Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors

Murante, Anna Maria; Seghieri, Chiara; Vainieri, Milena; Schäfer, Willemijn

doi:10.1016/j.socscimed.2017.06.005

Cited by 38 publications

(40 citation statements)

References 26 publications

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“…The study by Malhotra et al concluded that socioeconomic disparities exist in the health system responsiveness in India, irrespective of the type of health facility used. 5 The same finding was reported in a study by Maria et al 7 No significance was found in sociodemographic factors and responsiveness domains in the present study. This is in accordance with the study by Rashidan et al 2 The reason might be the improvement in the public health services' responsiveness and improved access to health services.…”

Section: Discussionsupporting

confidence: 91%

“…1,3 Responsiveness in the context of a system can be defined as the outcome that can be achieved when institutions and institutional relationships are designed in such a way that they are cognisant and respond appropriately to the universally legitimate expectations of individuals. 1 for the dignity of persons; (2) autonomy to participate in health related decisions; (3) confidentiality and trust; (4) prompt attention; (5) adequate quality of basic amenities; (6) clear communication; (7) access to social support networks (only for inpatients); and (8) choice of health care providers (Gostin et al). The intrinsic goal of responsiveness is important because it deals with basic Human rights of individuals, reflects a positive orientation to those the system is designed to serve and holds promise to make health improvement among population.…”

Section: Introductionmentioning

confidence: 99%

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A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

Vemuri

Kiranmai

Cheedarla

et al. 2019

Int J Community Med Public Health

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Background: According to WHO, responsiveness is an important goal of the health system, in addition to the two predominant goals of improving health and fairness of financing. Responsiveness includes non-medical aspects of health care. As the progress to universal health coverage is gaining pace, the present study has attempted to study the domains of responsiveness in the government and private health services and health care providers. Methods: A community based cross-sectional study for a period of 3 months in the households of the urban field practising area. Sampling technique was simple random sampling. Assuming the prevalence of 50% and allowable error of 5%, 400 households were surveyed. KISH table method was used at household level. Study tool was World Health Survey responsiveness module questionnaire for the eight responsiveness domains-prompt attention, dignity, communication, autonomy, confidentiality, choice, quality of basic facilities and social support (for inpatients). Results: The mean age (yrs) of the study subjects is 46.078±13.998. 68.25% (273) were males.31.75% (127) were females. 46.25% (185) were using government services and 53.75% (215) were using private services. The mean waiting time (min) in the public health facilities was 135.2±111.2 which was more than private facilities, 62.4±40.8. Conclusions: All the responsiveness domains (except confidentiality) were found to be positively associated (p<0.05) with the government health services. Proportion of people rating the responsiveness domains from most important to the least important showed prompt attention (52%) and dignity (30%) as the most important domains.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

Vemuri

Kiranmai

Cheedarla

et al. 2019

Int J Community Med Public Health

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“…23 Quality of care is comparatively well rated in public health services in some western European countries. 24,25 Other studies nd it di cult to draw clear deductions about the advantage of any particular type of settings, instead associating quality of care with the main features of health service provider such as the organization of and remuneration for services, number of skilled health specialists rather than the clear ownership of the health facilities. 26,27 Recent systematic reviews led to contradictory conclusions in respect to quality of care differences between public and private providers due to different review methodologies and, above all, diverse settings and contexts where private providers played different roles within the health system.…”

Section: Quality Of Care and Patient Experience Across Settingsmentioning

confidence: 99%

Users' perspectives on non-clinical quality of care in public and private primary healthcare in Albania

Gabrani

Schindler

Wyss

2020

Preprint

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Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyse perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along eight non-clinical domains of quality of care. The data of 954 patients were analysed through descriptive statistics and linear mixed regression models.Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain ‘communication’ (3.75) followed by ‘dignity’ (3.65), while the lowest mean scores were given for ‘choice’ (2.89) and ‘prompt attention’ (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in ‘coordination of care’ (2.90 vs 2.12, p < 0.001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in ‘confidentiality’ (3.77 vs 3.38, p = 0.04) and ‘quality of basic amenities’ (3.70 vs 3.02, p < 0.001). For the other domains, no statistically significant differences were observed. ‘Autonomy’ was reported as least important attribute of quality. Enrolment in health insurance was a predictor of higher quality ratings (coefficient = 0.06, p = 0.02).Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to shift from a ‘paternalistic’ model to a ‘co-managing the illness’, raising awareness on autonomy.

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“…Assessment of quality and performance of healthcare based on structure and process do not overlap with the results of the patient evaluation. Therefore, it is also important to take into account patients' preferences, needs and expectations in order to ensure a high quality in the primary care system (Murante et al, 2017). Patient satisfaction is currently seen as an important indicator of health service outcomes; however, this professed utility is based on a number of implicit assumptions about the nature and meaning of 'satisfaction' (Williams, 1994).…”

Section: Literature Reviewmentioning

confidence: 99%

Evaluation of selected indicators of patient satisfaction and economic indices in OECD country

Štefko¹,

Gavurová²,

Rigelský³

et al. 2019

Economics &Amp; Sociology

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The primary aim of the research is to estimate the relationship between healthcare indicators and economic indices in the selected OECD countries. The goal was met in three main procedures. Firstly, a cluster of the selected countries was identified, then a relationship analysis was realized on eight variables that determined satisfaction and economic indices (Global Innovation Index-GII, Human Development Index-HDI) and at the end, regression analysis which calculates the impact of innovation activity (GII) on healthcare satisfaction was used (the mean of 8 healthcare satisfaction variables-MeanHC) as well as the impact of this variable on maturity (HDI) in the selected OECD countries (the sample of 33 countries). The cluster was estimated by using the method based on Euclidean distance, and the number of clusters was defined by Silhouette method. Two clusters were computed. Also, the coefficients such as Spearman ρ and Pearson r were used in analysis of this relationship. A significant relationship is not evident only in the variable that determined cost satisfaction. The differences between clusters in the individual satisfaction variables were confirmed by t-test, Welch test and Wilcoxon test. A significant difference between the clusters is in satisfaction with staff friendliness. Regression analysis was computed by means of using a method based on Least Trimmed Squares Robust Regression. Significant impact was reflected in both assumptions (GII to MeanHC and also MeanHC to HDI).

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Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors

Cited by 38 publications

References 26 publications

A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

Users' perspectives on non-clinical quality of care in public and private primary healthcare in Albania

Evaluation of selected indicators of patient satisfaction and economic indices in OECD country

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