing responsiveness between countries. In spite of recognizing these issues and after much debate, no empirical research has been undertaken. Hence there is a need to recognize what constituents of responsiveness need to be reorganized, which other elements need to be added to existing WHO proposed elements of responsiveness in culturally, socially, politically different society. The paper through extensive study on responsiveness concludes the need to tailor responsiveness domains according to citizen’s priority in a particular background.

INTRODUCTION

There are three goals of health system given by World Health Organisation health, responsiveness and fairness of financing. The performance of a health system is measured on these parameters [29]. Responsiveness for any system is defined as ‘The outcome that can be achieved when institutions and institutional relationships are designed in such a way that they are cognizant and respond appropriately to the universally legitimate expectations’ [34]. Here universally legitimate term is very important as some individuals may have unrealistic expectations which should not be considered when measuring responsiveness. Responsiveness is concerned only with a person’s legitimate expectations regarding the non-health enhancing aspects of the health system as health related expectations are being taken care of in first goal of health system. For responsiveness both the distribution as well as average level of responsiveness in a country is considered important [34]. Various researchers in the past, suggested that the term ‘consumer’ should be used for patients as the user is not passive and dependent [32].Some were in favour of use of term consumer over customer as consumers’ is used for a group of individuals who can protect their rights. According to them term patient denotes powerlessness and hence does not truly depicts the relationship with professional [13].Terms which are often used along with responsiveness are quality of care and expectations [33]. Expectations are important as meeting expectations is what responsiveness is about. Also patient satisfaction which is often used to measure the quality of healthcare services is a complex mix of perceived need, expectations and experience. Quality of care is even wider. Unlike responsiveness it includes technical aspects of healthcare aspects of healthcare.

Page(s) 27–36
URL http://dspace.chitkara.edu.in/jspui/bitstream/1/794/3/31004_JMRH_sood.pdf
ISSN Print : 2393-8536, Online : 2393-8544
DOI https://doi.org/10.15415/jmrh.2016.31004
CONCLUSION

In spite of recognizing these issues and after much debate, no empirical research has been undertaken. After extensive review of existing literature we feel there is a need to reorganize or tailor the elements of responsiveness in each culturally, socially, politically different society according to the preferences of concerned population.

