title: Healthcare system responsiveness in Jiangsu Province, China.
abstract: The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service settings. However, the factors that affect the responsiveness have been inconclusive so far and measures of improved responsiveness have not always thoroughly considered the factors. The aim of this study was to evaluate both the responsiveness of the healthcare system in Jiangsu Province, China, the factors that influence responsiveness and the measures of improved responsiveness considering it, as determined by a responsiveness survey.
  
  
  
  A multistage, stratified random sampling method was used to select 1938 adult residents of Jiangsu Province in 2011. Face-to-face interviews were conducted using a self-designed questionnaire modeled on the World Health Organization proposal. The final analysis was based on 1783 (92%) valid questionnaires. Canonical correlation analysis was used to assess the factors that affect responsiveness.
  
  
  
  The average score of all responsiveness-related domains in the surveyed healthcare system was satisfactory (7.50 out of a maximum 10.0). The two highest scoring domains were dignity and confidentiality, and the two lowest scoring domains choice and prompt attention. The factors affecting responsiveness were age, regional economic development level, and geographic area (urban vs. rural). The responsiveness regarding basic amenities was rated worse by the elderly than by younger respondents. Responsiveness ranked better by those with a poorer economic status. Choice in cities was better than in rural regions.
  
  
  
  The responsiveness of the Jiangsu healthcare system was considered to be satisfactory but could be improved by offering greater choice and providing more prompt attention. Perceptions of healthcare system responsiveness differ with age, regional economic development level, and geographic area (urban vs. rural). Measures to increase the perceived level of responsiveness include better service at higher level hospitals, shorter waiting time, more hospitals in rural regions, an improved medical environment, and provision of infrastructures that makes the medical environments more comfortable.
authors.affiliation: Department of Medical insurance, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Jianqian
authors.initials: J
authors.lastname: Chao
authors.affiliation: Xuzhou Medical University, Xuzhou, Jiangsu, China.
authors.forename: Boyang
authors.initials: B
authors.lastname: Lu
authors.affiliation: Department of Medical insurance, Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
authors.forename: Liguo
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China. liupeiseu@126.com.
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003219:Confidentiality; D003695:Delivery of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014944:World Health Organization; D055815:Young Adult
keywords: Canonical correlation analysis; Health system performance; People characteristics; Responsiveness