Comparison of health system responsiveness between HIV and non-HIV patients at infectious disease clinics in Yunnan, China

Figures & data

Figure 1 Framework of HSR, vignette example, and vignette ordering by investigators.

Abbreviation: HSR, health system responsiveness.

Figure 2 Framework of measurement and analysis about HSR experience and vignettes.

Abbreviation: HSR, health system responsiveness.

Table 1 Clinical status among HIV-positive patients

Variables of clinical status	HIV patients
	n	%
Days between HIV diagnosis and ART
Median (range)	292.6	(0, 4,745)
Route of transmission
Unprotected sex	541	77.7
Sharing injection equipment	107	15.4
Mother-to-child	22	3.2
Unknown	26	3.7
Clinical stage
Stage 1	389	55.9
Stage 2	160	23.0
Stage 3	100	14.4
Stage 4	47	6.8
CD4 count
<200	305	43.8
200–499	337	48.4
≥500	54	7.8
History of virus load testing
No	558	80.2
Yes	138	19.8
Distribution of virus load
Median (range)	89 378	(50, 7,060,000)
Treatment of opportunistic infections
No	624	89.7
Yes	72	10.3
Number of follow-up visits in the first 3 months
0	15	2.2
1	51	7.3
2	240	34.5
3	193	27.7
4	197	28.3
Missed ART in the last 7 days
No	223	32.0
Yes	473	68.0

Abbreviations: ART, antiretroviral therapy; HIV, human immunodeficiency virus.

Table 2 Distribution and ordered probit regression results of experience of HSR before and after adjusting for sociodemographic factors among HIV-positive and non-HIV patients

HSR domain	Patient group	Perceived experience										Ordered probit regression
		Very good		Good		Moderate		Bad		Very bad		Crude				Adjusted
		n	%	n	%	n	%	n	%	n	%	β	SE	OR	95% CI	β	SE	OR	95% CI
Prompt attention	HIV	83	11.9	306	44.0	228	32.8	67	9.6	12	1.7	-0.11	0.13	0.90	(0.70, 1.15)	-0.16	0.11	0.85	(0.69, 1.05)
	Non-HIV	21	3.0	442	63.2	206	29.5	21	3.0	9	1.3
Dignity	HIV	168	24.1	362	52.0	129	18.5	25	3.6	12	1.7	0.69	0.13	1.99	(1.54, 2.58)	0.63	0.12	1.88	(1.48, 2.40)
	Non-HIV	42	6.0	483	69.1	163	23.3	9	1.3	2	0.3
Communication	HIV	179	25.7	352	50.6	139	20.0	19	2.7	7	1.0	0.58	0.13	1.79	(1.39, 2.31)	0.6	0.11	1.83	(1.48, 2.27)
	Non-HIV	49	7.0	455	65.1	177	25.3	13	1.9	5	0.7
Quality of amenities	HIV	135	19.4	335	48.1	180	25.9	33	4.7	13	1.9	3.16	0.16	23.65	(17.35, 32.54)	2.99	0.14	19.88	(15.11, 26.43)
	Non-HIV	10	1.4	26	3.7	445	63.7	201	28.8	17	2.4
Confidentiality	HIV	169	24.3	352	50.6	145	20.8	21	3.0	9	1.3	3.36	0.16	28.66	(20.87, 39.76)	3.21	0.14	24.85	(18.81, 33.16)
	Non-HIV	10	1.4	43	6.2	491	70.2	149	21.3	6	0.9
Choice of providers	HIV	136	19.5	332	47.7	192	27.6	30	4.3	6	0.9	3.14	0.16	23.01	(16.80, 31.83)	3.16	0.15	23.68	(17.57, 32.24)
	Non-HIV	11	1.6	32	4.6	494	70.7	152	21.7	10	1.4
Autonomy	HIV	167	24.0	354	50.9	138	19.8	29	4.2	8	1.1	3.27	0.16	26.39	(19.25, 36.54)	3.22	0.15	25.05	(18.87, 33.62)
	Non-HIV	11	1.6	31	4.4	479	68.5	165	23.6	13	1.9

Abbreviations: HIV, human immunodeficiency virus; HSR, health system responsiveness.

Table 3 COPR results for experience and vignettes of HSR before and after adjusting for sociodemographic factors among HIV-positive and non-HIV patients

HSR domain	Patientgroup	B-value												COPR
		1		2		3		4		5		6		Before		After
		n	Pr.	n	Pr.	n	Pr.	n	Pr.	n	Pr.	n	Pr.	β	SE	β	SE
Prompt attention	HIV	49	0.070	493	0.710	35	0.050	88	0.130	0	0.000	31	0.040	−0.44	0.09	−0.52	0.08
	Non-HIV	33	0.048	575	0.840	55	0.080	2	0.003	1	0.001	17	0.020
Dignity	HIV	63	0.091	485	0.697	18	0.026	104	0.149	7	0.010	19	0.027	0.38	0.09	0.33	0.07
	Non-HIV	21	0.030	471	0.684	33	0.048	97	0.141	65	0.094	2	0.003
Communication	HIV	85	0.122	483	0.694	71	0.102	39	0.056	4	0.006	14	0.020	0.25	0.09	0.23	0.08
	Non-HIV	95	0.141	28	0.041	529	0.783	8	0.012	1	0.001	15	0.022
Quality of basic amenities	HIV	116	0.167	25	0.036	527	0.757	4	0.006	2	0.003	22	0.032	1.13	0.10	1.08	0.08
	Non-HIV	2	0.003	20	0.029	581	0.854	4	0.006	59	0.087	14	0.021
Confidentiality	HIV	148	0.213	517	0.744	7	0.010	1	0.001	0	0.000	22	0.032	1.16	0.10	1.03	0.08
	Non-HIV	22	0.032	603	0.874	3	0.004	0	0.000	18	0.026	44	0.064
Choice	HIV	535	0.769	121	0.174	–	–	10	0.014	–	–	30	0.043	1.60	0.10	1.44	0.08
	Non-HIV	24	0.034	117	0.167	–	–	520	0.744	–	–	38	0.054
Autonomy	HIV	155	0.223	6	0.009	513	0.737	5	0.007	0	0.000	17	0.024	1.64	0.11	1.50	0.09
	Non-HIV	10	0.015	4	0.006	569	0.827	21	0.031	2	0.003	82	0.119

Note: “–” means calculation of B-scale was not possible. Bold figure= p-value <0.05.

Abbreviations: COPR, censored ordered probit regression; HIV, human immunodeficiency virus; HSR, health system responsiveness; Pr., probability.