Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China
Background Evaluation of health system responsiveness (HSR) can improve patient satisfaction, promote health equity and enhance the quality of health services.Objectives To explore the differences in HSR among medical institutions at different levels and in various domains.Methods A multi-stage stra...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2024.2446693 |
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| author | Zhuang Hong Jing Lu Gang Chen Qi Tang Heqi Sun Ting Wei Sitang Zhao Jun Lu |
| author_facet | Zhuang Hong Jing Lu Gang Chen Qi Tang Heqi Sun Ting Wei Sitang Zhao Jun Lu |
| author_sort | Zhuang Hong |
| collection | DOAJ |
| description | Background Evaluation of health system responsiveness (HSR) can improve patient satisfaction, promote health equity and enhance the quality of health services.Objectives To explore the differences in HSR among medical institutions at different levels and in various domains.Methods A multi-stage stratified sampling method was used to select 820 participants aged 18 years and older from Kunshan City, China. Analysis of variance was used for univariate analysis. Linear regression and ordinal logistics were applied to explore the relationship between different hospital levels and HSR. Forest plots were used to illustrate the relationship between each domain and the hospital level.Results The relationship between hospital level and HSR remained significant (p < 0.05). Compared with primary healthcare institutions, secondary hospitals had lower HSR scores (β = -1.47, 95%CI = [-2.15, −0.79], p < 0.001). Similarly, tertiary hospitals had lower HSR scores compared with primary healthcare institutions (β = -1.54, 95%CI = [-2.39, −0.70], p < 0.001). The study found that attention, communication, basic amenities, social support, and the choice of healthcare providers were lower in secondary hospitals compared to primary healthcare institutions (OR < 1; p < 0.05). In tertiary hospitals, attention, communication, autonomy, basic amenities, social support, and the choice of healthcare provider were lower compared to primary healthcare institutions (OR < 1; p < 0.05).Conclusions By comparing the HSR of hospitals at different levels, the study identified areas for improvement. Particularly, urgent improvements are needed in prompt attention, communication, basic amenities, social support and the choice of healthcare providers. |
| format | Article |
| id | doaj-art-19675b481edc4cfd9e71c1b4b8742cfe |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-19675b481edc4cfd9e71c1b4b8742cfe2025-01-04T15:54:34ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2024.2446693Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, ChinaZhuang Hong0Jing Lu1Gang Chen2Qi Tang3Heqi Sun4Ting Wei5Sitang Zhao6Jun Lu7School of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaSchool of Public Health, Fudan University, Shanghai, ChinaBackground Evaluation of health system responsiveness (HSR) can improve patient satisfaction, promote health equity and enhance the quality of health services.Objectives To explore the differences in HSR among medical institutions at different levels and in various domains.Methods A multi-stage stratified sampling method was used to select 820 participants aged 18 years and older from Kunshan City, China. Analysis of variance was used for univariate analysis. Linear regression and ordinal logistics were applied to explore the relationship between different hospital levels and HSR. Forest plots were used to illustrate the relationship between each domain and the hospital level.Results The relationship between hospital level and HSR remained significant (p < 0.05). Compared with primary healthcare institutions, secondary hospitals had lower HSR scores (β = -1.47, 95%CI = [-2.15, −0.79], p < 0.001). Similarly, tertiary hospitals had lower HSR scores compared with primary healthcare institutions (β = -1.54, 95%CI = [-2.39, −0.70], p < 0.001). The study found that attention, communication, basic amenities, social support, and the choice of healthcare providers were lower in secondary hospitals compared to primary healthcare institutions (OR < 1; p < 0.05). In tertiary hospitals, attention, communication, autonomy, basic amenities, social support, and the choice of healthcare provider were lower compared to primary healthcare institutions (OR < 1; p < 0.05).Conclusions By comparing the HSR of hospitals at different levels, the study identified areas for improvement. Particularly, urgent improvements are needed in prompt attention, communication, basic amenities, social support and the choice of healthcare providers.https://www.tandfonline.com/doi/10.1080/07853890.2024.2446693Health service researchhealth system responsivenessprimary healthcare institutionsecondary hospitaltertiary hospitalChina |
| spellingShingle | Zhuang Hong Jing Lu Gang Chen Qi Tang Heqi Sun Ting Wei Sitang Zhao Jun Lu Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China Annals of Medicine Health service research health system responsiveness primary healthcare institution secondary hospital tertiary hospital China |
| title | Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China |
| title_full | Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China |
| title_fullStr | Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China |
| title_full_unstemmed | Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China |
| title_short | Health system responsiveness: comparison of different levels of medical institutions in Kunshan City, China |
| title_sort | health system responsiveness comparison of different levels of medical institutions in kunshan city china |
| topic | Health service research health system responsiveness primary healthcare institution secondary hospital tertiary hospital China |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2024.2446693 |
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