Health system responsiveness: A comparison between public and private hospitals in Iran

ABSTRACT

Introduction

Responsiveness refers to the fulfilment of patient’s rational expectations in terms of non-medical healthcare aspects. This study aimed to assess and compare the responsiveness levels of private and public hospitals in Tehran from the patients’ perspective.

Methods

In this cross-sectional study, 500 discharged patients from two public and three private hospitals were selected randomly. Data collected using A 32-item questionnaire developed by the World Health Organization, and its validity and reliability were confirmed. For data analysis, descriptive statistics, T-test and regression tests were used through SPSS 19.

Results

The responsiveness’ mean score was 3.3 ± 0.6 and 3.8 ± 0.6 out of 5 for public and private hospitals, respectively. The difference between responsiveness score and its eight dimensions in public and private hospitals was significant (P < 0.001); the responsiveness score of private hospitals was higher. The highest and lowest difference in mean scores of responsiveness was pertinent to the provider choice and prompt attention.

Conclusion

The responsiveness of private hospitals was better than that of public hospitals. Patient participation in treatment decision-making, improvement of the patients’ right to provider choice and reducing waiting time by re-organising human resources, computerised appointment system and re-engineering patients’ admission process can lead to higher responsiveness.

KEYWORDS:

• Health system responsiveness
• public hospitals
• private hospitals
• inpatient services
• patient satisfaction

Acknowledgements

This study was conducted as part of an MS thesis in the field of Health Services Management at the Shahid Beheshti University of Medical Sciences. We would like to thank the directors and staff of Taleghani, Imam Hussein, Bahman, Iranshahr and Kian hospitals, for their friendly cooperation in the implementation of this thesis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr Abbas Daneshkohan is an Assistant Professor in Health Services Management.

Dr Ehsan Zarei is an Assistant Professor in Health Services Management.

Mr Sadegh Ahmadi Kashkoli has MSc in Health Services Management.

Additional information

Funding

This work was supported by the Shahid Beheshti University of Medical Sciences; under Grant number 7670.