REFERENCES
  • Agency for Healthcare Research and Quality (AHRQ).CAHPS 2.0 (1993)survey and reporting kit. Rockville, Agency for Healthcare Research and Quality.
  • Ajzen, I. (1991). The theory of planned behavior. Organizational behavior and human decision processes, 50(2), 179–211. http://dx.doi.org/10.1016/0749-5978(91)90020-T
  • Almeida C, Braveman P, Gold MR, Szwarcwald CL, Ribeiro JM, Miglionico A, Millar JS, Porto S, Costa NR, Rubio VO, Segall M, Starfield B, Travessos C, Uga A, Valente J, Viacava F: Methodological concerns and recommendations on policy consequences of the World Health Report 2000. Lancet 2001, 357(9269): 1692–1697. http://dx.doi.org/10.1016/S0140-6736(00)04825-X
  • Bandura, A. (1990). Perceived self-efficacy in the exercise of personal agency. Journal of applied sport psychology, 2(2), 128-163. http://dx.doi.org/10.1080/10413209008406426
  • Bandura A. (1997) Self Eflicacy. The Exercise of Control, New York: W H. Freeman & Co. Student Success,333:48461.
  • Bandura, A. (1995). Self-efficacy in changing societies. Cambridge university press. http://dx.doi.org/10.1017/cbo9780511527692
  • Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191. http://dx.doi.org/10.1037/0033-295X.84.2.191
  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.
  • Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of social and clinical psychology, 4(3), 359–373. http://dx.doi.org/10.1521/jscp.1986.4.3.359
  • Blendon, R. J., Kim, M., & Benson, J. M. (2001). The public versus the World Health Organization on health system performance. Health affairs, 20(3), 10–20. http://dx.doi.org/10.1377/hlthaff.20.3.10
  • Blumenthal D. (1996).Quality of care—what is it?. New England Journal of Medicine. 335(12): 891–4. http://dx.doi.org/10.1056/NEJM199609193351213
  • Bowling, A., Rowe, G., Lambert, N., Waddington, M., Mahtani, K. R., Kenten, C., ... & Francis, S. A. (2012). The measurement of patients’ expectations for health care: a review and psychometric testing of a measure of patients’ expectations.
  • Carr-Hill, R. A. (1992). The measurement of patient satisfaction. Journal of public health, 14(3), 236–249.
  • Darby, C., Valentine, N., Murray, C. J., & De Silva, A. (2000). World Health Organization (WHO): strategy on measuring responsiveness. Geneva, Switzerland: World Health Organization.
  • Donabedian, A. (1980). Explorations in quality assessment and monitoring.
  • Evans, D. B., Edejer, T. T. T., Lauer, J., Frenk, J., & Murray, C. J. (2001). Measuring quality: from the system to the provider. International Journal for Quality in Health Care, 13(6), 439-446. http://dx.doi.org/10.1093/intqhc/13.6.439
  • Festinger, L. (1954). A theory of social comparison processes. Human relations, 7(2), 117-140. http://dx.doi.org/10.1177/001872675400700202
  • Fitzpatrick, R., & Hopkins, A. (1983). Problems in the conceptual framework of patient satisfaction research: an empirical exploration. Sociology of health & illness, 5(3), 297-311. http://dx.doi.org/10.1111/1467-9566.ep10491836
  • Gakidou, E., Murray, C. J., & Frenk, J. (2000). Measuring preferences on health system performance assessment. Geneva: World Health Organization.
  • Haas-Wilson, D. (1994). The relationships between the dimensions of health care quality and price: the case of eye care. Medical care, 32(2), 175–182. http://dx.doi.org/10.1097/00005650-199402000-00008
  • Haddad, S., Fournier, P., & Potvin, L. (1998). Measuring lay people’s perceptions of the quality of primary health care services in developing countries. Validation of a 20-item scale. International Journal for Quality in Health Care, 10(2), 93–104. http://dx.doi.org/10.1093/intqhc/10.2.93
  • Houweling, T. A., Kunst, A. E., & Mackenbach, J. P. (2001). World Health Report 2000: inequality index and socioeconomic inequalities in mortality. The Lancet, 357(9269), 1671–1672. http://dx.doi.org/10.1016/S0140-6736(00)04829-7
  • Hsu, C. C., Chen, L., Hu, Y. W., Yip, W., & Shu, C. C. (2006). The dimensions of responsiveness of a health system: a Taiwanese perspective. BMC Public health, 6(1), 1. http://dx.doi.org/10.1186/1471-2458-6-72
  • Kenagy, J. W., Berwick, D. M., & Shore, M. F. (1999). Service quality in health care. JAMA, 281(7), 661–665. http://dx.doi.org/10.1001/jama.281.7.661
  • Kirsch, I. E. (1999). How expectancies shape experience. American Psychological Association. http://dx.doi.org/10.1037/10332-000
  • Linder-Pelz, S. (1982). Toward a theory of patient satisfaction. Social science & medicine, 16(5), 577-582. http://dx.doi.org/10.1016/0277-9536(82)90311-2
  • Maddux, J. E. (1999). Expectancies and the social–cognitive perspective: Basic principles, processes, and variables.
  • Murray, C. J., & Frenk, J. (2000). A framework for assessing the performance of health systems. Bulletin of the world Health Organization, 78(6), 717–731.
  • Murray, C. J., & Frenk, J. (1999). A WHO framework for health system performance assessment. Evidence and Information for Policy, World Health Organization. Sood,
  • Navarro, V. (2000). Assessment of the world health report 2000. The Lancet, 356(9241), 1598-1601. http://dx.doi.org/10.1016/S0140-6736(00)03139-1
  • Nord, E. (2002). Measures of goal attainment and performance in the World Health Report 2000: a brief, critical consumer guide. Health Policy, 59(3), 183–191. http://dx.doi.org/10.1016/S0168-8510(01)00172-5
  • Owens, D. J., & Batchelor, C. (1996). Patient satisfaction and the elderly. Social science & medicine, 42(11), 1483–1491. http://dx.doi.org/10.1016/0277-9536(95)00234-0
  • Sitzia, J., & Wood, N. (1997). Patient satisfaction: a review of issues and concepts. Social science & medicine, 45(12), 1829–1843. http://dx.doi.org/10.1016/S0277-9536(97)00128-7
  • Valentine, N., De Silva, A., & Murray, C. (2000). Estimating responsiveness level and distribution for 191 countries: methods and results. Geneva: World Health Organization.
  • an Campen, C., Sixma, H. J., Kerssens, J. J., Peters, L., & Rasker, J. J. (1998). Assessing patients’ priorities and perceptions of the quality of health care: the development of the QUOTE-Rheumatic-Patients instrument. Rheumatology, 37(4), 362–368. http://dx.doi.org/10.1093/rheumatology/37.4.362
  • Williams, B. (1994). Patient satisfaction: a valid concept?. Social science & medicine, 38(4), 509-516. http://dx.doi.org/10.1016/0277-9536(94)90247-X
  • World Health Organization. (2000). The world health report 2000: health systems: improving performance. World Health Organization