title: Health system responsiveness: a case study of general hospitals in iran.
abstract: BACKGROUND
  Considering patients' needs and expectations in the process of healthcare delivery improves the quality of services. This study aimed to investigate the responsiveness of general public and private hospitals in Mashhad, Iran.
  
  
  METHODS
  In this cross-sectional and explanatory study, hospitalized patients (with at least 2 days of stay) in general private and public hospitals in Mashhad were investigated. In total 425 patients (259 from private and 166 from public hospitals) were selected using a stratified and simple random sampling. Standard responsiveness questionnaire was used as the data collection tool. Data were analysed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05.
  
  
  RESULTS
  Access to the social support during hospitalization as well as confidentiality of the patient's information achieved the highest score (3.21±0.73) while the patient participation in decision-making process of treatment received the least score (2.34±1.24). Among the research population 1.6%, 4.1%, 17.6%, 63.3% and 13.2% commented on the responsiveness level as very low, low, moderate, good, and excellent, respectively. There was no significant difference between the overall responsiveness scores of public and private hospitals ( P ≥0.05).
  
  
  CONCLUSIONS
  The hospitals have enough potential to improve various aspects of their responsiveness. We suggest a number of measures can help improve the non-clinical aspects of care. These include: using educational courses to improve the knowledge and attitudes of medical and nonmedical staff, changing the resource allocation method, and using quality tools such as reengineering to modify the healthcare delivery processes.
authors.affiliation: Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ebrahimipour
authors.affiliation: Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Vafaei Najjar
authors.affiliation: Faculty of Health and Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Khani Jahani
authors.affiliation: Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Arefeh
authors.initials: A
authors.lastname: Pourtaleb
authors.affiliation: Student Research Committee, Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Javadi
authors.affiliation: Department of Health Services Management, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Rezazadeh
authors.affiliation: Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Vejdani
authors.affiliation: Student Research Committee, Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Shirdel
keywords: General Hospital; Health System; Mashhad; Non- Clinical Aspect of Care; Responsiveness