Patient-Perceived Health System Responsiveness of the Epilepsy Management Project in Rural China during the Period of COVID-19

Abstract

Health system responsiveness (HSR) measures the experience of health-system users in terms of the non-clinical domains of the health system, which has been regarded as the three major goals of health performance evaluation. Good HSR may promote the use of health services and ultimately the health of patients. However, the HSR has not been measured as the main goal of the Epilepsy Management Project (EMP) in rural China. This study aims to evaluate the levels and distributions of the patient-perceived HSR of the EMP in rural China during the period of COVID-19 and identify its relevant factors so as to provide advice on the improvement of further strategies. Based on the key informant survey (KIS) of responsiveness from the World Health Organization proposal, we conducted a cross-sectional survey of 420 epilepsy patients selected proportional randomly from seven rural areas in the Hunan province of China in 2021. Eight domains of patients-perceived HSR were assessed by face-to-face interview. The overall HSR scored at a fairly “good” level of 8.3 (8.3 out of a maximum of 10.0). During the COVID-19 period, the scores of responsiveness domains were highest at 8.66 to 8.93 in “confidentiality”, “dignity” and “choice of providers”, while lowest at 8.38 to 8.53 in “prompt attention”, “social support” and “basic amenities”. The representative responsiveness equality index (REI) was 0.732, indicating the moderately balanced distributions of responsiveness of the EMP in rural China. Female, old age, and low education were significantly related to the lower HSR scores of rural EMP (p < 0.05). The HSR of EMP in rural China was fairly good. However, measures to improve the patient-perceived HSR are still needed, especially including better service, higher social support, and more comfortable medical environments.

Mediating effect of integrated health commodities procurement system on the relationship between responsiveness and health service delivery

“…Subsequently, upholding a sense of responsiveness helps customers build trust and good relationships with service providers, which are one of the best ways to understand customers' problems and ensure timely availability of health services in a convenient manner. These findings concur with Kapologwe et al (2020) and Qin et al (2022) findings, which suggest that health service facilities with responsive service providers who are willing and able to respond to customers' queries on time stand a high chance of improving health service delivery. Table 3.…”

“…According to Mirzoev and Kane (2017), responsiveness encompasses service providers' readiness and willingness to provide prompt service to the target customers at any time without inducements. Consequently, the literature acknowledges a positive and significant relationship between responsiveness and health service delivery (Kapologwe et al, 2020;Qin et al, 2022;Malakoane et al, 2020). Service providers' responsiveness strongly influences the level of service quality.…”

“…A stream of empirical literature reveals a lack of responsiveness as one of the contemporary issues which impede the effectiveness of public health service delivery (Kapologwe et al , 2020; Qin et al , 2022; Amani et al , 2020; Hussein and Wanyoike, 2015; Mirzoev and Kane, 2017). Although prior studies have shown the relationship between responsiveness and health service delivery, less is known about the role of digital technologies.…”

Healthcare system responsiveness in Covid-19: An experience from capital city of I.R of Iran

“…Data were collected using the WHO questionnaire on responsiveness as well as a checklist on demographic information. The validity and reliability of this questionnaire are evaluated in Iran[ 14 ] in several studies conducted on various groups of patients. For outpatients, it contains seven domains of prompt attention (five items), dignity (four items), communication (four items), autonomy (three items), confidentiality (three items), choice of provider (three items), and basic amenities (three items).…”

“…The result of this study showed that the HSR was fairly good. [ 14 ] Despite the importance of research and documentation on the responsiveness of health services, to our knowledge, this is the first study conducted to investigate HSR after the announcement of the Covid epidemic in Iran.…”